Post on 19-Jan-2016
description
Metabolic SyndromeUnderstanding Health Risk Indicators and Proper Application to Worker Safety and Health
Mike Stumbo, CSHO
B&W Pantex
BIO
Mike Stumbo has been employed as a Security Police Officer at the Pantex site for 20 years and is the Safety Officer for the Pantex Guards Union. Mike attended the OSHA Training Institute in Dallas Texas, where he received his certification as a Safety and Health Official in the fields of General Industry and Construction. Mike is currently the President of the National Council of Security Police representing approximately 3000 Dept of Energy Security Police Officers.
The SituationAmerica’s South is the most unfit region of our increasingly-unfit nation. Consequently, it serves as a perfect testing ground for a wellness program’s validity. If a preventive wellness model works here, it will work anywhere.
Obesity Trend
4
1995
(* BMI 30, or about 30 lbs overweight for 5’4” person)
2000
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% =30%
2005
Disease Rates per 100,000
Less than 200
200 to 219.9
220 to 250
More than 250
Source: Kaiser Family Foundation, State Health Facts
Heart Disease
Less than 185
185 to 196.9
197 to 204
More than 204
Cancer
DiabetesDiagnosed Diabetes Prevalence - Age 18+
CDC National Health Interview Survey - 1984 to 2004
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
19
84
19
86
19
88
19
90
19
92
19
94
19
96
19
98
20
00
20
02
20
04
•America is “producing” too much disease.
•One out of every three Americans will develop Type 2 diabetes by the age of 50.
•And it will be even worse for some…
230% increase in the prevalence of diabetes
230% increase in the prevalence of diabetes
The 5/50 Principle
Acute
Chronic / Episodic
Healthy
Effective future cost control comes from a focus on the
small fraction (<5%) of
participants who account for the
majority (>50%) of the claim cost.
Plan Participants Annual Paid
Claims• Who are the next claimants to enter the red category?
• Can anything be done to measurably reduce their likelihood of reaching this
high cost category?
Metabolic SyndromeThe EnemyBefore we could design a wellness model to reverse our workforce’s unwell inertia, we had to first navigate a myriad of disease symptoms to define the singular source of our problems: Metabolic Syndrome.
Testing for Metabolic Syndrome
99
RiskStar
Fasting Glucose
Triglycerides
Waist Circumference
Blood Pressure
HDL Cholesterol
Total CholesterolMax VO2
Resting Heart Rate
Body Mass Index
LDL Cholesterol
Which numbers matter most?
Risk Factors for Men and Women
10
Metabolic Syndrome /Syndrome X
HeartDisease
HeartDisease
DiabetesDiabetes
Trigl.>150
HDL<40 M<50 F
Waist>40 M>35 F
Blood Press.>130/85
FastingGlucose
>100
Impact on Mortality
1111
0
5
10
15
20
25
All-cause Mortality Cardiovascular Mortality
Mo
rta
lity
Ra
te (
%)
Without metabolic syndromeWith metabolic syndrome
Isomaa B et al. Diabetes Care. 2001;24:683-689.
Perceived Increased Health Risk
1212
DiabetesDiabetesHeart AttackHeart Attack
Gall bladder diseaseGall bladder disease
PanceatitisPanceatitis
HypertensionHypertension
PsoriasisPsoriasis
PhlebitisPhlebitis
CataractCataract
Pulmonary diseasePulmonary disease
Alzheimer’sAlzheimer’s
Nonalcoholic FattyNonalcoholic FattyLiver DiseaseLiver Disease
Gynecologic abnormalitiesGynecologic abnormalitiesErectile DysfunctionErectile Dysfunction
ArthritisArthritis
GoutGout
RetinopathyRetinopathy
Kidney DiseaseKidney Disease
Sleep ApneaSleep Apnea
Cardiovascular disease,Cardiovascular disease,Congestive Heart FailureCongestive Heart Failure
StrokeStroke
Urinary Tract CancerUrinary Tract Cancer
Colorectal CancerColorectal Cancer
Endometrial CancerEndometrial Cancer
Esophagus CancerEsophagus Cancer
LeukemiaLeukemia
Pancreas CancerPancreas Cancer
Non-Hodgkins LymphomaNon-Hodgkins LymphomaOvarian CancerOvarian Cancer
Breast CancerBreast Cancer
DiabetesDiabetesHeart AttackHeart Attack
Why Programs Fail
1313
• They utilize the Taj Mahal approach.
• They recycle the same ineffective weight-loss programs (symptom) rather than targeting Met S (source).
• They lack practical education and personal accountability.
• They are based on dated bodybuilding-inspired protocol rather than a dynamic functional movement.
• They utilize external rather than internal scoring criteria.
• They are not fun.
Redefining Pantex Wellness
1414
Know Your Numbers• Blood Pressure < 130/85
• HDL Cholesterol > 50mg/dl
• Fasting Glucose < 100mg/dl
• Triglycerides < 150 mg/dl
• Waistline < 35”
Aggressive Intervention• Naturally Slim
• Get Active
The Strategy
Nutrition and Behavior Education
1515
Not another diet! Instead, Naturally Slim is a behavior modification program which reinforces lifelong nutrition success. In only 10 weeks, participants average:
• 15.5 pounds lost!
• A 50% reversal in metabolic syndrome!
NATURALLY SLIM
Pantex Pilot Results *post 3 months
16
88%
66%
77%68%
63%67%
33%
68%
41% 45%
0%10%20%30%40%50%60%70%80%90%
100%
Elevated Waist Circumference
Elevated Triglycerides
Reduced HDL ["good cholesterol"]
Elevated Blood Pressure
Elevated Fasting Glucose
Prevalence of Specific Risk Factors in Population(N=520)
Before After
Pantex Pilot Results *post 3 months
100.00%
50.19%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
% of Before Population with Metabolic Disease(N=520)
Before After
Pantex Pilot Results
Average starting weight = 200.9#
Average ending weight = 185.7#
Average weight lost = 15.2# (7.3%)
Biggest weight loser = 53#
Biggest % loser = 19.84%
Total weight lost = 1232#
0/5: From 6 to 21
1/5: From 8 to 29
2/5: From 25 to 17
3/5: From 21 to 12
4/5: From 14 to 1
5/5: From 7 to 1
Statistics Met S Factors
What is it Worth?
Average yearly cost of providing health care for an individual without Metabolic
Syndrome = <$3500
Average yearly cost of providing health care for an individual with Metabolic Syndrome =
>$7000
Estimated yearly savings for Pantex on 83 employees after only 10 weeks: >$196,000