On our recent webinar, Dr. Mike Roizen, Chief Wellness Officer Emeritus at the Cleveland Clinic, shared what we do and don't know about COVID-19 risk.
Consistent, credible data reporting throughout the COVID-19 pandemic in the U.S. has provided insight on who is at high risk: Age and underlying conditions.
It's well-documented that COVID-19 has disproportionately targeted individuals with underlying conditions, including those with comorbidities such as diabetes, hypertension and obesity, which can be prevented or controlled through lifestyle.
In this blog, we'll cover the importance of avoiding chronic disease, and the evidence that proves how a healthy lifestyle can reduce both chronic disease and COVID-19 risk.
The Prevalence of Chronic Disease in the U.S.
We know that chronic disease can be deadly when entangled with COVID-19. But chronic disease, especially those that can be modified through lifestyle, was on the rise before COVID-19. It’s been a fundamental issue in our nation, the leading cause of death and disability, and accounts for $3.5 trillion in annual healthcare spend. What’s scarier is the prevalence of chronic conditions and health risks that can lead to those chronic conditions:
- 60% of U.S. adults have one chronic condition, and 40% of U.S. adults have 2 or more (CDC)
- 39.8% of U.S. adults have obesity (CDC)
- 45% of U.S. adults have hypertension (Million Hearts)
- 34.5% of U.S. adults have prediabetes, 9.4% of U.S. adults have diabetes (American Diabetes Association)
The Importance of Avoiding Chronic Disease
In many cases, a high percentage of several prevalent chronic diseases can be prevented through healthy lifestyle and health promotion:
- Coronary heart disease: 80%
- Stroke: 70%
- Cancer: 40% of all cancer; 70% of colon cancer; 80% of lung cancer
- Diabetes: 90% of Type 2 diabetes
"When it comes to reducing early deaths, medical care has a relatively minor role, potentially preventing 1 in 10 premature deaths. Rather, the single greatest opportunity to improve health and reduce premature death lies in favorably modifying unhealthy behaviors, which account for approximately 40% of all deaths in the United States."
- Foundational Factors for Cardiovascular Disease: Behavior Change as a First-Line Preventive Strategy
How to Avoid Chronic Disease
A 2019 study found that by adopting healthy lifestyles, the participants’ life expectancy free of diabetes, cardiovascular diseases and cancer at age 50 increased:
- From 23.7 to 34.4 years for women, or 10.7 more years
- From 23.5 to 31.1 years for men, or 7.6 more years
Those healthy lifestyle factors were:
- Tobacco/Smoke free
- BMI < 25 kg/m2
- Moderate to vigorous physical activity (≥30 minutes/day)
- Moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day)
- Higher diet quality score (upper 40%)
This evidence is echoed in other studies listed in our recent webinar: How to Use Workplace Wellness to Manage Health Risks Related to COVID-19.
Workplace Wellness Strategies To Reduce Chronic Disease Risk and COVID-Related Health Risks
It’s imperative now more than ever to invest in a wellness program for your employees that helps them understand and manage their health risks through lifestyle change.
Here are several time-tested, proven strategies from Cleveland Clinic and Bravo based on our over 20+ combined years of experience in creating sustainable healthy behavior change and wellness ROI:
1. Help employees know and understand their numbers.
The first step to managing risk is measuring it. Bravo, Dr. Roizen and the Cleveland Clinic wellness program all leverage a similar 6+2 Normals philosophy, which says if you achieve at least four of the following “normal” measures of good health, as well as two behaviors, you’ll dodge chronic disease about 80% of the time.
6 Normal Measures
- Blood Pressure <130, <85
- Body Mass Index (BMI) 21 to 29.9, or Waist< 1/2 of height
- Fasting Blood Glucose <107 or HgBA1C< 6.4
- LDL Cholesterol < 130 or <100
- No Cotinine in Urine (Tobacco Free)
- Keep Stress in Check
2 Behaviors
- See primary care provider physician regularly
- Keep immunizations up to date
These biomarkers and behaviors provide valuable insight to employees about their risk for chronic preventable diseases such as diabetes, heart disease and hypertension, and potential risk for COVID-19. By offering and incentivizing participation in a screening and health assessment through the wellness program, you provide access to that insight and collect insight from the aggregate level about risk in your population (more on that in #5).
2. Educate employees on how to achieve healthy numbers.
Achieving the 6+2 Normals isn’t easy, and it won’t happen overnight. Some employees need more support than others to overcome social, familial or economic barriers to wellness. Be sure to offer evidence-based coaching to employees who need guidance and a personalized plan to achieve a healthy lifestyle.
Your wellness program should remind employees that making progress – even reducing one level of risk for blood pressure or losing 5 lbs. can produce additional health improvements that will make a huge difference in their risk profile for COVID-19, risk of chronic disease.
"The amazing thing about BMI," said Dr. Roizen on our recent webinar, "And I don't know specifically for [COVID-19] because we've never had that trial done, but as you start to lose weight, your body senses you're becoming more insulin sensitive. So just losing five pounds, a pound every other week or a pound every three weeks is a major thing for you in reducing your risk of chronic disease. And I'll bet of getting this disease as well."
–Dr. Mike Roizen,How to Use Workplace Wellness to Manage Health Risks Related to COVID-19.
3. Don’t forget the importance of stress management and emotional well-being.
Just like poor physical health has been shown to negatively impact workplaces around the globe, employees struggling with mental health issues can be just as concerning.
Collateral damage inflicted by stay-at-home orders, isolation, social distancing, social injustice and national protests include increased feelings and reports of depression, stress, anxiety and substance abuse.
While researchers continue to explore the connection between mental and physical health, common behavioral symptoms of stress show that a healthy lifestyle may be at the bottom of the priority list:
- Lack of exercise
- Eating more
- Escape behaviors like drinking, sleeping or smoking
While the ability to decrease stress and worry among your employees may seem difficult, taking inventory of existing resources through your wellness program, employee assistance program, health plan or even your local community is a great place to start.
These efforts not only initiate the healing process and offer a means of coping with emotional health issues, but they also encourage employees to engage in wellness initiatives that can improve their lives and your culture.
Learn more about how to improve your employees’ emotional well-being from our webinar with Dr. Kellie Kirksey, PhD, LPCC-S and Ashley Neuman, PCC-S:
4. Make data-driven decisions to target health coaching and resources more effectively.
As an employer with a program that focuses primarily on health awareness, prevention and risk reduction, you should be demanding actionable reporting from your vendor.
In order to understand how your wellness program is improving population health, reporting should go far beyond engagement metrics like logins, app downloads, or recipe views. You should also be able to know comorbidity prevalence in your population, and a breakdown of risk prevalence by location.
This level of reporting will help you not only reduce COVID-19 risk but also improve productivity and healthcare costs over time when you really start to impact those comorbidities and employees become healthier.
Additional Information about Returning To Work Guidance With COVID-19
Learn how you can use workplace wellness to manage and reduce health risks related to COVID-19 by watching our recent webinar with Dr. Mike Roizen, Chief Wellness Officer Emeritus at the Cleveland Clinic:
