Employee Health & Fitness is Powerful

May is Global Employee Health and Fitness Month, a time to recognize the importance of health and wellness for everyone. It’s a month dedicated to promoting physical activity, healthy habits, and emotional well-being in the workplace. It serves as a reminder that taking care of us is essential to thriving in all areas of life.

Whether you’re working from an office, at home, or somewhere in between, prioritizing health is not just an employee benefit. It is something that positively impacts everyone, from individuals to organizations to communities. Let’s explore how focusing on employee health and fitness benefits us all.

Better Health for Employees, Better Health for All

At the core of Global Employee Health and Fitness Month is the idea that healthier individuals create healthier communities. When employees take care of their physical and mental well-being, they experience fewer health issues. Issues such as chronic diseases and stress-related illnesses, which drive a majority of healthcare costs, can be reduced. This, in turn, creates a ripple effect that extends beyond the workplace.

For employees, better health means more energy, fewer sick days, and a greater sense of personal well-being. It’s not just about feeling good on the job—it’s about feeling good in every aspect of life. Focusing on health can reduce the risk of heart disease and diabetes. It also helps people live fuller, more balanced lives.

Increased Productivity and Engagement

Employee health and wellness significantly impacts how engaged people are at work. Healthy employees are more likely to show up feeling energized, focused, and ready to tackle their tasks. Physical fitness, regular exercise, and good nutrition all improve cognitive function, memory, and mental clarity. This means healthier individuals are more productive, which benefits everyone in the workplace. “The staff’s physical and mental well-being has a direct influence on operational possibilities of companies,” according to a study published in The Journal of Modern Science.

When people feel better physically and mentally, they’re more motivated and excited about their work. A workplace that fosters wellness is one where individuals are more likely to engage with their tasks, collaborate with colleagues, and contribute their best efforts to the team’s goals. The result is not only a healthier workforce but also a more dynamic and creative environment.

Stronger Relationships and Teamwork

Employee wellness goes beyond just the individual—it can enhance team dynamics as well. Wellness activities, such as group fitness challenges or mindfulness sessions, create opportunities for employees to bond over shared goals and activities. Whether it’s participating in a yoga class, joining a wellness challenge, or simply supporting one another in healthy habits, these activities foster a sense of camaraderie and teamwork.

As people connect through wellness activities, they build stronger relationships with their coworkers, which leads to better collaboration, improved morale, and a more positive work environment. This sense of community extends to the overall atmosphere of the workplace, creating a culture of support, empathy, and mutual respect.

Mental Health Matters Too

While physical health is often the focus, emotional and mental well-being are just as crucial. Global Employee Health and Fitness Month is a reminder that mental health is a vital part of overall wellness. Practices like mindfulness, stress management, and emotional resilience can have a profound impact on an employee’s well-being. When employees are supported in their mental health journeys, they experience reduced stress, better coping mechanisms, and improved emotional balance.

For many, a focus on mental wellness can lead to improved job satisfaction, reduced burnout, and a greater sense of work-life balance. A workplace that promotes mental health support allows employees to feel valued and cared for. This can positively affect their attitude, productivity, and overall happiness. For more information on mental health and how it can impact physical wellbeing, check out this post.

Healthier Workforce Leads to Healthier Communities

The benefits of employee health and fitness go beyond just the workplace. Healthier employees contribute to healthier communities. When individuals are physically active and emotionally resilient, they are better able to participate in community events, support local causes, and engage in positive social interactions. This creates a broader, more supportive community where people are empowered to live their best lives.

In addition, healthier individuals are less likely to rely on healthcare services, which can reduce overall healthcare costs in society. By encouraging employees to prioritize their health, companies play a role in reducing the burden on the healthcare system, ultimately benefiting everyone.

Creating Lasting Habits for the Future

Global Employee Health and Fitness Month is a reminder that health isn’t just about one month of focus—it’s about creating habits that last. When employees are given the tools, resources, and motivation to adopt healthier habits, they’re more likely to carry those habits with them for years to come. Whether it’s setting aside time for exercise, making healthier food choices, or incorporating stress-reducing practices into their daily lives, these small changes add up to big results over time.

The long-term impact of creating lasting health habits extends far beyond the workplace. Employees who adopt healthy routines are better equipped to handle life’s challenges, manage stress, and live more fulfilling lives. And as employees become healthier, they inspire others around them to do the same, creating a positive ripple effect that benefits both the workplace and the wider community.

Everyone Benefits When We Prioritize Health

Global Employee Health and Fitness Month is a celebration of the power of health and wellness to improve lives. Whether you’re an individual, part of a team, or someone who works for an organization, focusing on your physical, emotional, and mental well-being has a ripple effect that benefits everyone. Healthier individuals lead to more productive teams, stronger communities, and a more positive work environment.

As we take this time to celebrate health and fitness, let’s remember that wellness is a lifelong journey. Small changes today can lead to big benefits tomorrow, both for ourselves and those around us. So, whether you’re participating in a workplace wellness challenge or simply taking time to focus on your well-being, remember: health is an asset we all share.

Cracking Cholesterol: What we Know now


As September rolls around, we recognize Cholesterol Education Month—a time to shine a light on a topic that often feels more confusing than clear. For many of us, cholesterol has been a health buzzword for decades. If you grew up in the 90s, you might remember the era of low-fat everything and the message that cholesterol was public enemy number one. But science, as it often does, has evolved. Today, the story of cholesterol is much more nuanced.

Cholesterol: The Basics


Cholesterol is a waxy, fat-like substance found in every cell of your body. It’s essential for building cells, producing hormones, and aiding in digestion. However, too much cholesterol in your blood can lead to health issues. These issues include heart disease and other cardiovascular problems. For a more in-depth explanation on cholesterol check out this article from The American Heart association.

When people talk about cholesterol, they’re usually referring to two types:

LDL (Low-Density Lipoprotein): Often called “bad cholesterol” because high levels can lead to plaque buildup in arteries.
HDL (High-Density Lipoprotein): Known as “good cholesterol” because it helps remove other forms of cholesterol from your bloodstream.
There’s also triglycerides, a type of fat in your blood that can increase cardiovascular risk. Together, these markers create your lipid profile, which gives a snapshot of your heart health. You might recognize lipid profiles from last month’s post as an important screening for understanding your metabolic health.

Symbolic image for heart health, something good or bad cholesterol has a large impact on.

The Evolution of Cholesterol Understanding


For decades, cholesterol was vilified, becoming another one of the many dietary myths. Foods like eggs and butter were demonized as culprits of high cholesterol. As research advanced, scientists discovered that dietary cholesterol doesn’t affect blood cholesterol in most people. Instead, the focus shifted to the type of fat in your diet. Saturated and trans fats are more significant factors in raising LDL cholesterol. Experts now recognize that cholesterol levels are influenced by multiple factors. These include genetics, diet, physical activity, and overall lifestyle. This evolution has led to more personalized approaches to cholesterol management.

What We Know


Modern guidelines emphasize the importance of regular cholesterol screenings because they help identify your individual risk. Understanding your cholesterol levels is essential, as ideal levels can vary. In general, you should:

  • Keep LDL levels low to minimize the risk of plaque buildup.
  • Aim for higher HDL levels to better protect your heart.
  • Maintain healthy triglyceride levels to reduce cardiovascular risk.

Additionally, diet plays a critical role in cholesterol management. For example, foods high in fiber, such as whole grains, fruits, and vegetables, are effective in lowering LDL cholesterol. On the other hand, healthy fats—found in olive oil, nuts, and fish—can improve overall cholesterol levels. However, it is still important to avoid trans fats and excessive saturated fats.

Exercise also significantly impacts cholesterol and heart health. For instance, regular physical activity can increase HDL cholesterol and boost overall heart health. Even small lifestyle changes, like taking daily walks, can lead to meaningful improvements.

Practical Tips for Supporting Healthy Cholesterol

A bowl of Oats, a source of good cholesterol.


Here are a few actionable steps to help manage cholesterol levels:

Focus on Fiber: Add oats, beans, lentils, and vegetables to your meals.
Choose Healthy Fats: Use olive oil instead of butter, and snack on nuts instead of chips.
Stay Active: Aim for 30 minutes of moderate exercise most days.
Limit Harmful Fats: Reduce processed foods, fried items, and baked goods with trans fats.
Consider Your Lifestyle: Quit smoking, drink less alcohol, and manage stress for better heart health.
Most importantly, consult your healthcare provider to create a plan tailored to your needs.

The Takeaway


Cholesterol doesn’t have to be a mystery. By understanding its role in your health, you can take steps to manage it. Balanced nutrition and a healthy lifestyle are the foundation for long-term well-being. Hopefully this helped to shed some light on cholesterol and clear up any misconceptions that may have been lingering from the 90’s. Understanding the fuel we put into our body’s is a critical step toward optimizing our health.

Pesticides & Produce: What you Need to Know

Did you know that Americans consume a staggering amount of produce every year? From fresh salads to juicy fruits, the average American eats around 270 pounds of produce annually. However, alongside the nutritional benefits of fruits and vegetables comes the concern of pesticides that can affect consumer health. The ability to make informed decisions while choosing what you feed yourself and your family is crucial.

Are Pesticides IN or ON Produce?

When it comes to pesticides, it’s important to understand how they interact with the produce you buy. Some pesticides are systemic, meaning the plant itself absorbs the pesticide. On the other hand, contact pesticides remain on the surface where they can be washed away more easily. Despite efforts from the farming industry to reduce pesticide levels from farm to table, it’s challenging to eliminate them entirely. The amount of pesticide in and on our produce can decrease through harvest, transportation, washing, and cooking, but they still exist.

It’s important to note that regulatory agencies, such as the Environmental Protection Agency (EPA), establish safety limits for pesticide residues in food and water to help minimize risks. For those concerned about pesticide consumption, washing fruits and vegetables thoroughly, peeling when appropriate, and choosing organic options can help to reduce exposure.

The Dangers of Consuming Pesticides

Long-term consumption of trace amounts of pesticides in produce, even at levels deemed safe by regulatory agencies, has been linked to several potential health risks. Studies suggest possible connections between pesticide exposure and serious health issues such as cancer, disruptions in hormonal balance, and neurological effects. However, ongoing research continues to evaluate the full extent of health effects related to pesticide exposure. While the exact risks can depend on various factors, including the type of pesticide, individual health, and overall diet, the research highlights several areas of concern. These risks underscore the importance of making informed choices about the produce we consume.

Differing Opinions on Pesticides in Produce

Opinions within the scientific community vary regarding the safety of pesticide residues in produce. While some experts argue that the quantities are too low to pose significant harm compared to the benefits of consuming fruits and vegetables, others advocate for minimizing pesticide exposure as much as possible. Ultimately, the decision rests with individuals in determining their tolerance for pesticide residues in their diet. Ideally, all produce would be organic, and the consumption of pesticides would not be a concern for anyone. However, factors such as economic pressure, market demand, and competition collectively drive the continued use of pesticides in produce production.

Resources

There are a number of resources that exist to educate consumers on the different pesticides that can be found in their food. The Environmental Working Group (EWG), a non-profit, compiles two lists known as the Dirty Dozen and Clean Fifteen. These lists rank fruits and vegetables based on the amount of pesticide residue present at testing, guiding consumers towards safer options and those best purchased organically. The EWG updates and publishes these lists annually, allowing consumers to keep up with any material changes each year.

The Dirty Dozen

Image of the Environmental Working Group's "The Dirty Dozen" list of the 12 produce items containing the most amount of residue from pesticides

The Dirty Dozen highlights produce items that tend to carry higher pesticide residues. While this list emphasizes the top 12 produce items that tested for the highest levels of pesticides, it does go up to 46 in total. The top three from this year’s Dirty Dozen are strawberries, spinach, and kale/collard/mustard greens. These three were found to contain chemicals linked to cancer, reproductive damage, and pesticides that have been banned in Europe. Despite their nutritional benefits, these items would require more attention when it comes to purchasing and preparation. Depending on what you consider acceptable, these are items you may want to consider purchasing the organic alternatives for.

The Clean Fifteen

Image of the Environmental Working Group's "The Clean Fifteen" list of the fifteen produce items containing the least amount residue from pesticides

Conversely, the Clean Fifteen features non-organic produce items with lower pesticide residues, making them safer conventional options. This list serves as a quick and helpful tool to make more informed choices while grocery shopping. While prominently featuring the top 15 produce items with the lowest pesticide residue levels, it includes 46 items in total. At the top of this year’s list, we have avocados, sweet corn, and pineapples, among others. Using the Clean Fifteen can be helpful for the budget, as it allows you to reduce pesticide exposure without necessarily opting for organic produce, which can be more expensive.

Tips for Making Informed Choices

When shopping, prioritize organic options for produce on the Dirty Dozen list to minimize pesticide exposure. Although, if cost is a concern, refer to the Clean Fifteen list for safer conventional choices. Regardless, it is best you do your research before heading out to purchase your groceries. Allowing for ample time to read up on the potentially harmful products used to grow produce might save you some dirty looks in the produce section. No matter what you buy, remember that properly washing fruits and vegetables can also reduce pesticide residues. Try using a vinegar-water solution or a vegetable wash for best results.

Chef preparing bell pepper by thoroughly washing to remove pesticides and any other contaminants

Remember…

While the debate over pesticide residues in produce continues, consumers can take proactive steps towards healthier eating. By utilizing resources like the Dirty Dozen and Clean Fifteen lists and staying informed about pesticide risks, individuals can make choices that align with their health priorities. Remember, every decision counts towards reducing pesticide exposure and promoting a healthier lifestyle. If you’re interested in more info on what produce can do for you, check out Fruits and Veggies: More Matters.

How Mental Health can Shape Your Physical Being

In recent decades people have increasingly started to recognize the importance of mental health. Since 1949, the month of May has been observed as Mental Health Awareness month, seeking to destigmatize mental illness. In that spirit, we are going to explore the topic of the broader connection shared by mental and physical health. Let’s take a look at the various ways mental health can impact physical well-being, both negatively and positively.

The Difference Between Clinically Diagnosed Mental Health Disorders and Every-day Emotional Distress

Clinically diagnosed mental disorders and everyday experiences of emotional distress can differ in their severity, duration, and impact on daily functioning. Clinically diagnosed disorders, such as major depressive disorder or generalized anxiety disorder, typically involve persistent symptoms that significantly impair one’s ability to function in various areas of life, including work, relationships, and self-care. These disorders often require professional intervention, such as therapy or medication, for effective management.

Picture of a man speaking with a mental health professional. A practice that can be extremely beneficial whether you have a clinical diagnosis or not.

On the other hand, everyday experiences of feelings like depression and anxiety may be transient and less severe, occurring in response to life stressors or situational challenges. While these feelings cause distress and interfere with daily life, they may not meet the criteria for a clinical diagnosis. Regardless, your mental state impacts how you care for yourself physically, and it’s important to be cognizant of that. The most essential thing is to recognize the spectrum of mental health experiences and seek appropriate support when needed. If you’re experiencing frequent feelings of anxiety and depression, unrelated to life’s stresses, consider seeking professional help.

The Physical Effects of Negative Mental Health

  • Brain Chemistry & Neurobiology- Our mental health can have a profound impact on our brain chemistry and neurobiology, both playing a part in how we care for ourselves physically. Conditions like depression alter neurotransmitter levels and brain structure. These changes often lead to symptoms such as fatigue, cognitive impairment, and disrupted sleep patterns. Sleep disturbances are a common manifestation of mental health issues, with anxiety and depression frequently disrupting sleep patterns. The regular disruption of sleep patterns will almost always lead to a crushing lack of motivation to do the things necessary to care for our physical bodies.
  • Physical Manifestations- Changes in appetite and weight are prevalent among those facing mental health challenges. Depression and eating disorders can significantly affect appetite regulation. This can result in weight loss or gain, nutritional deficiencies, and related health complications. All of which are equally detrimental to our overall health and wellbeing. Chronic pain and physical symptoms also accompany mental health conditions. Headaches, muscle tension, and gastrointestinal distress are frequently exacerbated by poor mental health. I don’t know about you, but when I’m experiencing any of these physical ailments, exercising or eating a proper diet are typically the last things on my mind.
  • Immunity Issues- Mental health struggles can also compromise the immune system. Chronic stress and mental disorders can weaken immune function. This increases susceptibility to infections, autoimmune conditions, and delays wound healing. These negative effects highlight the urgent need for comprehensive mental health care. For more information on the effects stress can have on the body and tips for dealing with those, check out one of our previous blogs: 5 Stress Mangement Tips to Implement This Year.

Positive Mental Health and Its Effect on the Physical Body

Mind-body interventions offer promising avenues for improving physical health. While there are more studies tying physical effects to negative mental health, there have been a few linking a positive mindset to healthier behaviors and improved physical wellness. Most people have probably heard how positive mental health leads to a reduced risk for cardiovascular events like heart attack or stroke. While true, that’s typically through the lens of reducing stress levels. So, what other ways are there to maintain a positive mental attitude and reap the health benefits? Fortunately, there are a number of techniques we can use to manage the ebb and flow of our mental health:

Techniques for Maintaining a Positive Mindset

Image of a man out in nature meditating, a technique that can be effective for managing one's Mental Health.
  • Mindfulness and Meditation- Practicing mindfulness and meditation can help individuals become more aware of their thoughts and feelings without judgment. It allows them to observe negative emotions as they arise and let them pass without getting caught up in them.
  • Deep Breathing Exercises- Deep breathing exercises, such as diaphragmatic breathing, or the 4-7-8 technique, can help calm the nervous system and reduce stress and anxiety.
  • Physical Activity- Engaging in regular physical activity, whether it’s walking, practicing yoga, or playing a sport, can boost mood and reduce feelings of negativity.
  • Gratitude Practice- Taking time each day to reflect on things you are grateful for can shift focus away from negativity.
  • Journaling- Writing down thoughts and feelings can help you gain clarity and perspective on your emotions. It can also serve as a release for pent-up emotions.
  • Seeking Support- Seeking support from a trusted friend, family member, or therapist about your feelings can provide validation, support, and new perspectives.
  • Setting Boundaries- Learning to say no to things that drain your energy or cause negative emotions can help you protect your mental and emotional well-being.
  • Engaging in Hobbies- Spending time doing activities you enjoy can help distract from negative emotions and promote feelings of fulfillment and joy.
  • Practicing Self-Compassion- Being kind and understanding towards yourself during difficult times can help you cultivate resilience and maintain a positive outlook.
  • Limiting Media Consumption- Limiting exposure to negative news or social media can prevent overwhelming feelings and anxiety.
  • Visualization- Visualizing a positive outcome or envisioning yourself overcoming challenges can help you stay motivated and optimistic.
  • Seeking Professional Help- If negative emotions persist or significantly impact daily life, seeking support from a mental health professional can provide tailored strategies and interventions.

Additional Techniques Beneficial to Mental Health

Developing effective coping mechanisms and resilience mitigates the physical effects of stress and other negative emotions. Additionally, they allow us to achieve a mental state conducive to self-motivation. The added benefit of practicing healthy behaviors regularly is that they can become routine. Humans are creatures of habit and the more we adapt healthy routines the better off our physical bodies will be.

Social support also plays a crucial role in maintaining physical health. Supportive relationships can foster accountability, motivation and act as a safety net. It’s important to have a core group you can rely on to share and look out for your best interests. In the event that you fall on hard times emotionally, those burdens can be lessened by a close-knit group. Ultimately, your physical health is up to you, but there are a number of things you can do to increase your overall quality of life. Seeking professional help and adhering to treatment plans can significantly improve physical health outcomes.

Keep in Mind

The interconnected nature of mental and physical health cannot be overstated. Whether you’re struggling with every-day emotions, or have a clinical diagnosis, properly addressing mental health is vital for overall well-being. By prioritizing self-care and seeking support when needed, you can adopt a pro-active approach to health maintenance. Far too often people decline to seek help for their mental struggles, and the effects can be devastating. Invest in yourself and your future, both mentally and physically, and you may be surprised where life takes you.

Getting the Most out of GLP-1 Agonists

GLP-1 agonists have quickly become a popular treatment for weight loss and type 2 diabetes. However, is successful treatment really as simple as starting a new medication? Let’s take a closer look at the relationship between GLP-1 agonists and lifestyle changes.

GLP-1 Agonists

GLP-1 agonists, or glucagon like peptides, have been around since the FDA approved the first one in the U.S., exenatide (Byetta & Bydureon) in 2005. While quite a few have been approved since then, we have seen their popularity increase substantially in the last few years. In fact, in 2022 alone we saw over 5 million prescriptions written for this class of drugs, a 2000% increase since 2019. Researchers are still learning about their potential benefits and uses, but their main function remains as a treatment for type 2 diabetes, and more recently, weight loss. There’s also a growing sentiment among researchers that GLP-1 efficacy can be greatly improved with companion programs centered around lifestyle modification and behavior change.

Before you Begin GLP-1 Agonist Treatment

For anyone considering taking GLP-1 agonists, laying a sturdy foundation for behavioral changes is the key to maximizing results. GLP-1 agonists fundamentally change how users view and crave foods. It stands to reason that making dietary modifications, such as embracing whole foods and moderating sugar intake, will serve you well in preparation for beginning GLP-1 agonist therapy. By incorporating an array of nutrient-rich foods—such as fruits, vegetables, whole grains, and lean proteins—your odds of success increase greatly.

Equally essential is the integration of regular physical activity into one’s daily routine. Exercise not only aids in weight management, but also enhances insulin sensitivity, allowing for more efficient glucose utilization by the body. Getting into the habit of regular exercise early on is paramount to increasing your chances of sustained weight loss. From brisk walks to strength training sessions, finding activities that bring joy and fulfillment can make exercise a long-term habit. Moreover, cultivating healthy habits, such as getting adequate sleep, managing stress levels, and abstaining from tobacco use, make achieving optimal wellness that much easier.

A group of individuals headed to an exercise class. Exercise combined with the use of GLP-1 agonists is far more effective than the medication by itself.

Maximizing the Benefits of GLP-1 Agonists

Lifestyle changes and GLP-1 agonists intertwine harmoniously, amplifying each other’s efficacy. These medications, when aligned with dietary alterations and regular exercise, exhibit enhanced glucose-lowering effects vital to weight loss. While GLP-1’s alone are effective, GLP-1’s with positive and lasting change are even more so.

Jason Balette, a bariatric surgeon at Memorial Hermann Medical Group in Houston, Texas, had this to say on the matter, “Studies demonstrate that a GLP-1 agonist along with a diet and exercise program will result in up to 15% body weight loss.”

To put that into perspective, 15% of weight loss on a 195lb adult would leave them around 165lbs. That’s roughly a 30lb reduction in weight. The key to long-term wellness when it comes to weight loss is avoiding regression. Without making the necessary lifestyle modifications, your chances of regression once off of GLP-1 agonists, become significantly higher. Click here to learn more about the regression of GLP-1 users without the support of a lifestyle modification component. Ultimately, commitment to healthy habits remains indispensable in realizing long-term health goals.

The Value of Companion Programs

We’ve established that lifestyle modifications and behavior changes play a large role in increasing success with GLP-1 agonists. So, what resources exist that can be utilized while taking GLP-1 agonists? The answer is companion programs, which we are seeing more and more of being offered each day.

You should check with your health care provider about what programs or opportunities you can take advantage of. If your health care provider does not offer this option, there are alternative companion programs available through various other sources. These companion programs typically provide educational components that outline the benefits of lifestyle modifications. Others have gone so far as to offer cost savings benefits. MetaOne, an offering from U.S. Preventive Medicine, even provides continued support for when participants come off of GLP-1 agonists.

Life After GLP-1 Agonists

The journey to wellness extends far beyond the realm of medication. When it comes time to stop using GLP-1 agonists, a foundation of healthy habits can make all the difference. Strategies for navigating post-treatment life are important, from setting realistic goals to cultivating resilience in the face of challenges. Your relationship with your prescribing physician is invaluable, and you should discuss with them their recommendations for sustaining results.

By embracing the benefits of the lifestyle changes you’ll have already made, you can safeguard yourself against regression. There are other strategies as well, like taking advantage of continued support from programs offered by your healthcare provider. Transitioning from weight loss assisted by GLP-1’s to going it alone can be difficult. Another program from U.S. Preventive Medicine, The Preventive Plan, offers weight loss pursuits that can also help participants sustain healthy habits while coming off of GLP-1 agonists.

2 individuals, man and woman, smiling as they work on losing weight by going for a jog. Continued exercise after using glp-1 agonists is key to sustaining results.

Looking Back

As we reflect on the symbiotic relationship between GLP-1 agonists and lifestyle modifications, it becomes evident that successful treatment extends beyond the mere administration of medication. GLP-1 agonists have emerged as powerful tools in the management of weight loss and type 2 diabetes, yet their effectiveness is greatly enhanced when coupled with behavioral changes. By laying a sturdy foundation of healthy habits before embarking on treatment, individuals can optimize their outcomes and pave the way for sustained wellness.

Accessibility to GLP-1 Agonists: How Hard is it?

In the realm of diabetes management and weight loss, GLP-1 agonists have emerged as promising treatment options. However, navigating the hurdles of accessibility presents significant challenges for individuals seeking these medications. Understanding the barriers to access is crucial for addressing disparities in diabetes care and obesity treatments.

Understanding GLP-1 Agonists in Weight Loss & Diabetes Treatment

To begin, let’s explore the role of GLP-1 agonists in diabetes treatment and weight management. These medications mimic the action of glucagon-like peptide-1, a hormone that regulates insulin secretion and blood sugar levels. Beyond glycemic control, GLP-1 agonists have shown efficacy in promoting weight loss, making them valuable tools in the management of both diabetes and obesity. From a weight loss perspective, the way these drugs work is crucial to understanding how they aid in losing weight. GLP-1 Agonists have been shown to change appetite and eating habits altogether by slowing down the duration of digestion, leaving GLP-1 users feeling fuller and more likely to consume smaller portions.

A plate depicting word tiles reading "weight loss", one of the more common reasons people seek out the use of GLP-1 agonists, which has led to accessibility issues for some.

The Rising Costs of GLP-1 Agonists

Transitioning to the financial aspect, the rising cost of diabetes treatment compounds the challenge of accessing GLP-1 agonists. Factors such as escalating medication prices and healthcare expenses contribute to the financial strain faced by individuals and healthcare systems. As a result, affordability becomes a significant barrier to accessing these essential medications. Employer funded health care plans have experienced a meteoric rise in claims costs since the introduction of GLP-1 agonists to the market. For more on the impact of the introduction of GLP-1 agonists to healthcare costs, check out Boom in Weight-Loss Drugs to Drive up US Employers’ Medical Costs in 2024 – Mercer.

Accessibility Challenges

Moreover, accessibility issues further exacerbate the hurdles faced by individuals seeking GLP-1 agonist therapy. The current demand for these medications is becoming increasingly difficult for suppliers to keep up with. Additionally, insurance coverage limitations, formulary restrictions, and high out-of-pocket costs create barriers to accessing these medications. These challenges disproportionately affect marginalized communities and those with limited financial resources, widening health disparities in diabetes care.

While the price of GLP-1 agonists remains relatively accessible for the treatment of type 2 diabetes, for those whose insurance plans cover it, those who don’t have coverage are left to pay steep out of pocket costs. Individuals seeking the help of GLP-1 agonists for use as a weight loss aid likely find their insurance also does not cover it, or they don’t meet the requirements for coverage, and they too must deal with staggering prices. Currently GLP-1 agonists cost, on average, between $900-$1,350 per month, leaving health plan sponsors in a precarious position. Most are forced to choose between providing competitive coverage or constraining rising claims costs.

Strategies for Affordability

Despite these obstacles, some strategies do exist to help patients navigate the cost of GLP-1 agonists. Researching insurance coverage options and formularies can provide insight into available benefits. Some health plan sponsors have shifted to the use of educational and companion programs as requirements before providing coverage for GLP-1 agonists. This strategy has shown to increase the likelihood of success for GLP-1 users and the sustainability of their results. Those seeking coverage of GLP-1 agonists can even stand to benefit from lowered co-pays upon completion of these programs.

Exploring patient assistance programs and prescription savings cards can also mitigate out-of-pocket expenses. Engaging in candid discussions with healthcare providers about affordability concerns may also lead to alternative treatment options that better align with patients’ financial circumstances.

Depiction of information pamphlets on diabetes, which GLP-1 agonists were primarily designed to treat.

Patient Perspectives

To gain a comprehensive understanding of the impact of accessibility barriers, it’s essential to consider patient perspectives. Personal stories and testimonials from individuals navigating the complexities of diabetes care shed light on the human side of this issue. GLP-1 agonists have also been useful in treating those with prediabetes.

One such example would be the married couple of Susan and Michael Dixon. Susan, a prediabetic, and Michael, a type 2 diabetic, shared their successful experience with GLP-1 agonists in this article. While prediabetes patients can benefit from GLP-1 agonists, there are other ways to manage or arrest it without the use of GLP-1’s. To learn more about Prediabetes check out one of our earlier posts, Prediabetes: What you Need to Know.

What to Remember

The hurdles to accessing GLP-1 agonists for diabetes treatment and weight loss are multifaceted and impactful, but not insurmountable. As more benefits are discovered about this medication, more will likely be done to for accessibility. Although hurdles do exist to obtaining this medication, there are programs out there that aim to address these issues. Talk to your physician, find out if you meet coverage requirements, and start making lifestyle changes today in preparation. No medication is a silver bullet, and making changes that lead to a healthier life will always serve you well.

We’ve All Heard of Them…What are GLP-1 Agonists?

Managing diabetes requires a multifaceted approach, most often involving medications to regulate blood sugar levels. One class of medications gaining attention is GLP-1 agonists. These drugs play a pivotal role in controlling blood sugar levels in individuals with type 2 diabetes. Understanding the function and significance of GLP-1 agonists is vital for effective diabetes management.

What are GLP-1’s?

GLP-1 agonists, short for glucagon-like peptide-1, are medications designed to mimic the action of a hormone produced in the intestines. GLP-1, is a naturally occurring hormone with several important functions, including regulating blood sugar levels. By mimicking GLP-1’s action, GLP-1 agonists help stimulate insulin secretion and inhibit glucagon release, thereby lowering blood sugar levels. This ability makes GLP-1’s an extremely effective tool for treating type 2 diabetes. According to the CDC, out of the approximate 38 million Americans with diabetes, 90-95% of them suffer from Type 2 diabetes. To learn more about type 2 diabetes, and how to avoid it, check out one of our earlier posts, Prediabetes.

Mechanism of Action

The primary mechanism of action of GLP-1 agonists lies in their ability to activate GLP-1 receptors in the body. This activation stimulates insulin secretion from pancreatic beta cells in response to elevated blood sugar levels. Essentially, blood sugar levels begin to rise after the ingestion of food. GLP-1’s kick in after ingestion by stimulating the receptors that release the insulin to lower sugar levels in the blood. Additionally, GLP-1 agonists suppress the release of glucagon, a hormone that raises blood sugar levels, further aiding in glucose control. Furthermore, GLP-1’s slow down gastric emptying, leading to increased feelings of fullness and reduced food intake. Those increased feelings of fullness contribute greatly to the effectiveness of GLP-1’s as weight loss aids.

GLP-1’s Benefits in Treating Type 2 Diabetes

GLP-1’s offer several benefits for individuals with type 2 diabetes. One of the key benefits is their ability to improve blood sugar control by enhancing insulin secretion and inhibiting glucagon release. This can lead to reductions in HbA1c levels, a measure of long-term blood sugar control. Convenience is another benefit of GLP-1’s in treating type 2 diabetes. Administered once daily or weekly, this increases the likelihood of patient adherence to the GLP-1 medication regiment. Additionally, GLP-1’s promote weight loss, making them particularly valuable for overweight or obese individuals with diabetes.

Depiction of items commonly associated with the treatment of type 2 diabetes, including GLP-1 Agonists.

The Different Types of GLP-1 Agonists

There are several types of GLP-1 agonists available on the market, each with its unique characteristics. The two main categories of GLP-1 agonists are short-acting and long-acting. Short-acting GLP-1 agonists are typically administered before meals to help control postprandial blood sugar levels. Examples include exenatide and lixisenatide which have to be administered more frequently because they achieve relatively shorter GLP-1 receptor activation. In contrast, long-acting GLP-1 agonists, such as liraglutide and dulaglutide, are administered once daily or weekly and provide sustained blood sugar control throughout the day. It is their ability to generate continuous GLP-1 receptor activation at their recommended dose that makes their infrequent dosage possible.

Medication Safety & Side Effects of GLP-1 Agonists

While generally well-tolerated, GLP-1’s may cause side effects in some individuals. Common side effects include nausea, vomiting, diarrhea, and abdominal discomfort, particularly during the initial weeks of treatment. These side effects can vary in intensity based on dietary choices. However, these side effects often diminish over time as the body adjusts to the medication or as the necessary dietary changes are made. It’s essential for individuals using GLP-1 agonists to be aware of potential side effects and consult their healthcare provider if they experience any concerning symptoms. If you’re considering taking GLP-1’s, you should consider researching all the potential side effects and their risks.

Looking Back

GLP-1 agonists are valuable medications in the management of type 2 diabetes. They work by mimicking the action of GLP-1, a hormone that plays a crucial role in regulating blood sugar levels. By enhancing insulin secretion, inhibiting glucagon release, and slowing gastric emptying, GLP-1 agonists help improve glycemic control and promote weight loss in individuals with diabetes. Understanding the mechanisms and benefits of GLP-1 agonists is essential for effective diabetes management and improving overall health.

Health Literacy: The Truth is Out There

In a world inundated with health information, navigating the complexities of healthcare can be daunting, especially in the United States. Yet, amidst the abundance of resources, one critical skill stands out as essential: health literacy. Health literacy empowers individuals to obtain, understand, and apply health information to make informed decisions about their health and well-being. In this post, we’ll explore the significance of health literacy and its transformative impact on individual and public health.

The Basics

Health literacy encompasses a spectrum of skills, from reading and numeracy to comprehension and critical thinking. All must be applied within the context of health information to successfully navigate decisions we face regularly. It’s not just about understanding medical jargon or deciphering complex health literature; it’s about equipping individuals with the tools they need to navigate the healthcare system effectively and advocate for their own health needs. Furthermore, it is no secret healthcare information can be extremely complex and requires some contextual knowledge.

The Impact on Health Outcomes: Bridging the Gap

Although the link between health literacy and health outcomes is undeniable, a large gap still exists. Individuals with higher health literacy are more likely to engage in preventive health behaviors, adhere to medication regimens, and seek timely medical care. Conversely, limited health literacy is associated with poorer health outcomes, increased healthcare costs, and higher rates of hospitalization and mortality. By bridging the gap between knowledge and action, health literacy plays a pivotal role in shaping individual and population health. Therefore, it falls on us as individuals to equip ourselves with the necessary tools to start to close the gap that currently exists.

Health Literacy Rates: The Scope of the Issue

Despite its importance, health literacy remains a challenge for many individuals worldwide. According to the National Assessment of Adult Literacy (NAAL), only 12% of adults in the United States possess proficient health literacy skills, while nearly half have basic or below-basic skills. Moreover, disparities in health literacy persist across demographic groups, with marginalized communities disproportionately affected. These sobering statistics underscore the urgent need to address health literacy as a public health priority.

Barriers: Identifying the Challenges to Health Literacy

A number of factors contribute to limited health literacy, including educational attainment, language proficiency, cultural beliefs, and socioeconomic status. Complex health information, inadequate communication between healthcare providers and patients, and limited access to healthcare services further aggravate the problem. As a result, individuals with limited health literacy face barriers to understanding their health conditions, navigating the healthcare system, and making informed decisions about their care. Additionally, there is no single entity recognized as the primary source for equipping the general public with the necessary health literacy skills. So, where do we go for help?

Young adult woman sitting at her laptop visibly frustrated, due to issues with health literacy, while navigating her way through complex healthcare decisions.

Health Literacy Resources for Empowerment

Fortunately, there are resources and strategies to promote health literacy and empower individuals to take control of their health. Clear communication, patient-centered care, and health education programs are offered by a lot of the players in the healthcare space. These resources and opportunities, when taken advantage of, can enhance understanding and facilitate informed decision-making. The U.S. Department of Health and Human Resources has compiled a wonderful list of resources to empower individuals to improve their health literacy. Also, the CDC has a directory detailing what each state in the U.S. is doing for Health Literacy initiatives.

What Options Exist?

Additionally, leveraging technology, such as health apps and digital health platforms, can provide accessible, user-friendly resources to support health literacy efforts. Also, for those that prefer a more personal touch, there are wellness providers like U.S. Preventive Medicine that offer Health Coaching Services. These coaches can have a tremendous impact on health literacy, and so much more. For more information on what a Health Coach can do for you, check out How a Health Coach Will Change Your Life(style). By leveraging these programs or applications, investing in health information literacy, and utilizing the services available to us, we can equip ourselves with the knowledge and skills needed to thrive in today’s healthcare landscape.

Going Forward

Ultimately, health literacy is a fundamental skill that can empower individuals to make informed decisions about their health and well-being. By understanding the basics of health literacy, recognizing its impact on health outcomes, acknowledging the barriers to health literacy, and utilizing strategies for empowerment, we can work towards a future where everyone has the knowledge needed to lead healthy, fulfilling lives. Let’s harness the power of being health literate to create a healthier, more equitable world for all.

Summer’s Here: Beat the Heat with Hydration

As the temperature rises and the sun shines brighter, staying hydrated becomes more crucial than ever. Properly hydrating is essential for supporting bodily functions, regulating body temperature, and maintaining overall health, especially during the summer months. We’ll explore the importance of hydration, common causes of dehydration, and practical tips for staying hydrated. By the end of this post, you’ll have all the tools to ensure a healthy and enjoyable summer season.

Why Water Matters

Water is essential for life, accounting for a significant portion of our body composition. Water plays a crucial role in various physiological processes. Adequate hydration is essential for supporting cellular function, facilitating nutrient absorption, lubricating joints, and regulating body temperature. During the summer, perspiration rates increase due to higher temperatures and the body’s need for hydration becomes even more pronounced.

Middle aged man on basketball court maintaining hydration with water.

Common Causes of Dehydration: Recognizing the Signs

Dehydration occurs when the body loses more fluids than it takes in, leading to imbalances in electrolytes. This imbalance can have a profound effect on vital bodily functions. Common causes of dehydration include excessive sweating, prolonged exposure to heat and sun, inadequate fluid intake, excessive alcohol consumption, and certain medical conditions, such as diarrhea and vomiting. Recognizing the signs before it’s too late is paramount. It takes far longer to rehydrate than most people think. Signs such as thirst, dark urine, fatigue, dizziness, and dry mouth, are critical indicators for needing to take prompt action. When you start seeing these signs, it’s time to rehydrate if you want to prevent further and more serious complications.

Staying Hydrated: Essential to Beating the Summer Heat

Staying hydrated during the summer months requires proactive measures to ensure adequate fluid intake and electrolyte balance. Many people make the mistake of waiting until the day of, or right before physical activity, to hydrate. This can be deadly as it takes time for your body to properly absorb the fluids you’ve consumed. Another common misconception is that sports drinks are superior to water for staying hydrated. This is not exactly true, while sports drinks can be helpful for rehydrating, their best suited for when your body has depleted a large number of salts, sugars and electrolytes. Take a look at Stop Drinking Your Calories for more information on why water is preferred over sugary sports drinks for hydration.

Tips for Proper Hydration

  • Drink plenty of water throughout the day, aiming for at least 8-10 glasses or more, depending on activity level and environmental conditions.
  • Incorporate hydrating foods into your diet, such as fruits and vegetables with high water content, including watermelon, cucumber, oranges, and strawberries.
  • Avoid sugary beverages and caffeinated drinks, which can contribute to dehydration. Opt for water, herbal teas, or electrolyte-rich beverages, such as coconut water or sports drinks, to replenish fluids and electrolytes lost through sweating.
  • Set reminders to drink water regularly, especially during outdoor activities or prolonged periods of sun exposure.
  • Monitor urine color as a simple indicator. Pale yellow or clear urine indicates adequate hydration, while dark yellow or amber-colored urine may signal dehydration.
  • Be mindful of alcohol consumption, as alcoholic beverages can increase urine output and contribute to dehydration. Alternate alcoholic drinks with water or non-alcoholic beverages to stay hydrated.

Hydrating for Specific Populations: Catering to Individual Needs

Certain populations may have unique hydration needs that require special attention. This includes older adults, who may have decreased thirst sensation and kidney function. Also, children may be more susceptible to dehydration due to higher water requirements relative to body weight. Another vulnerable cohort is individuals with certain medical conditions, such as diabetes or kidney disease, who may require careful monitoring of fluid intake and electrolyte balance. Tailoring your strategies for hydrating to meet your specific needs is essential for promoting optimal health and well-being. For more information on how to properly hydrate relative to your specific needs, check out Get the Facts: Data and Research on Water Consumption provided by the CDC.

Older gentleman keeping up with his hydration by drinking water while exercising.

The Bottom Line: Prioritizing Hydration for Health and Wellness

In conclusion, staying hydrated is essential for maintaining health and well-being, especially during the summer months when the risk of dehydration is higher. By understanding the importance of hydrating, recognizing the signs of dehydration, implementing practical tips for staying hydrated, and catering to individual needs, we can ensure a safe and enjoyable summer season for ourselves and our loved ones. So, remember to drink up, stay hydrated, and embrace the benefits of proper hydrating for a healthier, happier you.

Six Things Employees Don’t Know about Coronavirus

Here are the six corona tips, covering issues from the large to the smallest imaginable, that most seem to check the twin boxes of generally not known but generally helpful to know for health and/or financial reasons.

1. You may be able to skip a mortgage payment…but you still owe it

Most people don’t know whether their mortgage is backed by the government or not, since it’s a “mortgage servicer” that sends them the bills and answers the phone. If it is, you get a reprieve. That doesn’t mean you never have to pay. You just don’t have to pay now. To find out if yours is or isn’t, call the number on your bill, but expect to wait on hold long enough to make Comcast blush.

2. Your landlord may not be able to evict you

Likewise, if you rent an apartment in a building with a government-backed mortgage as many tenants do, a specific provision in the CARES Act applies—there is a 120-day moratorium on evictions.

Obviously, no one ordinarily has any clue whether this applies to them or not, but it’s worth finding out. Otherwise, no CARES Act provision benefits renters. As a practical matter, eviction proceedings have come to a halt in many states or cities, and some are outright preventing it. There is no “official” list of these jurisdictions but try this website. They seem legit.

There may be no risk to your credit score either — landlords rarely report to credit agencies because for them eviction has been the go-to remedy for non-payment. Yours may start doing this but obviously they would threaten you with it first since reporting does no good if the tenant doesn’t know they’re being reported.

Not just for rent, but In all bill-paying cases, those of us who are not familiar with “stretching” strategies might not realize that, for just about any bill, partial payments and proactive communication go a long way towards not getting cut off.

4. No product on the internet “boosts” your immune system

Google on “boost your immune system to prevent coronavirus” and you’ll get 11 million hits, virtually all of which are wrong – including zinc, essential oils, and the “electrolyte elixir drink.” (We can’t make this stuff up.)  Here is a good example of the right answer:

“Obviously good and balanced nutrition is important, but I actually do not think there is any strong scientific evidence for any specific type of food being linked to better immune function, and certainly there is no serious work on the are that I am aware of,” says Shiv Pillai, a professor of medicine at Harvard Medical School and director of the Harvard immunology program.

5. Drink gallons of tonic water only if that’s your idea of a good time

Tonic water is flying off the shelves, because the active ingredient is quinine, as found in the remedy-du-jour of hydroxychloroquine (Plaquenil).

Where to start? First, you’d have to drink maybe a dozen bottles of tonic water to get to the level of quinine found in Plaquenil. Even then, it’s not the same formulation, and even then, it is very far from clear that the latter has any noticeable beneficial impact in the prevention or treatment of coronavirus. (We were skeptical of this one early on.)

Six Easy Ways to Reduce Workplace Corona Risk

We can’t tell you whether to send everyone home or not. But let’s assume you do have to run a workplace (and a home). Beyond the basics of hand-washing and not touching your face, here are six simple ways to reduce the risk of coronavirus transmission:

1. Mark your fingers like this

Use an indelible marker or tie a string or rubber band around your fingers, especially on your right hand. This will remind you not to shake hands, not to touch your face — and to wash your hands or sanitize them if you do. If you are left-handed, you should probably do both hands.

2. Use humidifiers at work

Most workplaces are very dry. Viruses can stay airborne longer in dry air. (Winter air being drier is thought to be one of the reasons cases of flu are seasonal.) To oversimplify, the viruses attach to water droplets and fall to the ground faster in the humid air.

3. Avoid contact with hard surfaces

One would think that viruses would live longer on soft, cushy surfaces than hard, shiny ones. That’s quite counter-intuitive. If you met someone for the first time, you would certainly open their door, but you wouldn’t jump into their bed. (Cue sophomoric joke here about swiping right.)

And indeed beds and other soft surfaces do harbor all sorts of other microscopic life forms, most of which wouldn’t harm you or we’d all be extinct by now. For instance, you should swap out your pillows every year or so because dust mites like to set up housekeeping in them. But for cold, flu and coronavirus, it’s the hard, shiny public surfaces that will get you.

4. Reduce the number of hard surfaces in public places

Prop open doors. Door handles (or pushing on revolving doors) are probably the #1 surface that people come into contact with, without thinking twice about it. Obviously, this isn’t always practical. One could do it for the break rooms but perhaps not the restrooms.

5. Wrap/tape a soft surface around the door handles

Viruses die sooner on softer surfaces, and since people think of softer surfaces as carrying more germs (they do – just not coronavirus), they will be more likely to wash afterward.

6. Play the Quizzify coronavirus quizzes…and send them to your employees

The first covers the basics. It was profiled recently in Employee Benefit News.

Click here for a helpful link to the CDC website about Coronavirus prevention and mitigation.


This blog post was written by Al Lewis.

USPM has recently partnered with Quizzify to enrich our content for our customers with its unbiased and trustworthy health information, reviewed and approved by doctors at Harvard Medical School. Quizzify provides the education employees need to be health-literate, wiser and more confident healthcare consumers.

Suicide Rates Rising Across the U.S.

USPM is taking this time to share information and resources in an effort to bring awareness to this difficult topic.

Considered one of the biggest public health problems nationwide, suicides have been steadily increasing in nearly every state according to the latest Vital Signs reported by the Centers for Disease Control and Prevention (CDC).

In 2016, approximately 45,000 people ages 10 or older died by suicide. It is the 10th leading cause of death, and one of just three leading causes of death on the rise1. Although suicide affects people of all ages, the majority of cases are occurring in people over 60 years of age.

Suicidal thoughts or behaviors can be both damaging and dangerous and should be considered a psychiatric emergency. Seek immediate assistance from a health or mental health care provider if you or someone you know is experiencing suicidal thoughts.

Know the Warning Signs

  • Threats or comments about killing themselves, also known as suicidal ideation, can begin with seemingly harmless thoughts like “I wish I wasn’t here” but can become more obvious and dangerous
  • Increased alcohol and drug use
  • Aggressive behavior
  • Social withdrawal from friends, family and the community
  • Dramatic mood swings
  • Talking, writing or thinking about death
  • Impulsive or reckless behavior2

Imminent Danger

If you notice any person exhibiting these behaviors, seek immediate care:

  • Putting their affairs in order and giving away their possessions
  • Saying goodbye to friends and family
  • Mood shifts from despair to calm
  • Planning, possibly by looking around to buy, steal or borrow the tools they need to complete suicide, such as a firearm or prescription medication2

If you are unsure, contact a licensed mental health professional to help assess the risk.

 Risk Factors for Suicide

Research has found that more than half of people (54%) who died by suicide did not have a known mental health condition. Other things may have put a person at risk of suicide, including:

  • A family history of suicide.
  • Substance abuse. Drugs and alcohol can result in mental highs and lows that worsen suicidal thoughts.
  • More than one in three people who die from suicide are found to be under the influence.
  • Access to firearms.
  • A serious or chronic medical illness.
  • Gender. Men are four times more likely to die by suicide even though more women than men attempt suicide.
  • A history of trauma or abuse.
  • Prolonged stress.
  • Isolation
  • Age. People under age 24 or over age 65 are at a higher risk for suicide.
  • A recent tragedy or loss.
  • Agitation and sleep deprivation2.

Crisis Resources

  • If you or someone you know is in an emergency, call 911
  • If you are in crisis or are experiencing difficult or suicidal thoughts, call the National Suicide Hotline at 1-800-273 TALK (8255).
  • If you’re uncomfortable talking on the phone, you can also text NAMI to 741-741 to be connected to a free, trained crisis counselor on the Crisis Text Line3.

Suicide prevention is important to address year-round…everyone can help prevent suicide – because all it takes is just one conversation to change a life. #SuicidePrevention #StigmaFree. #moregoodyears

References:

1: https://www.cdc.gov/media/releases/2018/p0607-suicide-prevention.html

2: https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Risk-of-Suicide

3: https://www.nami.org/Get-Involved/Awareness-Events/Suicide-Prevention-Awareness-Month

Stress and Your Heart’s Health

You may be surprised to learn that you might be bringing unnecessary stress into your life by your own choices and lifestyle habits. It’s important to remember, even during times of stress, anxiety, or depression, that your heart health is vital to both your mental and physical wellbeing.

The Effects of Stress

During stress, your body releases adrenaline, the hormone that temporarily causes your breathing and heart rate to speed up, and raises your blood pressure1. These are normal reactions (the “fight or flight” response) that help you prepare to face a stressful situation. Constant stress, however, can have a negative wide-ranging effect on emotions, some of which include:

  • Frequent headaches, jaw clenching or pain
  • Neck ache, back pain, muscle spasms
  • Unexplained or frequent “allergy” attacks
  • Chest pain, palpitations, rapid pulse
  • Depression, frequent or wild mood swings
  • Increased or decreased appetite
  • Difficulty concentrating, racing thoughts
  • Increased frustration, irritability, edginess2

Prolonged or chronic stress increases cortisol, the stress hormone, and can wreak havoc on your health by compromising your immune system and contributing to many diseases including high blood pressure. Research shows that excessive stress can affect lifestyle behaviors and factors that increase the risk of heart disease3.

  • Sudden stress increases the pumping action and heart rate resulting in rising blood pressure.
  • Stress alters the heart rhythms posing a risk for rhythm abnormalities in people with existing heart rhythm disturbances.
  • Stress causes certain blood cells to become stickier.
  • Stress impairs the clearance of fat molecules in the body making it more difficult to lose weight.
  • Stress that leads to depression appears to be associated with an increased intima-medial thickness (a measure of the arteries that signifies worsening blood vessel disease)2.

Heart disease accounts for 1 in 7 deaths and remains the number 1 cause of death in the United States4.

Stressors, any event that causes the release of stress hormones, can be different for each person. Stressors can be helpful during emergency situations, meeting deadlines or reaching your goals. But stressful situations, such as divorce or job loss, can produce long, low-level stress that over time wears down the body’s immune system and increases the risk of heart disease and a variety of other health problems5.

When stress persists, it can often affect various organs and tissues all over the body including:

  • Nervous system
  • Musculoskeletal system
  • Respiratory system
  • Cardiovascular system
  • Endocrine system
  • Gastrointestinal system
  • Reproductive system6

Tips to Reduce Stress

While we’re unable to rid ourselves from all inevitable stressors, fortunately, there are lifestyle changes and stress-reduction techniques you can practice to improve your response to stress and help minimize its damaging effects on your heart and overall health.

  • Exercise. When you exercise, your body releases natural, mood-lifting chemicals that help you feel better. Your workout doesn’t have to be extreme; a short walk every day is all it takes.
  • Nutrition. Eating meals that are balanced and portion-controlled will keep you mentally and physically healthy.
  • Sleep. Poor sleeping habits can have a harmful effect on your mood. It is important to get plenty of sleep and rest. Most people need about seven to eight hours each night.
  • Social Support. Talk with friends and family frequently. Think about joining a special-interest class or group. Volunteering is a great way to meet people while helping yourself and others.
  • Deep Breathing. Taking a deep breath is an automatic and effective technique for winding down.
  • Meditation. Studies have suggested that regular meditation can benefit the heart and help reduce blood pressure.
  • Humor. Research shows that humor is an effective mechanism for coping with acute stress. It is recommended to keep a sense of humor during difficult situations. Laughter can release tension and help you maintain perspective, but it can also have physical effects that reduce stress hormone levels in your body.
  • Avoid Alcohol Use. If you are going to drink alcohol, limit how often you drink, and practice moderation as alcohol may increase your risk of depression.
  • Recognize When You Need Help. If you continue to have problems, are unable to overcome the difficult circumstance, or are thinking about suicide, talk to a professional counselor, psychologist or social worker2,7.

Adopting and maintaining healthy lifestyle behaviors is instrumental in preserving your health and preventing disease. Health is more than just the absence of disease; it is a resource that allows you to reach your goals, satisfy your needs and cope within your environment for more good years®.

References

  1. http://www.heart.org/HEARTORG/HealthyLiving/StressManagement/HowDoesStressAffectYou/Stress-and-Heart-Health_UCM_437370_Article.jsp#.WV0hu1GQxQI
  2. A.D.A.M. Stress
  3. http://www.heart.org/HEARTORG/HealthyLiving/StressManagement/HowDoesStressAffectYou/How-does-depression-affect-the-heart_UCM_460263_Article.jsp#.WVo-IlGQxQI
  4. https://www.cdc.gov/heartdisease/facts.htm
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/
  6. https://www.stress.org/stress-effects/
  7. nlm.nih.gov/medlineplus

Depression Affects More Than We Think

Depression is a common but serious medical condition that can cause severe symptoms affecting how you think, feel, and act. The CDC estimates that more than 1 out of 20 Americans 12 years of age and older reported depression symptoms in 2009 – 2012.

Depression by the Numbers

Major depressive disorder is one of the most common mental disorders in the United States.

  • Each year about 6.7% of U.S. adults experience major depressive disorder.
  • Women are 70% more likely than men to experience depression during their lifetime.

Depression has also been associated with several chronic diseases, making it one of the most common complications of chronic illness. People diagnosed with a chronic medical condition (heart disease, diabetes, cancer, etc.) have a higher risk of depression, and it’s also true that people with depression are at higher risk for cardiovascular disease, diabetes, stroke and Alzheimer’s among others.

Chronic mental health conditions are becoming increasingly widespread across the U.S. and if not addressed could cost up to $3.5 trillion by 2030 – $3.4 trillion in medical costs and another $140.8 billion in societal costs. Like other chronic illnesses, mental health conditions contribute heavily to productivity losses, but can also worsen unemployment, substance abuse, homelessness, and incarceration.

Learn the signs and symptoms of depression and promote the benefits of early identification and intervention. Once diagnosed, a person with depression can be treated in several ways. The most common treatments are medication and psychotherapy.

Signs and Symptoms Include:

  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment

To Help a Friend or a Relative

  • Offer emotional support, understanding, patience, and encouragement.
  • Talk to him or her, and listen carefully.
  • Never dismiss feelings, but point out realities and offer hope.
  • Never ignore comments about suicide, and report them to your loved one’s therapist or doctor.
  • Invite your loved one out for walks, outings and other activities. Keep trying if he or she declines, but don’t push him or her to take on too much too soon.
  • Provide assistance in getting to the doctor’s appointments.
  • Remind your loved one that with time and treatment, the depression will lift.

If you have depression, you may feel exhausted, helpless, and hopeless. It may be extremely difficult to take any action to help yourself. But as you begin to recognize your depression and begin treatment, you will start to feel better.

To Help Yourself, Keep Busy

There is a lot to do in life. There is a lot to do every day! Staying busy can help direct your thoughts away from what may be troubling you. Try to focus on important daily routines:

  • Work and hobbies
  • Household projects
  • Social and family gatherings
  • Volunteering in the community

If you get overwhelmed, consider delaying tasks, setting priorities and breaking up projects into manageable bits.

Exercise Regularly

Some people find that regular aerobic exercise improves their symptoms as much as antidepressant medication. Others find that their mood improves by getting out in the sun more often. You might combine the benefits of both by increasing your activity outdoors.

People new to regular exercise should increase their activity level gradually. A good place to start is to add steps to your daily commute, errands, and chores.

Get Enough Sleep

Deep sleep helps the body’s cells grow and repair themselves from such factors as stress. So, getting enough sleep may improve your ability to function while awake. To improve the quality of your sleep, be sure to eat healthy foods, exercise at least moderately on most days, and create a sleep-friendly environment:

  • Avoid caffeine and other stimulants during the day.
  • Block out light and noise.
  • Establish a bedtime routine: Go to bed at the same time each night and do something relaxing before getting into bed (take a warm bath, listen to pleasant music).
  • Reduce screen time before bed

Talk to a Friend, Have Some Fun

Don’t try and deal with what you are going through alone. Talk to someone on a regular basis. And while you are at it, put some fun into your life!

In case of an emergency, call:
  • Your doctor.
  • 911 or go to a hospital emergency room to get immediate help or ask a friend or family member to help you do these things.
  • The toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor.
For more information, call:
  • Depression and Bipolar Support Alliance: 800.826.3632
  • National Alliance on Mental Illness (NAMI): 800.950.6264
  • National Institute of Mental Health (NIMH): 866.615.6464

References

5 Ways to Spread Workplace Wellness

Wellness Programs - Blog Feature Graphic

Look around, and you’ll notice we are spending the greatest amount of our time at work; most full-time employees will spend over 2,000 hours at work every year, some even more.

This not only minimizes the amount of time we have to spend with family and do the things that make us happy, but it also makes it more difficult to fit in the required physical activity and to make healthier nutrition choices.

Healthcare Rates & Chronic Disease are on the Rise

Healthcare spending is on the rise, but so are chronic diseases such as diabetes, heart disease, heart failure, hypertension, and obesity – many of which could be prevented with a few behavior changes in our nutrition and physical activity.

According to the Organization for Economic Co-operation and Development (OECD), the United States spends far more on healthcare than any other nation. Yet, the average American’s life expectancy is only 78.3 years, which is lower than the average and the lowest among the top healthcare spending nations. Our lifestyle choices in this country are partially to blame for the rise in chronic disease.

Chronic diseases are responsible for 7 out of 10 deaths every year in the United States, and treating people with chronic diseases accounts for 86% of our nation’s healthcare costs.1

Spending more on healthcare is not making us healthier or bringing us longevity; we realize that prevention is considerably cheaper than managing any health condition and/or chronic disease. As a result, wellness is getting a lot of attention lately as we become more aware that we own our health and have complete control of our wellness.

Many businesses are adopting new approaches and beginning to implement workplace wellness programs – which are proving essential for creating and maintaining healthier, happier, hard-working employees while reducing the costs of health insurance claims, absenteeism, and receiving maximum productivity in return. Happy, healthy employees are more productive. It’s nothing short of a win-win symbiosis.

So, what is a workplace wellness program?

A successful workplace wellness program enables employees to increase control over, and improve, their health by offering healthier opportunities and empowering them to make healthier choices with ease.

The wellness program may offer risk assessments, screenings, flexibility for time to exercise, healthier snacking options in vending machines, behavior modification, educational and tobacco cessation programs, and much more. Access to a wellness program allows the employee to take care of their health regularly and reduce stress. Offering incentives may also be used to encourage employee participation and increase engagement.

Here are a few low-cost tips to get you started on spreading workplace wellness and transforming your organization into one of the best places to work:

  1. Healthy Pantry Club: Start a healthy pantry stocked with healthy choices essential to a healthy diet and productivity at work. Keep it junk-food free by stocking it with healthy snacks, fresh fruits, vegetables, and low-sugar, low-sodium drinks. A contribution box for employees to donate to keep the pantry stocked is a great way to get everyone involved.
  2. Fitness Trackers: Fitness trackers can encourage employees to increase their steps while being more active through participation in challenges that will keep them motivated and mindful of their health and nutrition choices. Office challenges are a fun way to increase steps and build camaraderie – award prizes for the top stepper, wellness champion, best effort, etc.
  3. Office Gym or Gym Memberships: Transform an unused office or space into a gym by adding yoga mats, free weights, and other fitness equipment. This helps the strapped-for-time employee fit exercise into their busy schedule. Subsidize or reimburse gym membership fees bringing fitness within reach for all employees to help create a routine they can stick with.
  4. Walking Meetings: Incorporate moving meetings to stimulate creativity and new ideas by walking around the building. Physical activity gives you energy and makes you feel more alert.
  5. Wellness Communications: Communication is the key to a successful wellness program. Get employees excited and engaged by sending wellness communications that provide ideas, strategies, short articles, tips, recipes, reminders, and more. Create awareness posters and flyers to display around the office, coordinate your content with the year’s seasons and monthly health observances.

Remember, it’s not the number of extravagant perks you offer, it’s how successful you are at fulfilling the employees’ basic human and emotional needs to foster a healthy, conscious, and happy environment that inspires employees to be their best.

References:

  1. http://www.cdc.gov/chronicdisease/
  2. https://data.oecd.org/healthres/health-spending.htm
  3. http://www.oecd.org/unitedstates/Briefing-Note-UNITED-STATES-2014.pdf
  4. http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT
  5. http://www.oecd.org/els/health-systems/health-data.htm

Can a Healthier and Safer Workforce Promote a Healthier Bottom Line for Employers?

A growing body of evidence supports the notion that focusing on the health and safety of a workforce is good business.

Engaging in a comprehensive effort to reduce the health risks of a workforce and mitigate the complications of chronic illness within these populations, can produce remarkable impacts on health care costs, productivity and performance.

An excerpt from the Journal of Occupational Occupational & Environmental Medicine:
Fabius, R; Loeppke, R; Hohn, T: et.al. “Tracking the Market Performance of Companies That Integrate a Culture of Health and Safety: An Assessment of Corporate Health Achievement Award Applicants”. JOEM. Volume 58: Number 1. Jan, 2016.

ABSTRACT
  • Objective: To test the hypothesis that comprehensive health and safety efforts, judged separately on their merits by the CHAA, contribute to better performance in the marketplace.
  • Methods: Stock market performance of CHAA winners tracked under 6 different scenarios using simulation and past market performance.
  • Results: The results demonstrate that a portfolio of companies recognized for excellence in workforce health or safety, or both, outperform in the marketplace. When we deconstructed the CHAA process and established portfolios among the applicants and award winners that achieved threshold scores in either health or safety as well as threshold scores in both, all significantly outperformed the S&P 500 standard index companies.
  • Conclusions: This study adds to the growing evidence that a healthy and safe workforce correlates with a company’s performance and its ability to provide “healthy” returns to shareholders.

To more objectively test this hypothesis, the stock market performance of the prior American College of Occupational and Environmental Medicine (ACOEM) Corporate Health Achievement Award (CHAA) winners were tracked under 4 different scenarios. Using simulation and past market performance, a theoretical initial $10,000 investment in publicly traded award winners was tracked from 1999 to 2012.  This portfolio of publicly traded award winning companies clearly outperformed the market. Though correlation is not the same as causation, the results consistently and significantly suggest that companies focusing on the health and safety of their workforce are yielding greater value for their investors as well. More research needs to be done to better understand the value of building these “cultures of health” in the workplace. Perhaps such efforts as this simply identify “smart” companies that outperform. But the evidence appears to be building that healthy workforces provide a competitive advantage in ways that benefit their investors.

The literature is replete with examples demonstrating that the health of employees impacts their performance and productivity. Additionally, for the majority of employers who pay for the cost of health care provided to their employees there is a direct impact on the bottom line.

Consider these statistics…
  • Over 22% of working age adults surveyed reported health-related work impairment from chronic illness in the previous 30 days. Those with impairment average 6.7 lost days. This is equivalent to $2.5 billion impaired days per year.(1)
  • In a 2003 study, it was found that illness and disability reduces total work hours by approximately 8.6%, with nearly 8.7 million Americans unable to work. The loss to the U.S. economy represented about $468 billion.(2) In 2006, over $2 trillion was spent on health care with three-fourths of that amount focused on treating chronic conditions.(3)
  • In a multi-employer study by ACOEM, IBI and Dr. Kessler of Harvard Medical School, Loeppke, et.al., reported that for every dollar of medical and pharmaceutical costs spent an employer lost an additional $2.30 of health-related productivity costs. Health-related presenteeism was shown to have a larger impact on lost productivity than absenteeism, with executives and managers suffering higher losses. Co-morbidities demonstrated the largest effects on productivity loss.(4) 
These facts led to a hypothesis…

Companies that envelope their employees and dependents in an environment that reinforces conscious and unconscious lifestyle choices as well as more effective accessing of healthcare, i.e. surround them with a “culture of health,” should be more productive and that productivity should be reflected in the price of their stock.

Testing the Hypothesis

To test the hypothesis, we turned to the American College of Occupational & Environmental Medicine’s corporate health awards (http://www.chaa.org/). The Corporate Health Achievement Award (CHAA), established in 1997, recognizes organizations with exemplary health, safety and environmental programs. Participating organizations submit a comprehensive application about their program and undergo a rigorous review by an expert panel to assess four key categories:

  1. Leadership & Management
  2. Healthy Workers
  3. Healthy Environment
  4. Healthy Organization

Awards have been given to organizations in manufacturing and service sectors, including city health departments, federal agencies and healthcare systems. Most years since inception of the award there has been at least one recipient. Most recipients have been publicly traded companies.

Since these award-winning companies are recognized for their exemplary efforts in creating a healthy workforce and since a healthy workforce generates less health care costs and improved productivity, we tested the thesis that a portfolio of these companies would outperform the marketplace.

Our results strongly support the notion that focusing on the health and safety of a workforce is good business. Engaging in a comprehensive effort to reduce the health risks of a workforce and mitigate the complications of chronic illness within these populations, can produce remarkable impacts on health care costs, productivity and performance.

The Cost of Chronic Disease

Dee Edington, Ph.D., has demonstrated that companies who do not pay any attention to elevating the health status of their workforce will see their employees developing increasing health risks and health care costs.(12) His results found that non-managed workforces acquire increased health risks and conditions resulting in increased costs over time. In fact, his research found that within non-managed populations the low risk cohort diminishes by roughly 5% while the moderate and high risk segments increase by roughly 8% and 11% respectively over a three-year period. He also demonstrated that it is possible to markedly reduce this trend through the execution of risk reduction programs at the workplace.(13)

Preventive services can stem the progression of health risks, chronic conditions and medical costs. RAND Corporation estimates one fifth of all healthcare expenditures will be devoted to treating consequences of obesity by 2020. Lowering obesity rates to 1998 levels could lead to annual productivity gains of $254 billion as well as the avoidance of $60 billion in annual treatment expenditures.

Seven chronic conditions (cancer, heart disease, hypertension, mental disorders, diabetes, pulmonary conditions and stroke) are currently costing the U.S. economy alone more than $1 trillion per year. Assuming the current trend continues to 2023, it would lead to a 42% increase in cases of the seven chronic diseases for a total of 230.7 million cases of these diseases with $4.2 trillion in treatment costs and lost economic output.

Plausible estimates of potential gains in 2023 associated with reasonable improvements in prevention, detection and treatment of just those seven conditions include:

  • Preventing 40 million fewer cases of illness
  • Cutting annual treatment costs in the U.S. by $217 billion
  • Reducing annual health-related productivity losses by $905 billion
  • Yielding more than $1 trillion in labor supply and efficiency(14)

Employers can realize similar results by implementing the best efforts in prevention, early detection and evidence based treatment for their workforce and covered lives.

A critical Meta-Analysis of 22 research studies in the scientific literature published in Health Affairs in February 2010 showed that medical and pharmacy costs fall by about $3.27 and absenteeism costs fall by about $2.73 for every $1 invested in wellness.(15)  This results in a return on investment of six to one.

Recognizing the merits of a healthy workforce even before this paper, ACOEM provided significant guidance. The College has stated that the marketplace has markedly underestimated the full impact of poor health in the workplace and on the economy. Employers would benefit by having a better understanding of the diseases and conditions that impact their employees and covered lives so that they could implement programs to mitigate their consequences. There is a connection between the health and safety and the productivity of workforces. Health care costs should be viewed as an investment in their employees rather than an expense. Health improvement strategies have proven to produce excellent returns. Comprehensive programs focus on primary, secondary as well as tertiary prevention.(16)

The workplace offers unique advantages for the implementation of health improvement initiatives. Roughly one quarter of our population is employed. When including retirees and family members this reach includes the majority of Americans. The workplace environment and the corporate culture can reinforce healthy behaviors. Powerful communication and educational assets can be leveraged. Incentives, penalties and mandates can be built into compensation and health benefits. Tenured employee relationships can promote sustainability. And finally employers possess the capability to measure the impact of health improvements on performance, productivity and business results.

The logic behind investing in workplace health is straight forward.

  • A large proportion of illness is preventable by reducing health risks. (17)
  • Health risks can be improved through workplace health programs. (18)
  • Reductions of health risks can lead to reductions in health costs. (19)
  • Worksite health programs can produce a positive ROI and VOI. (20,21,22,23,24)

Moreover, research supports a corporate-wide impact. Towers Watson has demonstrated that employers with highly effective health and productivity programs:

  • Generate 20% more revenue per employee
  • Realize a 16.1% higher market value and
  • Deliver 57% higher shareholder returns(25)

A recently published paper by Loeppke et al(26) emphasized the importance of integrating health promotion and health protection. This paper suggests that the CHAA assessment process should be realigned to follow the format of the DJSI. The CHAA’s current categories of measurement would be converted to mirror the DJSI’s categories, which include economic, environmental, and social metrics. This would result in an Integrated Health and Safety Index (IH&S Index).

Imagine a future scenario in which employers of sufficient size would be required or encouraged to publicly report on the degree to which they have achieved a culture of integrated health and safety. Those that report high Integrated Health and Safety Index scores could potentially be rewarded in the marketplace with greater investment as well as premium cost-reductions for group health and/or workers’ compensation insurance.

This would provide a major incentive for more companies to focus on the health and safety of their workforces and markedly aid in addressing many of the factors that are driving the American health care crisis—including the rise of chronic disease. If enough companies were able to improve and sustain the health status of their workforces, it could impact millions of Americans, providing a national tipping point in our effort to improve health outcomes and lower costs. The data in this paper suggest that such an effort might also contribute to investment-oriented opportunities and company differentiation in the marketplace.

Integrating health promotion (wellness) and health protection (safety) strategies creates synergy among these efforts, enhancing the overall health and well-being of the workforce, empowering employees to perform at the height of their potential and improving the organization’s bottom line.

References:

  1. Kessler et al. the Effects of Chronic Medical Conditions on Work Loss and Work Cutback. JOEM. 2001; 43(3):218-225.
  2. Berger, M, et al. Investing in Healthy Human Capital. JOEM. 2003; 45(12):1213-1225)
  3. Goetzel R. Do Prevention or Treatment Services Save Money? The Wrong Debate. Health Affairs. 2009; 28(1):37-41.
  4. Loeppke, R., et al., “Health and Productivity as a Business Strategy: A Multi-Employer Study”, JOEM, 51:4, April, 2009. pp 411-428.
  5. Peterson K W, Yarborough CM III, Ferguson EB, Matthew SJ. ACOEM Award: The American College of Occupational and Environmental Medicine’s Corporate Health Achievement Award.J Occup & Environ Med. 1996;38(10):969-972.
  6. Baldrige Award Winning Quality, 17th edition, by Mark Graham Brown, CDC Press, 2008.
  7. Malcolm Baldrige National Quality Award. [website]
  8. C. Everett Koop Award [website]
  9. Yarborough, CM. Administrative Track: What Constitutes Excellence for the Corporate Health Achievement Award. J Occup & Environ Med. 1998;40(4):381.
  10. Scope of Occupational and Environmental Health Programs and Practice. J Occup Environ Med. 1992;34:
  11. NCQA. Health Evaluation Data Information Set (HEDIS) 3.0. Washington, DC. National Commission on Quality Assurance. 1996.
  12. Edington, AJHP, May-June 2001, Vol 15, No. 5, pp-341-349. Research Overview of Natural Flow
  13. ZERO TRENDS by Dee Edington, 2009, published by the Health Management Research Center – University of Michigan
  14. Loeppke, R; Edington, D; Bender, J; Reynolds, A. “The Association of Technology in a Workplace Wellness Program with Health Risk Factor Reduction” Journal of Occupational and Environmental Medicine: March, 2013; Volume 55, Number 3: pp 259–264.
  15. Devol, R et.al, 2007, An Unhealthy America: The Economic Burden of Chronic Disease. Charting a New Course to Save Lives and Increase Productivity and Economic Growth, Milken Institute
  16. Baicker, K., et.al., Workplace Wellness Programs Can Generate Savings., Health Affairs, Feb. 2010, Vol 29, No. 2. pp: 1-8
  17. ACOEM Guidance Statement, Healthy Workforce/Healthy Economy: The Role of Health, Productivity and Disability Management in Addressing the Nations’ Health Care Crisis, JOEM, 51:1, pp 114-119, January, 2009.
  18. Healthy People 2000, 2010; Amler & Dull, 1987; Breslow, 1993; McGinnis & Foege, 1993; Mokdad et al., 2004.
  19. Loeppke, et al., 2008; Wilson et al., 1996; Heaney & Goetzel, 1997; Pelletier, 1999.
  20. Edington et al., 2001; Goetzel et al., 1999
  21. Aldana SG. Financial impact of health promotion programs: A comprehensive review of the literature. Am J Health Promotion 2001;15:296-320.
  22. Loeppke R. “The Value of Health and the Power of Prevention”. Int J Workplace Health Manage. 2008; 1(2):95-108.
  23. Serxner, S., et.al., Do Employee Health Management (EHM) Programs Work? Am J Publ Health2009; 23(4):
  24.  Goetzel, R; Loeppke, R, et al. “Do Workplace Health Promotion (Wellness) Programs Work.” J Occup Environ Med. 2014; 56 (9):927-934, September, 2014.
  25. National Business Group on Health/Watson Wyatt “Staying at Work Report” 2007/2008 from Survey of 355 Large Employers
  26. Loeppke, R; Hohn, T; et.al. “Integrating Health and Safety in the Workplace: How Closely Aligning Health and Safety Strategies can Yield Measureable Benefits.” Journal of Occupational & Environmental  Medicine 2015: 57 (5): 585-597. May, 2015.