The value of prevention for plan sponsors

Prevention has joined diagnosis as a top concern when it comes to keeping employees healthy in the workplace.

On May 22, attendees gathered to gain inspiration from speakers at Benefits Canada’s ROI of One Life Forum on how to implement everything from cancer screening to diabetes education to exercise programs.

Dr. Linda Rabeneck, vice-president of prevention and cancer control with Cancer Care Ontario, began by identifying the top four chronic illnesses—cancers, cardiovascular disease, chronic respiratory disease and diabetes—as well as the top risk factors for these often interrelated conditions—tobacco use, physical inactivity, unhealthy eating and alcohol consumption.

After revealing both high prevalence in Ontario for all these factors (for instance, 20.3% of adult Ontarians are still smoking, and 57.4% are eating unhealthily) and the high costs (smoking weighs in at $7.5 billion), Rabeneck moved quickly to reviewing possible solutions at every level. For instance, she noted that possible government actions could include the following:

  • increasing tobacco taxes;
  • maintaining socially responsible pricing and controlling the availability of alcohol; and
  • creating an Ontario food and nutrition strategy (this already exists in B.C.).

Action is also important at the workplace level, said Rabeneck, and could include the following initiatives:

  • ensuring that benefits cover smoking cessation systems;
  • promoting workplace physical activity; and
  • providing healthy snacking options in vending machines.

In workplaces, key to successful actions include champions at the executive level, fostering employee ownership, effective communication, incentive programs and multi-faceted approaches.

Expert panel

Several industry experts convened in the next panel to share their experiences with patients and the feedback they heard about workplace support. The experts particularly emphasized the importance of the following:

  • an overall strategy that integrates prevention with existing programs and culture;
  • workplace screening clinics to aid in early detection of diseases, including some cancers and diabetes;
  • a focus on mental health that provides added services but minimizes stigma;
  • repeated and multi-channel communications to make sure employees are aware of and using available resources; and
  • the need for employers to take responsibility for prevention while also motivating employees to self-assess and reach out for help.

Two prevention case studies

Speakers Jason Fitzsimmons from Ontario Power Generation (OPG) and Steve Sproule from Husky Energy Corp. added a concrete dimension by supplying case studies on successful prevention initiatives in their organizations. Fitzsimmons emphasized prevention ROI by describing how his organization’s expert (yet ultimately stressed and sedentary) nuclear reactor operators were “grown not hired” at significant cost.

Fitzsimmons revealed some significant metrics. For instance, from 2010 to 2011, the organization had reduced mental health-related sick days by 16%, or $865,000, and early detection initiatives had reduced cancer sick days by 9%, a savings of $129,000.

Employee education, increased benefits for mental health, partnering with provincial health associations to make use of existing resources and authority, and training supervisors to recognize early signs of illness so that at-risk employees (particularly in the mental health space) could get help earlier were key to these successes.

At Husky, Sproule described the shift in attitude from a focus on disability and drugs to retention and turnover. Today, his organization runs annual health fairs and screenings with more than 600 employees in attendance. Screening initiatives cover everything from BMI to bone density to PSA tests. Other initiatives include pedometer challenges and a points system to reward everything from healthy snacking to mental health initiatives.

Diabetes screening

Honorary chair Dr. Alain Sotto, medical consultant for the Toronto Transit Commission and chief physician for the wellness division of OPG, introduced a session on Type 2 diabetes by reminding attendees that in 2010 the World Health Organization had declared the disease an epidemic and that in Canada today it affects one in 10 adults. He explained the importance of action at the pre-diabetic stage and reviewed warning signs for metabolic syndrome (precursor to pre-diabetes), which include the following:

  • a waist circumference greater than 40 inches in males or 35 inches in females;
  • low HDL cholesterol levels and high triglycerides;
  • high blood pressure; and
  • high fasting blood glucose levels (even 5.7 is borderline pre-diabetic).

The prevention and even cure? Healthy diet and exercise. Sotto says these days he’s even started writing prescriptions for the latter.

Following his overview, Sotto invited consultant Nancy Thomson to introduce a diabetes screening machine called the Scout DS that OPG had piloted in 2011. It provides broad screening for diabetes by measuring the protein in the skin. Approved by Health Canada in 2011, the tool’s non-invasive approach sidesteps key elements that typically scare employees off: taking blood and fasting. Many attendees lined up to try the machine after the session ended.

If attendees indicated interest in prevention simply by their presence at the forum, the sessions provided concrete and prioritized actions that they could take back to their workplaces.