Chronic disease risk factors, healthy days and medical claims in South African employees presenting for health risk screening

BACKGROUND: Non-communicable diseases (NCD) accounts for more than a third (37%) of all deaths in South Africa. However, this burden of disease can be reduced by addressing risk factors. The aim of this study was to determine the health and risk profile of South African employees presenting for health risk assessments and to measure their readiness to change and improve lifestyle behaviour. METHODS: Employees (n = 1954) from 18 companies were invited to take part in a wellness day, which included a health-risk assessment. Self-reported health behaviour and health status was recorded. Clinical measures included cholesterol finger-prick test, blood pressure and Body Mass Index (BMI). Health-related age was calculated using an algorithm incorporating the relative risk for all case mortality associated with smoking, physical activity, fruit and vegetable intake, BMI and cholesterol. Medical claims data were obtained from the health insurer. RESULTS: The mean percentage of participation was 26% (n = 1954) and ranged from 4% in transport to 81% in the consulting sector. Health-related age (38.5 +/- 12.9 years) was significantly higher than chronological age (34.9 +/- 10.3 yrs) (p < 0.001). Both chronological and risk-related age were significantly different between the sectors (P < 0.001), with the manufacturing sector being the oldest and finance having the youngest employees. Health-related age was significantly associated with number of days adversely affected by mental and physical health, days away from work and total annual medical costs (p < 0.001). Employees had higher rates of overweight, smoking among men, and physical inactivity (total sample) when compared the general SA population. Increased health-related expenditure was associated with increased number of risk factors, absenteeism and reduced physical activity. CONCLUSION: SA employees' health and lifestyle habits are placing them at increased risk for NCD's, suggesting that they may develop NCD's earlier than expected. Inter-sectoral differences for health-related age might provide insight into those companies which have the greatest need for interventions, and may also assist in predicting future medical expenditure. This study underscores the importance of determining the health and risk status of employees which could assist in identifying the appropriate interventions to reduce the risk of NCD's among employees

Bright spots, physical activity investments that work : Vitality Active Rewards—a smartphone app that incentivises programme members to be physically active

PROGRAMME CARD. COUNTRY/LOCALITY/COVERAGE : A smartphone app-based programme that has been activated by more than 415 000 people in South Africa. TARGET POPULATION : Adult members of Vitality, a health promotion and disease prevention programme linked to medical and life insurance plans. WHAT MODES/TYPES/DOMAINS OF PHYSICAL ACTIVITY DOES THE PROGRAMME PROMOTE? The Vitality Active Rewards (VAR) programme promotes, facilitates and incentivises all modes of physical activity, including walking, gym-based activities such as yoga, aerobics, aqua-aerobics; social walking and running programmes; and endurance events such as marathons, cycle races and triathlons. WHICH OF THE SEVEN BEST INVESTMENTS THE PROGRAMME ADDRESSES? The VAR programme encourages active transport (investment 3), community-wide programmes involving multiple settings and sectors and that mobilise and integrate community engagement and resources (investment 6) and sports systems and programmes that promote ‘sport for all’ and encourage participation across the life span (investment 7). WHAT SECTORS DOES IT INVOLVE? The programme is offered to members who subscribe to a private life insurance or health insurance policy offered by Discovery. Estimated programme reach. the VAR app has been downloaded by approximately 415 000 adult members of Vitality in South Africa who have an Apple or Android smartphone. Vitality (and VAR) is also offered by various insurers in numerous countries across the world. WHAT IS SPECIAL ABOUT THIS PROGRAMME? Drawing on insights from behavioural economics, sports science and social marketing, the programme integrates the latest advances in digital and wearable technology with a range of distinctive options to encourage physical activity. Using rewards from a range of partner companies as incentives, the programme has potential for successful physical activity behaviour change.http://bjsm.bmj.comhj2019Sports Medicin

The relationship between leadership support, workplace health promotion and employee wellbeing in South Africa

Leadership support has been identified as an essential component of successful workplace health promotion (WHP) programs. However, there is little research in this area and even less theoretical conceptualization on ways in which leadership support for WHP is related to improved employee wellbeing. In this paper, we developed and tested a model of leadership support for WHP and employee wellbeing outcomes using employer and employee data gathered from 71 South African organizations. A theoretical model based on social exchange theory was developed. It was hypothesized that perceptions of company commitment to health promotion mediates the relationship between leadership support, the provision of WHP facilities and employee wellbeing. A hierarchical structural equation modeling technique was used to test the model. We determined that leaders' support for WHP was important insofar as they also provided health promotion facilities to their employees. No direct relationship was found between leadership support alone and employee wellbeing

The healthiest company index: a campaign to promote worksite wellness in South Africa

Objective:: To describe a 2010 initiative to encourage companies in South Africa to adopt workplace health promotion programs. Methods:: Data documenting organizational efforts to improve workers' health were collected from 71 participating employers and 11,472 workers completing health assessments. Organizational and employee health were scored on the basis of responses to the surveys that asked about facilities and programs offered, leadership support for health promotion, and employees' health status. Results:: In its first year, the initiative recruited 101 organizations and 71 qualified for the award. Results aggregated across these companies focus on elements constituting organizational and individual health, with specific measures that companies can review to determine whether they and their employees are "healthy." Conclusions:: The Healthiest Company Index provided useful baseline data to support employers' efforts to develop and implement effective and impactful health promotion programs

Participation in fitness-related activities of an incentive-based health promotion program and hospital costs: a retrospective longitudinal study

Purpose. A retrospective, longitudinal study examined changes in participation in fitness-related activities and hospital claims over 5 years amongst members of an incentivized health promotion program offered by a private health insurer. Design. A 3-year retrospective observational analysis measuring gym visits and participation in documented fitness-related activities, probability of hospital admission, and associated costs of admission. Setting. A South African private health plan, Discovery Health and the Vitality health promotion program. Participants. 304,054 adult members of the Discovery medical plan, 192,467 of whom registered for the health promotion program and 111,587 members who were not on the program. Intervention. Members were incentivised for fitness-related activities on the basis of the frequency of gym visits. Measures. Changes in electronically documented gym visits and registered participation in fitness-related activities over 3 years and measures of association between changes in participation (years 1–3) and subsequent probability and costs of hospital admission (years 4–5). Hospital admissions and associated costs are based on claims extracted from the health insurer database. Analysis. The probability of a claim modeled by using linear logistic regression and costs of claims examined by using general linear models. Propensity scores were estimated and included age, gender, registration for chronic disease benefits, plan type, and the presence of a claim during the transition period, and these were used as covariates in the final model. Results. There was a significant decrease in the prevalence of inactive members (76% to 68%) over 5 years. Members who remained highly active (years 1–3) had a lower probability (p, .05) of hospital admission in years 4 to 5 (20.7%) compared with those who remained inactive (22.2%). The odds of admission were 13% lower for two additional gym visits per week (odds ratio, .87; 95% confidence interval [CI], .801–.949). Conclusion. We observed an increase in fitness-related activities over time amongst members of this incentivebased health promotion program, which was associated with a lower probability of hospital admission and lower hospital costs in the subsequent 2 years. (Am J Health Promot 2011;25[5]:341–348.

Chronological and Discovery Age for all employees (total), men and women

<p><b>Copyright information:</b></p><p>Taken from "Chronic disease risk factors, healthy days and medical claims in South African employees presenting for health risk screening"</p><p>http://www.biomedcentral.com/1471-2458/8/228</p><p>BMC Public Health 2008;8():228-228.</p><p>Published online 4 Jul 2008</p><p>PMCID:PMC2475536.</p><p></p