Company health and wellness programs are trying to catch up to scientific discoveries about health and wellness, but have been slow to do so.
While a corporate wellness program can be composed of many different elements – from cafeteria subsidizing and biometric screenings, to gym reimbursement and activity trackers – everyone from HR to CFO’s to the employees themselves are still asking “Are they actually creating healthier people?”
By now, we’re well-versed in data and what it can do for you. It’s the Guinea pig era, after all. Consider this common wellness program agenda:
- Step 1: You know that it’s important for your population to know what their risks are and what their starting point is (It’s not your first rodeo)
- Step 2: You invest in a “Know Your Numbers” campaign that provides evidence-based risk assessment to test the most common markers:
- Total Cholesterol
- Cotinine (identifies smokers)
- LDL Cholesterol
- BMI/Weight/Blood Pressure
[UPDATED 5/12/16: WellnessFX has since updated our recommendations regarding key biomarkers to track. WellnessFX does endorse the measuring of blood pressure, but in the scenario when it is not taken at the same time as a blood draw, or as a single stand alone measure. WellnessFX additionally recognizes that Body-Mass Index (BMI), while a popular marker to track, should not be considered a key marker of health. BMI is notoriously flawed, as it doesn’t factor body composition. There is now an extensive amount of literature indicating how poor BMI is as a measure.]
- Step 3: Communicate the availability of a new biometric screening program – Posters in the break room, electronic reminders via email. Maybe you even got your wellness champions involved.
- Step 4: Test on-site or at the annual health fair, to screen employees for the most popular markers and body composition
- Step 5: Institute a walking challenge, hand out pamphlets about eating right, send out electronic and hard copies of newsletters full of healthy tips, and include a vegetarian option when you order staff lunch.
Now that that’s over with, it’s time to ask some of the harder questions: Do you re-test again in 4 months or a year? How do you evaluate whether or not any of your 2015 initiatives worked? Is the money you’re investing in these programs worth it? Did people actually improve their health?
Common Corporate Wellness Program Flaws: Misused Biometric Screenings and Data Collection
Yes, biometric screenings are necessary to track in order to inform employees of their risk for chronic, preventable diseases, such as diabetes and cardiovascular disease. The reality is that by only testing the more common, traditionally popular markers, you’re only getting part of the story…and possibly still leaving some employees in the high risk category.
The biomarkers worth tracking are constantly evolving. For instance, at one time total cholesterol, which is commonly tested in an average biometric screening, was long thought to be a top indicator of heart disease risk, but now we know there are various types of cholesterol markers, with some healthier than others. Similarly, other biomarkers are being given increasing weight in their impact on health. For example, the biomarker high-sensitivity C-reactive protein (hs-CRP) measures inflammation aka the body’s response to internal damage. Newer research has shown there is a link between higher levels of inflammation and many chronic diseases including cardiovascular disease, dementia, and cancer, and that by lowering inflammation, you can potentially reduce risks of these diseases.
In short, most common biometric screenings seem to be focused on traditional box checking, rather than what their employee needs to be successful. Yet the success of an employer program depends on how it affects employees!
The Case For Going Beyond Those Popular Biomarkers
For employers, we recommend offering the following biomarker testing to employees, in addition to the popular markers:
- hs-CRP: As mentioned above, hs-CRP is a more complete piece of the cardiovascular and chronic disease landscape, by examining inflammation levels.
- Vitamin D: While for a long time Vitamin D has been known to support calcium absorption, it has more recently been understood to influence immune system health and the risk for chronic diseases such as heart disease and cancer. We also know that many are considered Vitamin D deficient, likely due to getting less sun exposure, our primary source of Vitamin D. We vary in our “set point” of how much vitamin D we need, which markers like hs-CRP can help identify.
- TSH: Thyroid-stimulating hormone triggers the production of thyroid hormones T3 and T4, which are crucial for the body’s use of energy, i.e. our metabolism. Thyroid dysfunction can cause weight gain/loss, fatigue, cold/heat intolerance or hyperactivity.TSH is used as a screening test for thyroid disease, which affects nearly 1 in 10 people and many of whom are undiagnosed.
- Magnesium: Did you know that 56% of the U.S. population is deficient in magnesium? Magnesium deficiency is linked to elevated inflammation, hypertension, cardiovascular disease, osteoporosis, diabetes, mellitus headaches, muscle aches, and asthma. As previously detailed by Dr. Rhonda Patrick , “the wide array of diseases and symptoms of magnesium deficiency have to do with the fact that approximately 99% of your body’s magnesium is located in bone, muscles, and soft tissue. The other 1% of magnesium is found in plasma and red blood cells.1 Needless to say, this creates a lot of places where things can go wrong.”
- Cortisol: Your adrenal glands, perched right atop your kidneys, make cortisol in an attempt to help your body handle stressful situations. While a little spike of cortisol is good in response to short-term stressors, it starts to become a problem when the body starts making too much, too often. High cortisol is an overreaction to chronic stress and can contribute to high blood pressure, elevated blood sugar, suppression of the immune system, and many more. Did you also know that stress affects the thyroid? Note: Cortisol is said to be best tested soon after waking up. Talk with your wellness team and vendors about what makes sense for your team.
- ApoB: Apolipoprotein B, or Apo B, is the protein in bad LDL cholesterol that helps these particles bind to and clog blood vessels. Because ApoB increases this clogging, ApoB levels may be a better measure of cardiovascular risk than even LDL cholesterol, which is what is commonly tested in employee wellness programs.
- HbA1c: Hemoglobin A1C is regarded as a more accurate marker than blood sugar when it comes to determining risk for diabetes type 2, because it tracks blood sugar over the span of 3 months, as opposed to just the moment of a fasting blood test.
4 Ways These Biomarkers Can Make a Difference
1. Get a complete view of the puzzle
When it comes to health and health data, no one marker used as indicator of health and risk. Many markers are pieces of an intricate puzzle. For this reason we believe in not just providing testing and results, but also information about the results and encourage seeking a medical professional for further guidance.
2. Design targeted wellness programs
What makes a weekly meditation course more effective than a monthly Fitbit challenge? What makes providing vitamin D supplements in the cafeteria more cost effective than purchasing stability balls to sit on? It has nothing to do with dollar amount spent, and it has everything to do with what your specific population needs. Are you wasting time rolling out programs that your population doesn’t need?
Consider this tale of two companies – by finding out that company A was actually fairly healthy when it came to all of the major cardiovascular and metabolic biomarkers (good job, team!) a majority was vitamin D deficient, which was an unintended consequence of engineers spending too much time inside working, and not enough time outside in the sun or eating the right foods, or both, because that’s how vitamin D is made. So instead of choosing to offer a meditation program via indoor yoga, they chose to provide vitamin D supplements at the cafeteria, as well as institute an outdoor walking meeting challenge.
That is how you stop wasting money.
3. Initiate meaningful changes
Some of the biomarkers we’ve mentioned, such as vitamin D, TSH, cortisol, and magnesium, are all markers that impact your present, day-to-day state. If a deficiency or risk is uncovered, you can begin to make lifestyle, nutrition, and supplement changes right away. Imagine what that kind of insight would do for your employees and how that might adjust their motivation and need to take time away from work for routine physician visits.
4. Achieve multi-dimensional ROI
ROI for corporate wellness programs is often interpreted as reduction in claims costs and medical fees. What that also means is that the waiting time to see ROI could be several years. Begin the process for what you can improve long term, but also be connected with the effects and ROI you can achieve in the beginning stages, such as presenteeism, performance, absenteeism, and sick days taken.
3 Ways WellnessFX Can Help
- For more blog posts on a healthier workplace, check out How to Create a Culture of Health at Work, our 6 Tips to Incorporate Volunteerism in the Workplace, and 11 Healthy Foods to Add to Your Office Kitchen (and a Peek into Our Own Fridge).
- If you’re in Silicon Valley, we’ll be at the upcoming 2015 Workplace Wellness Summit on June 12th. Ping us on twitter if you’re attending, too.
- Want to learn more about our work with employers and their corporate wellness programs?
The posts on this blog are for information only, and are not intended to substitute for a doctor-patient or other healthcare professional-patient relationship nor do they constitute medical or healthcare advice of any kind. Any information in these posts should not be acted upon without consideration of primary source material and professional input from one's own healthcare professionals.