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Dr. Brian Charles BSc. MBBS MSc. DM (Emerg. Med), SCM Emergency Physician Managing Director, Sandy Crest/Coverley Medical Centres Increasing Productivity; The importance of health and wellness

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Objectives Definitions Is there a problem? If so, of what magnitude? Solutions and recommendations

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But What are we talking about? Productivity Wellness

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The Productivity Cycle

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Causes of uncertified absenteeism Perceptions of procedural justice Commitment Job Satisfaction Weather Personal Errands Root Causes of Absenteeism

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Causes of Certified absenteeism Physical health Work-family/family-work conflicts Need for improvement in management practices Rapid changes in the industry generating stress Root Causes of Absenteeism

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Presenteeism

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National Insurance Scheme Data Year Sickness Benefits Paid ($ BDS) 2005 2006 2007 2008 2009 No disaggregation by disease 21,430,656 15,741,860 19,030,204 24,817,172 23,863,708

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Factors affecting productivity Illness; particularly the NCDs Fatigue (often caused by poor sleep) Lack of exercise Dehydration Stress

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NCDs account for more than 60% of the health budget - QEH: 65% budget: BDS (>$50M): Most on diabetes and hypertensionNCDs account for more than 60% of the health budget - QEH: 65% budget: BDS (>$50M): Most on diabetes and hypertension Estimated to consume more that 5% GDPEstimated to consume more that 5% GDP The major causes of illness and death in Barbados 7 out of every 10 deathsThe major causes of illness and death in Barbados 7 out of every 10 deaths One quarter of all adults have an NCDOne quarter of all adults have an NCD The common risk factors are physical inactivity, exposure to tobacco smoke, poor diet and harmful use of alcoholThe common risk factors are physical inactivity, exposure to tobacco smoke, poor diet and harmful use of alcohol Summary of the Impact of NCD's National NCD Commission

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What are the chronic non communicable diseases (NCDs) Cardiovascular Disease hypertension, heart attack and stroke Diabetes Mellitus Cancer prostate, breast, cervix and colorectal Pulmonary Disease

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Risk factors for NCDs Non-Modifiable (20-30%)Modifiable (70-80%) Age Sex Ethnicity Genetic susceptibility/ family history Exposure to tobacco (primary and secondary) Harmful use of alcohol Lack of physical activity and exercise Unhealthy diets e.g. high in saturated fat, cholesterol, salt and simple sugars, low fruit and vegetable intake

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NCDs are Preventable 80% of chronic disease excluding cancer is preventable using simple lifestyle interventions 30-40% of cancers are preventable using simple lifestyle interventions 50 % of chronic disease occurs in persons < 70 years old 80% of recorded death occur in middle and lower income countries

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NCDs and productivity Absenteeism (certified and uncertified sick days) Board certified (medically unfit) Disability (temporary or permanent) Time away from work accessing the health service Limited/reduced output at work Burden on the caregiver and family

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WHAT IS WELLNESS? The quality or state of being healthy in body and mind. An approach to healthcare that emphasizes preventing illness and improving quality of life, and by extension improving the ability to meaningfully provide for self and others.

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WHAT DIMENSIONS DOES WELLNESS INCORPORATE? Six Dimensions: Physical Social Intellectual Emotional and Spiritual Environmental Occupational

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OUTCOMES PERFORMANCE

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YOUR SPACE! Work place safe Parking Security Up to standards Lighting Ergonomics Clean No toxins, etc. Smoke-free work place

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LETS GET PHYSICAL Physical Activity On-site fitness centers Discounts to local gyms Signs supporting taking the stairs Activity groups (running, walking, swimming, biking, snorkeling, diving) Time off to exercise Subsidize local run/walks Incentive programs Discounted/subsidized personal training

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LETS GET PHYSICAL Nutrition Healthy meals in the cafeteria Healthy items in the vending machines Water available at all times Health food at meetings Nutrition education Healthy recipes Cooking demonstrations Taste testings Meals to go

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LETS GET PHYSICAL Physical Health Health screenings cholesterol, glucose, blood pressure, BMI, osteoporosis, body composition Vaccinations flu shots, Hepatitis B, etc. Age appropriate screenings Smoke free workplace Annual well checks Employee Health Offices Family Health Fairs Self Care Guides

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COMMUNICATION Communicate with employees Communicate with upper management Share successes Share results Share goals and direction Create a quarterly report and annual report

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HEART AND SOUL Employee Assistance Programs Pastoral Care Stress management programs and skills Ability to attend support groups or have them in the workplace Quiet rooms Supportive policies Volunteerism

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GET SMART Tuition reimbursement Flex schedules to go to school Mentoring programs Educational programs at work Job sharing Partnerships with local schools and universities

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GETTING TO KNOW YOU Employee Activity Groups Holiday parties Charity walk/runs Potluck lunches Discounts to local events Building networks, partnerships and trust

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WHAT WORKS Begins in this room Designated drivers Evidence-based practice Constant messaging with fresh content Patience

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Thank You