Addressing Obesity in the WorkplaceState of the Evidence

George Washington University and ICF International Forum on Obesity Prevention in Worksites

January 21, 2015

Nico Pronk, Ph.D.HealthPartners and

HealthPartners Institute for Education and ResearchMinneapolis, Minnesota

Harvard UniversityBoston, Massachusetts

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Prevalence

• Obesity has become highly prevalent

– More than 2.1 billion people—almost 30% of the global population—are overweight or obese

– Approximately 30% of the US workforce is obese

– Obesity has roughly doubled among US workers over the past 30 years

– Severe obesity is rising faster than other classes

Source: Pronk NP. Ann Rev Public Health, 2015 (in press)

Fig. Obesity prevalence of the US workforce, based on data from nationally representative samples

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Complexity

• The workplace is a complex social system

• Obesity is highly complex

• Single solutions are unlikely to generate success

• Multiple stakeholders working together is needed

• Aligning incentives and building cooperation is key

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Costs

• Durden, et al (2008), estimates that the incremental combined direct medical and indirect costs for overweight, obese, and severely obese employees are:

– Overweight $1,550.92

– Obese $2,223.58

– Severely obese $3,391.52

• Finkelstein, et al (2010) found an annual attributable cost of obesity among full-time employees of $73.1 billion (based on 2006 Med Expend Panel Study and 2008 Nat’l Health and Welln Survey)

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Source: Hertz, et al. JOEM 2004; 46:1196-1203.

Impact of obesity on work limitations is akin

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Source: Sturm, R. Health Affairs. 2002, 21(2):245-253

Impact of obesity on chronic conditions and QOL is akin to

20 or more years of aging

Impact of Health Risks on Disease and QOL

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Source: Franz, et al. J Am Diet Assoc 2007;107:1755-1767.

Systematic Review of Weight Loss StudiesAverage Weight Loss of Subjects Completing a Minimum 1-Yr Weight Management Intervention80 Studies, 24, 698 Subjects, 16,823 Completers (68%)

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Addressing Obesity at the Workplace

In: O’Donnell M. Health Promotion in the Workplace, 2015

Improved weight-related behaviors

Energy balance at healthier weight

Environments:•Physical •Psychosocial/cultural•Socioeconomic

Policy and advocacy

Multi-level influence:•Individual•Group•Organizational•Community

Vision and engagement :•Leadership •Cultural norms and values•Worker involvement

•Improved worker health and well-being

•Reduced direct and indirect costs

•Improved worker productivity

•Improved worker morale

•Improved company performance

•Improved corporate culture of health

•Improved corporate image

Activities Outputs Impact Outcomes

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Healthy Workplace, Healthy Community

e.g., meeting minimal regulatory standards for worker safety

e.g., corporate giving campaigns that enhance company brand, image

Compliance Charitable Strategic Systemic

e.g., core business and management systems deployed to generate health and business value

e.g., systemic solutions designed to intentionally generate population health, business value, and address social determinants of health

Schematic of the business case development continuum for employer engagement in community health

Source: Pronk, et al. In review

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Conclusions

• Obesity prevalence is high, increasing, and very costly

• No single solutions will generate sufficient impact—only comprehensive, multi-level, multi-stakeholder solutions will work

• Don’t prioritize some programs over others—do as many as possible

• No single stakeholders owns the problem—partnerships are required

• Connections between employers and community are needed to create scalable, sustainable solutions to obesity

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e.g., meeting minimal regulatory standards for worker safety

e.g., corporate giving campaigns that enhance company brand, image

Compliance Charitable Strategic Systemic

e.g., core business and management systems deployed to generate health and business value

e.g., systemic solutions designed to intentionally generate population health, business value, and address social determinants of health

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Thank You

Contact Information:

Nico.p.pronk@healthpartners.com

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To watch Dr. Nico Pronk’s presentation online, visit: www.icfi.com/ObesityPrevention-NicoPronk

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