Workplace is the target for 'obesity prevention'
Workplace is the target for 'obesity prevention'
Study: Obese workers more likely to be injured
The nation's rising rate of obesity has required hospitals to rethink patient care, including different beds and lift equipment. But obesity also poses issues for hospitals as employers.
Among the occupations with the highest rates of obesity: female nurses' aides, or "health service personnel," who have a rate of obesity of 36.6%. An analysis of body-mass index data from the National Health Interview Survey by researchers at the University of Miami showed that among women, health care technicians and technologists have a rate of 22.9%, and health-assessing/treating occupations (i.e., nurses) have a rate of 18.6%. Housekeepers have a high rate of 27.6%.1
Overall, the NHIS found that 23.8% of American adults were obese in 2002, the year that was analyzed by occupation. Someone with a body mass index of 30 or greater is considered obese.
"These are alarming [statistics]," says Alberto J. Cabán-Martinez, MPH, a research associate and osteopathic medical student/doctoral epidemiology candidate at the University of Miami. "[About] 30% of the sector is obese. It's an issue."
Beyond the personal health impact - such as higher rates of diabetes, cardiovascular disease, and cancer - obesity also reflects on the health message conveyed by the institution, he notes. "A lot of people see their physicians and nurse practitioners as role models when they seek care," he says.
But most importantly for employee health professionals, studies show that obese workers have a greater risk of occupational injury as well. "Obesity is not only a personal issue; it is something that relates very much to the workplace," says Truls Ostbye, MD, PhD, professor of community and family medicine at Duke University in Durham, NC.
Beware of weight discrimination
Ostbye and his colleagues at Duke found a relationship between overweight or obesity and injuries to the ankles, hips, back, and shoulder. Heavier workers had significantly more workers' compensation claims, lost workdays, and medical claims.2
"Our conclusion was that obesity is not only a problem for the individuals, but also for their employers," he says. The study provides financial justification for work-based health promotion programs, he says. "We want to have all workplaces as healthy as possible for anybody," he says.
However, Ostbye says he does not want employers to conclude that they shouldn't hire obese workers. "Obese people are discriminated against enough today," he says.
But that is just what worries Peggy Elam, PhD, a clinical and consulting psychologist in Nashville, TN, and chair of the Media Relations Committee for the Association for Size Diversity and Health. Heavy people already suffer from stress, shame, and stigmatization regarding their weight, she says.
"Obesity prevention programs are generally based upon an erroneous assumption that's it's actually possible to make fat people thin, permanently and safely," Elam says. "Some diets do work in the short term, but there's actually no indication - for the majority of people - that they work in the long term, and they can actually be harmful."
Ironically, weight-based programs also ignore thin people who could benefit from programs that encourage healthy eating and fitness. "The win-win situation is to focus on healthy behaviors. Just encourage health behaviors. Body size is not a behavior," says Elam, who notes that the "Health at Every Size" program is weight-neutral.
In fact, studies have found that fitness does not always correlate with weight, and that people who are overweight are more likely to live longer than those who are normal weight, she says.
Yet nationally, reducing obesity is a goal of the "Healthy People" national health objectives and the workplace is one target. Healthy People 2010 sought to reduce obesity to no more than 15% of the U.S. adult population. In 2007, 25.6% of the population was obese.
In June, the Centers for Disease Control and Prevention launched a web-based "workplace obesity prevention program" called LEAN Works (www.cdc.gov/LEANWorks/). It includes an "obesity cost calculator" for employers to determine how much obesity is costing them and the potential savings from an obesity prevention program.
The financial information is important to convince employers to invest in health promotion efforts in the workplace, says Marilyn Batan, MPH, of the Guidelines Development & Recommendations Team in CDC's Division of Nutrition, Physical Activity, and Obesity at the Oak Ridge (TN) Institute for Science and Education. "If you were to do an intervention, you can actually put those inputs into the calculator and it will show you how much you could save per employee based on that program," she says.
LEAN Works focuses on the workplace as a key influence on lifestyle choices, she says. For example, healthy foods in the cafeteria could be offered at lower prices and flex time can allow for time to work out at a gym, Batan says. Many employers also offer discounts on medical insurance premiums for employees who participate in health assessments or wellness programs.
"We are not trying to [stigmatize]," she says. "We're focusing on how we can make employees healthier and how we can improve their quality of life."
CDC also shares different interventions that have been validated as effective, of "promising practices." Multiple approaches are usually best, Batan says.
"Just having health education sessions at lunch may not prove effective, but adding other components will increase your chance of having an effective health promotion program," she says.
"[The answer] is going to be different for different worksites."
References
1. Caban AJ, Lee DJ, Fleming LE, et al. Obesity in U.S. workers: The National Health Interview Survey. Am J Public Health 2005; 95:1,614-1,622.
2. Ostbye T, Dement JM, Krause KM. Obesity and workers' compensation: Results from the Duke health and safety surveillance system. Arch Intern Med 2007; 167:766-773.
The nation's rising rate of obesity has required hospitals to rethink patient care, including different beds and lift equipment. But obesity also poses issues for hospitals as employers.Subscribe Now for Access
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