Preventing and Managing Health Challenges in the Workplace

A South African Perspectivewww.DrArien.co.za

Presented by Dr Arien van der MerweMBChB NHA ASCHP MISMA

Medical Doctor, Specialist Health & Wellbeing Consultant, Holistic Counselor & SAQA Registered

Trainer/Facilitator

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Outline• Burden of CDL’s – health challenges in wellness terminology

• CDL’s and productivity in the workplace - benefits

• Prevalence in communities – paying it forward

• Effects of effective workplace health promotion and interventions on productivity

• Introductory exploration of an exceedingly common CDL (health challenge), and guidelines to management:

➢Metabolic syndrome – truly an endocrine/

metabolic imbalance that includes:

• Heart health

• Glucose and carbohydrate balance

• Thyroid health

• Mental health

Lifting the Burden of Disease

Employee wellbeing: good ROI

Education

Accidents, absenteeism, presenteeism & CDL’s

Wellness definition

Integrative approach to employee wellbeing

Practical examples

Implementing wellness interventions

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Benefits of Workplace Wellness Interventions

IncreaseProductivityJob performanceWorkplace morale

DecreaseHealth care

costsPresenteeismAbsenteeism,

sick leaveEmployee

turnover

•Wellness paradigm:

balance, integration, harmony

•Conscious awareness, continuous integration:

learning, understanding health options available to

make healthy choices

Into communities – paying it forwardEmployee Wellbeing: sustainability,

empowerment, social responsibility, skills development - EDUCATION

Inner

being

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Wellness Definition: Quick Review

Wellness: conscious, continuousintegrative process leading toenhancement of individual,organisational, community healthand wellbeing

Integrate (v.) means to combineand assimilate into completefunctional wholeness, in thisinstance, of all dimensions of thehuman being.

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Companies & wellness: ROI6/10 employees: worksite wellness programs good

idea. 3-4/10 actively participate - WELCOA

Employee entitlement, skills development, education

Realisation that employees are a company’s most

important assets

Employees need assistance & support

Still looking after the bottom line:

productivity, creativity

sick leave, presenteeism, absenteeism,

resignations

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Burden of Disease: Company Health

Costs

• > 50% of organisation / institution / company

costs incurred by human resources

• Therefore, executive & employee health &

wellbeing critical:

➢Optimal production

➢Business success

➢ 80% health challenges (CDL’s) behavioural lifestyle

choices: mental-emotional brain patterns, beliefs,

stress, eating patterns, exercise

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Statistics

SA Health Review

• Chronic diseases of lifestyle

(CDL’s) responsible for 37% of

deaths in South Africa, add:

HIV / AIDS (39%)

TOTAL: 76% of all deaths in SA

preventable - wellness solutions

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Purpose, goals, benefits(supporting business objectives)

Motivating pro-active health & well care:

➢Screening procedures, VCT & HRA’s to assess & manage risk

➢Include stress, depression assessment

➢Health enhancing lifestyle changes & choices - wise & discriminate use incentives

➢Education & empowerment -self responsibility

Challenge: Risk HAS TO BE MANAGED!

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Workplace Wellness Starts with Executive

Team: Support & ACTIVE Participation

• Healthy employees

• Healthy company

• Healthy families

•Healthy communities

•Healthy country

Sound business sense: bottom line

ROI + social responsibility

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Common reasons for accidents, injuries

• Presenteeism (employees at work, but not optimally well)

• High blood pressure

• Sleep deprivation, chronic fatigue

• Low blood sugar

• High blood sugar

• Impaired vision

• Social concerns: e.g. family problems, financial, relationships

• Sub clinical infection

Emphasising the ‘H’ in SHE(Q)

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Olympic athlete: high fitness level, but osteopenia,

strain injuries, depression, sleep apnoea.

Fitness = Wellness!

Fit, eat well, disease free, but poor sleep, fatigue,

accidents, slow recovery from colds

The illness-wellness continuum

Reduce Downtime

Efficiency:PresenteeismAbsenteeism

Sick-leaveProductivity

Cafeteria / Canteen

WWSEnvironment Safety

EAP

Org.Development

Marketing Communication

Risk Management

HR

Corporate Culture

EducationTraining Negotiation

CommunicationFacilitation

Financial Wellbeing

Conflict ResolutionCultural Diversity

Work-life Balance

Behaviour Change

Workplace Wellness Strategy as part of existing Systems & Policies

Occ. Health

Citibank Health Management Program ROI

47 800 employees; 53.4% participation

• Program costs = $1.9 million (+/- R14 m)

• Program benefits = $8.9 million (+/- R63 m)

• Program savings = $7.0 million (+/- R49 m)

• ROI = $4.7 in benefits for every $1 in costs (R35 for every R7, or 5:1 ROI)

Ref:

Ozminkowski, R.J., Goetzel, R.Z., et al.,

Journal of Occupational and Environmental Medicine

Case studies: ROI / Business Case

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Meta Evaluation of Worksite Health Promotion

Economic Return Studies

- Larry Chapman (Art of Health Promotion, 2005)

• Analysis review 56 peer reviewed studies

• Number of combined subjects in all studies: 483 232

• Average study duration - 3.66 years

• Primary outcomes examined: health care

utilisation/cost

(28 studies); absenteeism (25 studies)

• Results:

– Average reduction in health care costs: 26%

– Average reduction in sick leave / absenteeism: 27%

– Average ROI: 5.81 : 1.00

(22 studies)

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Successful, popular, often requested Wellness Interventions / Programs

1. Physical: Sleep restoration/fatigue management & blood sugar balance

2. Practical stress management

3. Mobile Weight Control Clinic

4. Wellness or peer educator training (WET / PET) as part of SHE & EAP

training & support

5. Integrative health and wellness coaching. Topic examples:

i. Executive health

ii. Nutrition talks & cooking demo’s

iii. Heart health

iv. Immune system health

v. Fun fitness: esp. dancing, yoga

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• Awareness

• Participation

• Education

• Improved attitudes / mind set changes / self

responsibility

• Behaviour change

• Risk reduction

• Decreased utilisation of health care, sick leave

• Financial impact / ROI

Critical Steps to Ensure Success

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Metabolic Syndrome.Endocrine, metabolic

imbalance

• >3.5 million diagnosed diabetes

• 2010 - 150 million people diagnosed with metabolic syndrome

• 20% actually diagnosed -utmost importance of regular health, wellness screenings

• Increase to 300 million by 2030

• Compare: 35 million HIV+ people globally, 22 million of those in Africa

• Metabolic syndrome much bigger health challenge -integrative medical and wellness solutions essential

- Heart & Stroke Foundationwww.DrArien.co.za

Metabolic Syndrome: Chronic Inflammation

• Waist circumference: abdominal circumference > 102 cm men, > 88 cm women.

• Triglycerides: 1.7mmol/L or >

• HDL: < 1.0 mmol/L men; < 1.3 mmol/L women.

• Blood pressure : 130 mmHg systolic; 85mmHg diastolic or >

• Fasting glucose >5.5 mmol/L

• Fasting insulin > 50 years

• Often depression, hypothyroidism www.DrArien.co.za

• Often part of MetS

• Heart related health challenges (diseases) > 40 years of age, i.e.

Middle & top management employees, companies’ leadership

team, key decision makers

• Reasons:

➢ Type A personality

➢ Stress associated with above and work responsibilities

➢ Poor work-life balance

➢ Poor lifestyle

Heart Health Challenges

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Metabolic Syndrome

BIGGEST KILLER CEO’S: HEART ATTACK

Jim CantalupoCEO

McDonaldsDied: Age 60

Heart Attack

Phil BaxterCEO CVP

Died: Age

48

Heart Attack

Vin ProthroCEO Dallas

SemiconductorDied: Age 58

Heart Attack

Brenda BarnesCEO Sara Lee

Age 56

Stroke

Michael Browne

CEO Datacom

GroupDied: Age

46

Heart Attack

Family History

Hypertension, high cholesterol, cardiovascular disease risk factors

Age/Gender

Hypertension

High cholesterol

Diabetes Mellitus Sedentary Lifestyle

Smoking

Obesity

Uncontrolled / long term stress

&

Stress associated with the type A personality, worry, anxiety

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• Low antioxidant status

• Low levels of essential fatty acids

• High levels of CRP

• Low levels of magnesium and potassium

• Increased platelet aggregation (stickiness)

• Increased fibrinogen formation

• Elevated levels of homocysteine

• Emotional: hostility, anger, inability to forgive

Lesser known, but important risk factors

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Depression and Mental Health

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• Depression > 100 million people worldwide

• 2nd leading cause disability ages 15–50

• WHO: 2020 depression 2nd only to ischemic heart disease as leading cause of disability all ages, both genders.

• Findings Organisation for Economic Co-operation and Development (OECD): 1/5 workers mental illness - depression, anxiety

• Triad

• Huge impact productivity workplace as many struggle to cope

• Mental illness: often sick from work or presenteeism

• 30-50 % new disability benefit claims OECD nations poor mental health

• Policy makers: find innovative ways to manage social, economic problem mental illness - trigger factors e.g. stress at work, financial stress, relationships - will increase

• Increasing job insecurity, pressure in today's workplace - in mental health problems in coming years

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Depression and Mental Health

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Thyroid health• Hypothyroidism/ low thyroid function 10 – 40% adult population. Testing thyroid

function (min TSH) – essential part annual medical check-up

• Symptoms – extensive, serious impact on workplace productivity:

➢Metabolic: weight gain, sensitivity to cold weather (demonstrated by cold hands and feet), oedema - front of lower legs, ankles, feet, hands

➢Endocrine: loss libido men, menstrual abnormalities women – prolonged, heavy menstrual bleeding, shorter menstrual cycle; infertility

➢Skin, hair and nails: dry, rough skin covered with fine, superficial scales; coarse, dry, brittle hair with hair loss that could be severe; nails become thin, brittle, transverse grooves

➢Psychological: depression, weakness, fatigue – often 1st symptoms of hypothyroidism, followed later by difficulty in concentration and forgetfulness

➢Muscular and skeletal: muscle weakness, joint stiffness

➢Cardiovascular: hypothyroidism predispose hardening arteries - increase in cholesterol and triglycerides levels; hypertension, heart failure

• Other manifestations. shortness of breath, constipation, kidney function

Summary: Basic interventions for all health challenges

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Fuel: Healthy eating / Food supplements

INSULIN

Blood Sugar

HIGH

NORMAL

LOW

Low blood sugar and dumping

GLUCAGON

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Superfoods• Berries

• Nuts, seeds

• Cereal grains, grasses –wheatgrass, brown rice, oats

• Oils

• Raw honey

• Pulses/legumes

• Garlic

• Mushrooms

• Bee pollen

• Sprouts

• Aloe ferox – smoothie

• Seaweed

• Raw cacao Health Stress Management (Pty) Ltdwww.healthstresswellness.com

Additional nutrition essential for MetS, heart health, thyroid, nervous system

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• Food supplements essential - greatly

increased need for many nutrients

• Abnormal glucose metabolism in diabetics -

free radicals due to oxidative stress &

depletion of essential micronutrients

• Ginkgo biloba

• Crateagus oxyacantha

• CoQ10

• Quercetin (onions, garlic)

• Cinnamon, ginger, turmeric

• Milk thistle

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Infoceuticals, Nutriceuticals, BotanicalsLet your Food be your Medicine

Basic 31.Antioxidant 2.Calcium and

Magnesium 3.Omega- 3,6,9

Add system –Herbal remedies

Support Physiology:

Optimal Nutritional Support

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Wellness definition of fitness:

• Ability to meet the needs of your lifestyle with ease

• Exercise improves insulin sensitivity in muscles, better glucose uptake, more energy/fuel in muscles, drop in blood glucose levels. Heart health. Improved mood. Thyroid support.

• Interval training

Do something you enjoy –many health benefits:

• Dance, yoga, swimming, tai chi, walk

• Music & mood

• Healthy spine, core:

pelvis, chest, head

Regular physical activity

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Workplace wellness and stress

• 80-90% all visits to primary health care facility stress related

• BMJ: work stress i. 2x risk death heart disease; ii. 2.5x

• Karoshi death study Japanese researchers: severe work stress (long working hours, shift work, irregular work

schedules) sudden, unexplained death young men and women

• All CDL’s: stress at source

• Stress related illness most important cause for sick leave, absenteeism & presenteeism - direct impact on

productivity

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Step 1: Improve Oxygen Supply - optimal cellular function & energy generation

Glucose, oxygen fuel sources - one of most important components ofcell: mitochondria - power generators. Lack of oxygen, glucose -impossible for cells to work at full capacity or to be optimally healthy- hormonal, blood sugar imbalance, thyroid, cardiovascular,neurological, overweight/obesity.

Step 2: Sleep Restoration

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Step 3: relax at least twice a day

Daily Relaxation for Optimal Resilience

and Wellbeing

• Start, end day in alpha-theta mode:

stretch, tune in, connect to core –

10-20 minutes

• Set intentions

• Tune in to emotions - reset

• Journaling

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Workplace Wellness: A Philosophy for a Life of Optimal Wellbeing

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Wellness is more than the absence of disease, it’s the optimal health of body, mind and soul. - World Health Organisation

Wellness comes with joy, vitality and balance; it gives us a sense of fully embodying our potential, the ability to face our life with grace, dignity and enthusiasm. - AvdM

Workplace Wellness – Paying it Forward: Healthy workforce = healthy families,

communities, country!The day will come when

nations will be judged not by

their military or economic

strength, nor by the splendour

of the capital cities and public

buildings, but by the wellbeing

of their peoples; by their levels

of health, nutrition and

education

- UNICEF: Progress of Nations

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Ariani HEALTH SOLUTIONS: www.DrArien.co.zaSpecialist Service Provider ConsultantsTraining can be claimed from Skills Levy

• Education, Peer Educator and Wellness Team Training

• Training Manuals, Training Tools: Poster Sets, Books, CD’s

• Stress management and Optimal Resilience Training

• Freelance writing, talking on all health topics

• Article contributions to any wellness journal

• Nutrition, fitness specialist

• Key Wellness Solutions – Project Management

• Executive Wellness

• Talks, Courses (in house and online), Seminars, Health

Coaching

• Products: Nutritional Food Supplements, Books, eBooks, relaxation CD

Integrated & customised to your organisation’s needs!

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