Over the past 100 years, the leading causes of death for Americans have shifted from infectious to chronic diseases. The 10 leading causes accounting for 74.1% of all deaths in the United States in 2020 were1:
- Heart disease *
- Cancer *
- COVID-19 *
- Unintentional injuries and accidents *
- Cerebrovascular disease (stroke) *
- Chronic lower respiratory diseases *
- Alzheimer disease
- Diabetes mellitus *
- Influenza and pneumonia
- Kidney disease to include nephritis, nephrotic syndrome, and nephrosis
* Indicates condition has preventable or modifiable health risks
Figure 1
Most of the leading causes of death for adults in the United States have preventable or modifiable risk factors2.70% of premature mortality has a modifiable, behavioural, or environmental etiology3. Nearly 50% of Americans have at least one preventable chronic medical condition. Of these, over half have multiple conditions. 86% of the healthcare dollar is spent on treating these mostly preventable chronic diseases4. Indeed, the annual medical claim costs for individuals with five or more health risks that cause chronic disease were double the cost of those who had fewer risks5. Furthermore, a large study of close to 100,000 workers in seven large companies found that 22.4% of the organisations’ healthcare dollars were spent on conditions related to ten common yet modifiable risk factors.
Figure 10
Realising that reducing individual health risks is fundamental to improving health outcomes and preventing some chronic diseases, institutions in the civilian and government sectors alike have considered shifting from a reactive healthcare system to a proactive system for health. To this end, organisations and businesses have turned to wellbeing programs to create a healthy environment where health changes can take place through an integrated health promotion and wellbeing strategy. These wellbeing initiatives have produced sustainable, positive effects on reducing medical utilisation, absenteeism, presenteeism, illnesses, injuries, chronic disease, obesity, alcohol and tobacco use, morbidity, mortality and job and life-related stress while at the same time increased worker strength, flexibility, cardiovascular fitness, weight loss, cholesterol and glycemic control, endurance, fitness, productivity, life and job satisfaction17,18,19,20,21,22,23.
The National Institute for Occupational Safety & Health (NIOSH) has sought to address this growing concern by developing their “Total Worker Health” programme which addresses efforts to improve overall worker wellbeing by evaluating health risks and safety issues. Furthermore, CDC has outlined steps to enhance wellbeing and reduce preventable diseases, disability, injury, and premature death through “Healthy People 2030”. These programs focus on factors and objectives that improve health and wellbeing, especial those that have a modifiable component.
In addition to increasing the health of the worker, employers with proactive health promotion and wellbeing strategies often see financial benefit. There is ample research suggesting that enterprises that implement wellbeing programmes can realise reductions in total healthcare expenditures24,25,26,27,28,29. Additionally, specific, and targeted preventive health programs improved health outcomes while also having a positive effect on organisational return on investment30.
Figure 24
In conclusion, current studies suggest the need for a paradigm shift from a reactionary healthcare system to a value-based proactive system of health31. Disruptive innovation as a means of promoting an integrated, synchronised, and holistic approach to prevention may be in order to adequately address and improve the physical, mental and social wellbeing of employees through risk reduction. Evidenced-based lifestyle medicine aimed at reducing health risks and disease prevention is at the core of achieving better overall health, wellbeing and quality of life and can reduce healthcare costs and improve job performance and satisfaction32.
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