Every 23 seconds someone in the U.S is diagnosed with diabetes.
According to the Centers for Disease Control and Prevention (CDC), more than 29 million Americans are diabetic, and 86 million more have prediabetes. Together, these two groups comprise about 45 percent of the U.S. workforce.
The resulting impact on business is significant.
The Health Care Cost Institute found that, for adults covered by employer-sponsored insurance, the spending difference between people with and without diabetes averages more than $10,000 per capita. In addition to direct medical costs, diabetes causes $69 billion annually in indirect costs due to reduced productivity.
With employers bearing much of the cost for chronic disease, many are implementing workplace programs and policies to reduce health risk factors and lower direct costs, such as insurance premiums and workers’ compensation claims.
The CDC’s Workplace Health Program showed that in 2014, 73 percent of small companies and 98 percent of large companies offered at least one wellness program as part of their health benefits. Approaches range from lifestyle change to weight management and health promotion.
To counter costs from lifestyle diseases like diabetes, employers should aim for a mix of traditional programs, emerging methods and a supportive organizational environment. The right framework includes five effective, evidence-based ways for employers to promote workforce wellness and address diabetes-related costs:
1. Detect risk factors and disease early on
Type 2 diabetes develops slowly over months and years, so screening initiatives for early detection and treatment are essential.
A seven-item questionnaire from the CDC can be used as an initial screen for prediabetes risk, followed by blood glucose screening for further confirmation.
While the CDC questionnaire is a simple test to offer to all employees, the U.S. Preventive Services Task Force recommends screening for abnormal blood glucose for the 70 percent of adults ages 40 to 70 who are overweight or obese.
Employers should utilize workplace health programs that provide tools to measure workforce health. Having this information – the actual risk factors among their staff - will help determine the overall need and type of programs to implement.
2. Prevent the progression of health risk
A workplace program that emphasizes modest weight loss, improved diet, stress management and physical activity can help employers reduce the incidence and impact of type 2 diabetes among employees.
There is strong evidence that the progression from prediabetes to type 2 diabetes can be prevented or delayed.
Large clinical trials, including the Diabetes Prevention Program (DPP), showed that a structured lifestyle change program can cut the risk of progression to type 2 diabetes by 60 percent among adults who were at very high risk.
The American Diabetes Association and the CDC recommend that people with prediabetes should be counseled on lifestyle changes through programs with goals similar to those of the DPP, and research indicates that these types of initiatives can be highly cost-effective.
3. Help employees take control of their health
Providing employees with evidence-based programs helps them engage more actively in their health, a key step both in preventing type 2 diabetes and in managing the disease.
According to the CDC, “effective behavioral interventions combine counseling on a healthful diet and physical activity and involve multiple contacts over extended periods.” Initiatives that pair guidance with personal goal-setting, weekly action plans and encouragement can support the adoption of healthy behaviors over time.
New digital tools are also emerging to extend the delivery and effectiveness of these programs.
With the proliferation of smartphones, mobile platforms now empower people to manage their diet, physical activity and stress wherever they go, enabling employers to support their workforce efficiently and at scale.
4. Offer personalized programs adapted to employee needs
Programs to raise awareness, prevent and manage diabetes must be adapted to the needs and preferences of the workforce.
In particular, workforce efforts must take into account potential barriers such as health literacy – the capacity to make informed health decisions based on one’s understanding of health information.
According to the National Assessment of Adult Literacy, nearly 90 percent of adults lack proficient health literacy. Low health literacy is associated with higher rates of chronic conditions, more frequent preventable hospital visits, and less use of preventive services.
These outcomes are in turn associated with higher health care costs.
Programs that equip people of all health literacy levels with the ability to manage their health are more likely to be successful in helping employees change behaviors and avoid costly complications.
5. Support programs through policies, benefits and environment
A healthier work environment is a more productive work environment.
Evidence suggests that outcomes are best when individually-focused programs are supported by organizational-level policies.
This means creating a climate that is conducive to wellness: providing flextime for exercise, coverage for preventive services and screenings, and on-site resources such as fitness facilities, healthy foods in cafeterias and support from the organization’s leadership.