Employers Bear the Weight of Obese Workers

A new story in Benefits Pro describes the challenges employers face when employees are overweight or obese. Studies estimate compensating for obesity costs employers upward of $70 billion a year. Possibly further upping those costs and complicating the issue is a decision this summer by the American Medical Association to classify obesity as a disease, elevating it from a condition.

The Equal Employment Opportunity Commission has also considered obesity brought on by medical conditions, such as an underactive thyroid, to be an impairment under the Americans with Disabilities Act. The EEOC looks similarly at morbid obesity, which is defined as 100 percent more body weight over normal. To help combat obesity and improve the overall health of their workers, more and more employers offer wellness programs as part of their health care plans and benefits programs. They typically view them as ways to contain health care costs and retain their workforce.

Latest Research on Our Nation's Health: Poor Diet and Lack of Physical Activity Have Significant Impact

Yesterday findings from the first major analysis of the health status of the U.S. population in more than 15 years was released by a global collaborative of scientists led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, The research found that while Americans are showing progress in reducing death rates (adjusted for age, across a variety of diseases), our poor diet and inadequate physical activity are dramatically impacting our nation’s health. Additionally, death rates from illnesses associated with obesity, such as diabetes and kidney disease, as well as neurological conditions like Alzheimer's disease, are on the rise.

“If the US can make progress with dietary risk factors, physical activity, and obesity, it will see massive reductions in death and disability,” said Dr. Ali Mokdad, head of the US County Health Performance team for IHME and former director of the Behavior Risk Factors and Surveillance Survey at the US Centers for Disease Control and Prevention. “Unhealthy diets and a lack of physical activity in the US cause more health loss than alcohol or drug use.”

The findings were presented by Dr. Christopher Murray, IHME Director and one of the lead authors on the study at an event for mayors and other local officials hosted by First Lady Michelle Obama as part of the Let’s Move! Cities, Towns, and Counties anniversary convening.

In a study published in the Journal of the American Medical Association on July 10 – “The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors” – researchers show the impact of premature deaths in children and young adults, the significant toll of disabling conditions, and the overall burden on health systems from a range of fatal and non-fatal health factors. It includes estimates for death and disability from 291 diseases, conditions, and injuries as well as 67 risk factors.

To explore the trends for the United States in depth, go to our Global Burden of Disease visualization page and search for the US in any of our tools: www.ihmeuw.org/GBDCountryViz.

New Benfield Research on Obesity

The Benfield Group has published new research on employer disease priorities, citing obesity as employers' top concern. This is the first time since Benfield's annual research began in 2006 that diabetes or cardiovascular disease has NOT occupied the top spot. Nearly eight out ten employers indicated obesity was "highly important," but they report limited success with obesity management within their employee populations. Just 13% believe that the programs and support they provide to employees to prevent obesity are highly successful; and fewer than 10% report successfully helping obese employees improve their health.

The Benfield Group has produced a monograph on behalf of Eisai Inc. It provides information employers can consider when evaluating and modifying their workforce obesity prevention and management strategies. The monograph features recommendations from an employer Eisai-sponsored advisory board that employers can incorporate into their planning process. Click here to request a copy of the monograph.

NIH Funding Opportunity for Obesity Policy Evaluation

The National Institutes of Health (NIH) announced a new funding opportunity announcement for applications that propose to evaluate large scale policy or programs that are expected to influence obesity related behaviors (e.g., dietary intake, physical activity, or sedentary behavior) and/or weight outcomes in an effort to prevent or reduce obesity.

The announcement encourages innovative scientific partnerships between researchers and public or private partners (e.g., community based organizations, local governments, school districts, employers), and defines policy broadly to include both formal public policies at local, state and federal levels of government, and organizational level policies, such as those implemented by large organizations, worksites or school districts. Examples of appropriate studies include, but are not limited to, the following:

• Introduction of food or beverage taxes/subsidies/price changes/other incentives;
• Infrastructure initiatives such as retailers offering healthier food options in underserved areas;
• Changes to workplace food and/or physical activity environment;
• Polices expected to influence available options and purchasing, such as calorie labeling in restaurants, menu or food product reformulation, and supermarket layout or pricing strategies;
• Significant changes in policy or practice in large healthcare organizations that are expected to improve weight outcomes; such as changes in reimbursement, incentives, or wide scale implementation of prevention or treatment services;
• Modifications to the built environment to encourage active transportation or leisure physical activity, such as the implementation of bike lanes in urban areas, multi-use trails, subsidies for public transit, upgrades of sidewalks, or improved access to parks and recreation facilities.

The application cycle opens on May 5, 2013 and applications are due on June 5, 2013.

Adult Obesity Rates Could Exceed 60 Percent in 13 States by 2030

The number of obese adults, along with related disease rates and health care costs, are on course to increase dramatically in every state in the country over the next 20 years, according to F as in Fat: How Obesity Threatens America's Future 2012, a new report from the Robert Wood Johnson Foundation and Trust for America's Health.

The report forecasts adult obesity rates in each state by 2030 and the likely resulting rise in obesity-related disease rates and health care costs.

If states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020—and double again by 2030.

Medical costs associated with treating preventable obesity-related diseases could increase by up to $66 billion per year by 2030, and the loss in economic productivity could be as high as $580 billion annually.

The report also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index (BMI) of their residents by just 5 percent by 2030. In that scenario, millions of Americans would be spared serious health problems, and the country could save billions of dollars in health spending.

State by State Analysis of Obesity Rates

Twelve states currently have an adult obesity rate above 30 percent, according to a new analysis released by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). The analysis used the state obesity rates released made available by the U.S. Centers for Disease Control and Prevention (CDC). Mississippi had the highest rate of obesity at 34.9 percent, while Colorado had the lowest rate at 20.7 percent. Twenty-six of the 30 states with the highest obesity rates are in the Midwest and South.

“Obesity has contributed to a stunning rise in chronic disease rates and health care costs. It is one of the biggest health crises the country has ever faced,” said Jeffrey Levi, PhD, TFAH executive director. “The good news is that we have a growing body of evidence and approaches that we know can help reduce obesity, improve nutrition and increase physical activity based on making healthier choices easier for Americans. The bad news is we’re not investing anywhere near what we need to in order to bend the obesity curve and see the returns in terms of health and savings.”

Morbid Obesity Now Covered under Americans with Disabilities Act

According to Employee Benefit News, severe, or "morbid" obesity (usually defined as weighing twice one's normal weight) is a protected status under the Americans with Disabilities Act (ADA) and an employee is entitled to reasonable accommodations. However, the July 24 ruling by the Equal Employment Opportunity Commission (EEOC) provided little guidance to employers about where the EEOC would draw the line on when obesity is “severe” enough to constitute an ADA-protected disability. Although it is still unclear where that line can be drawn, it is now clear that the EEOC considers “morbid” obesity to be a protectable disability under the ADA.

Because morbid obesity – and perhaps even obesity – may be considered a “disability” under the law, employers should tread lightly when making employment decisions based on an employee’s weight or ones that detrimentally affect overweight employees, such as outcomes-based wellness programs. NBCH will continue to monitor this issue and provide updates.

NIH Grant Opportunity: Obesity Policy and Program Evaluation

The National Institutes of Health (NIH) has posted a Funding Opportunity Announcement (FOA) for a R01 research grant that is intended to encourage and support research in which a unique and time sensitive opportunity has arisen to collect baseline data and then prospectively assess effectiveness of an imminent policy or program designed to prevent or reduce obesity in a given population (e.g. designed to reduce energy intake, increase activity, or decrease sedentary behavior).

Application budgets are not limited, but need to reflect actual needs of the proposed project. The number of awards is contingent on NIH appropriations and the submission of a sufficient number of meritorious applications. The maximum project period is five years. Eligible organizations include higher education institutions, nonprofits other than institutions of higher education, for-profit organizations, governments, other domestic organization types, and foreign institutions.

There are several rounds of due dates between now and fall of 2015. For the first round of submissions, letters of intent are due September 12, 2012 and the application is due October 10, 2012. More information is on the Grants.gov website.

NBCH Survey: Employers' Views on Obesity

According to a recent study, published in the American Journal of Preventive Medicine led by Duke University, 42 percent of Americans will be obese in 2030. And as the number of overweight Americans reaches epidemic proportions, the associated and costly chronic conditions such as diabetes and cardiovascular disease are also rising.

To better understand the business attitudes and needs concerning obesity prevention and control to identify how best to combat this issue, NBCH, with suppport from the Centers for Disease Control and Prevention (CDC) and the National Safety Council (NSC), conducted a survey more than 500 employers.

While many U.S. employers are addressing obesity in the workplace, there is still much progress to be made as well as a need for tools and resources, especially among small and mid-size organizations.

“Given the amount of time an employee is at their place of work, there is an opportunity to positively influence the choices they make about their health,” said Andrew Webber, NBCH president and CEO. “A workplace that emphasizes health is more likely to have policies that promote healthy behavior such as incentives and access to health resources. While large employers have been at this for some time, small- to mid-sized employers have been less engaged, but are increasingly seeing the value of these types of programs."

The full report including survey responses, conclusions and recommendations for employers can be found on NBCH's website.

“This project was very helpful to us in understanding the small employer perspective,” said Jason Lang, MPH, MS, Team Lead, Workplace Health Programs, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. “We were able to use findings to inform the development of obesity prevention and control strategies and tools for the CDC National Healthy Worksite Program which is focused on helping small employers build comprehensive workplace health programs.”

New health and obesity report calls for private/public collaboration

A new report was released this week by the Bipartisan Policy Center, calling for the public and private sectors to collaborate in creating healthy families, schools, workplaces and communities.

The report, entitled, Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future, from the Bipartisan Policy Center’s Nutrition and Physical Activity Initiative, highlights existing best practices that can be implemented on a large scale to broaden their impact and help reduce obesity in the U.S.

The co-chairs recognize that given America’s limited federal resources, any effective plan to reduce obesity and health care costs will need to engage private sector partners and build on successful examples, targeting those actions with the most promise to bring about large-scale shifts over time.

"We applaud the efforts of the Bipartisan Policy Center to improve the health of Americans by focusing on physical activities and nutritional opportunities," said Andrew Webber, president and CEO, National Business Coalition on Health. "Businesses can benefit from the healthy workplace recommendations in their efforts to improve health in their workplace and in the communities where they draw their workforce. This information will be useful to the coalitions and employers that are collaborating in local communities to improve workplace wellness."

What costs more: obesity or smoking?

According to a new study by Mayo Clinic researchers... obesity. Both obesity and smoking contribute to higher individual health costs, but obesity brings more additional spending.

In an article in the Journal of Occupational and Environmental Medicine, March 2012 [subscription required], researchers analyzed data from more than 30,000 Mayo Clinic employees and retirees who had continuous health insurance coverage between 2001 and 2007 to identify the additional health costs of smoking and obesity.

Although both obesity and smoking were associated with additional costs, the researchers found that health costs for obese workers were higher than smokers. The average annual health costs for smokers were $1,275 more than nonsmokers, while obese workers cost $1,850 more than non-obese workers.

Additionally, the cost increased to $5,500 more per year for morbidly obese workers than non-obese workers.

According to CDC, U.S. obesity epidemic at a standstill

According to a new report from the CDC, Prevalence of Obesity in the United States, 2009-2010, there appears to have been a slowing down in the rate of increase or even a leveling off of the prevalence of obesity. Given the health risks, it is important to continue to track the prevalence among U.S. adults and children.

This report presents the most recent national estimates of obesity in the United States based on measured weight and height. More than one-third of adults and almost 17 percent of children were obese in 2009-2010. Those numbers are no different than they were in 2003.

"It's good that we didn't see increases," said CDC researcher Cynthia Ogden. "On the other hand, we didn't see any decreases in any group."

NBCH Action Brief December 2011

Weigh the Benefits of Bariatric Surgery

For appropriate candidates, bariatric surgery (e.g. gastric bypass and gastric banding) has proven to be one of the most effective and long lasting treatments for morbid obesity and the resolution of comorbidities, including type 2 diabetes, hypertension, and sleep apnea. An estimated 220,000 people in the United States had the surgery in 2008 alone, and more employers are considering the value of bariatric surgery for their eligible employees. This Action Brief highlights the advantages, costs, and outcomes of bariatric surgery as well as how health plans are responding by using data from eValue8- a resource used by purchasers to track health plan performance. The brief concludes with actions employers can take to ensure that bariatric surgery is an appropriate option for qualified employees.


Related Webinar:
NBCH Employer Webinar: The Obesity Care Continuum & Appropriate Treatment Options
Wednesday, December 14, 2011 2:00 PM - 3:00 PM EST
1-866-951-1151; ID5062618
Register Here: https://www2.gotomeeting.com/register/247749314

The Tipping Point in America's Obesity Epidemic

Earlier this month, Trust for America's Health released the seventh annual edition of our F as in Fat: How Obesity Threatens America’s Future 2011 in partnership with the Robert Wood Johnson Foundation. Ten years ago, no state had an obesity rate above 24 percent, and now 43 states have higher obesity rates than the state that was the highest in 2000. We found a clear tipping point in our national weight gain over the last 20 years – and it’s had serious ramifications for our health and health care spending. Read the full post...