Lessons from the US on workplace health promotion and disease prevention
Why workplace health is essential to the UK's future
I caught up with Dr Ronald Loeppke, Vice Chairman Emeritus of U.S. Preventive Medicine and former president of the American College of Occupational and Environmental Medicine. Dr Loeppke has provided testimony and numerous presentations to Presidential Task Forces at the White House and Congressional committees on Capitol Hill. He is also currently an advisor to the World Health Organization (WHO) Health and the World of Work initiative. He has just published a comprehensive guide to Health and Productivity Enhancement (see chapter 16 here). We discussed what the UK could learn from the USA on how to leverage the workplace for health promotion and disease prevention.
Medicine is too often reactive rather than proactive. Dr Ronald Loeppke saw the impact of this on his patients in his family medicine practice, who generally presented late down the line with established comorbidities. He began to think about how best to leverage incentives for health promotion and disease prevention. While policy makers recognised this as key in pivoting away from a sickness service and building a health service, they were stretched and forced to use resources on fighting fires not investing in the future.
Dr Loeppke saw that stakeholder buy in centred around seeing rapid return on investment. That’s why he turned to the workplace as the environment in which to catalyse change. Employers are significant stakeholders in the health of their own workforce because employee ill health impacts the business bottom line. This is true regardless of whether or not employers have a role in healthcare provision for their staff. Health related productivity costs are typically 2-3x direct medical costs. This means all employers are significantly invested in the health of their workforce, regardless of whether or not health insurance is part of compensation packages.
Dr Loeppke worked with U.S. Preventive Medicine to achieve population health management via corporate wellness. Using the aligned incentives of employers and employees when it comes to workforce health has been a powerful route to effective health promotion and disease prevention. Employers receive return on investment by way of human capital and the engagement and performance of their workforce. USPM has generated an evidence base demonstrating value of investment of workforce health programmes when it comes to reducing health risks, healthcare utilisation and the costs that follow. This has involved developing measures of value-based health programme design that generate high quality data that has weight in the boardroom as well as in the doctor’s office.
Lara’s take
The state of the NHS and the health of the working age population in the UK means the translatable learning from USPM goes beyond health promotion and disease prevention, to addressing wider socioeconomic issues we are facing.
We must learn from engaged US employers on leveraging the workplace as a route to health promotion and disease prevention. Evidence shows that health related productivity costs are much more significant than direct medical costs, which means there will be a return on investment for UK employers regardless of whether or not they offer health insurance to their staff.
What’s more, in the UK we are in desperate need of healthcare solutions working in complement to the NHS. The clock is ticking as population health projections indicate an upcoming imbalance between those able to contribute to government revenues through income and those in need of government health and welfare support.
Rising rates of economic inactivity due to ill health have been worse in the UK than other G7 economies. Workforce health solutions will be particularly powerful in delivering place-based interventions, supporting people to stay well enough to work, improving retention and bolstering the labour market.