A chronic illness is a disease state that has a prolonged course, does not resolve spontaneously, and rarely is completely cured. An estimated 99 million Americans currently live with one or more chronic illnesses. According to the CDC, chronic disease is the leading causes of death and disability in the United States, accounting for 70% of all deaths – totaling 1.7 million annually.

These diseases also cause major limitations in daily living for almost 1 out of 10 Americans, or about 25 million people. In addition, Americans who have common chronic health conditions cost the U.S. economy more than $1.3 trillion annually, a figure that could jump to nearly $6 trillion by 2050 unless individuals take steps to improve their health.

The economic impact of chronic illness goes far beyond the expense of treating disease. It takes an even greater toll on economic productivity in the form of extra sick days, reduced performance by ill workers and other losses not directly related to medical care.

Given this rapidly expanding chronic disease burden, efforts to control the expenditures, arrest or slow deterioration, and prevent disability from these illnesses will be among the paramount issues facing public health organizations for the foreseeable future.

According to a new report released by the Milken Institute, “An Unhealthy America: The Economic Burden of Chronic Disease” the eight most common diseases that afflict Americans are as follows:

• Cancer
• Heart disease
• Diabetes
• Pulmonary conditions
• Hypertension
• Mental illness
• Stroke
• Obesity

Although chronic diseases are among the most common and costly health problems, they are also among the most preventable. Adopting healthy behaviors such as eating nutritious foods, increasing physical activity, obtaining routine health screenings and avoiding tobacco use can prevent or control many of the devastating effects attributable to these diseases. Currently, however we are losing this vitally important battle. While the United States spends more on health care than any other industrialized nation, we are far from the healthiest. Only 3% of the National Institutes for Health (NIH) health care research budget is devoted to prevention. Our research and medical communities continue to overlook the tremendous potential of disease prevention in favor of costly medications, diagnostic testing and interventional procedures. We instead continue to proudly point to the past century’s advancement in medical technology, many of which have enabled better diagnosis and more effective, life-preserving treatment. These advances, however, do not come cheaply, accounting for roughly 60% of the increased cost of health care in this country.

The individual, cultural and environmental forces that prevent us from adopting and maintaining health behaviors are much greater than the forces that encourage us to be healthy. The CDC’s Behavioral Risk Factor Surveillance System estimates that Americans have more body fat, more cases of metabolic syndrome, and more diabetes than at any other time in human history. As far as other chronic conditions such as cardiovascular diseases and cancer are concerned, there are few nations in the world that have a higher prevalence than the U.S.

Chronic diseases don’t just happen; they are almost entirely the result of decades of unhealthy living. As a consequence, children, teenagers, young adults and seniors who eat a typical American diet, don’t exercise regularly and avoid preventative medical screenings are continuing to develop these chronic diseases at an alarming rate.

The Good News

Evidence indicates that with appropriate education, influence and social support, people can and will take charge of their health. We have an obligation as business and community leaders to aggressively promote programs that focus on individual responsibility and behavior change such as:

• School health programs that provide environments and instruction that promote healthy eating, daily physical activity, and the avoidance of tobacco, alcohol and illicit drugs.
• Institution of high quality, comprehensive work site wellness programs focusing on creating a “culture of wellness”.
• Better training and education of health care professionals to utilize effective prevention tools and strategies in their medical practice.
• Faith and community-based programs that bring together appropriate resources to support, encourage, and help people to engage in preventative health practices.
• Public and private health insurance programs that provide appropriate chronic disease prevention, screening and treatment services.

At the turn of the 20th century, the major causes of illness and death were infectious diseases such as pneumonia, influenza and tuberculosis. Thanks to a united effort in the development of vaccines, environmental enhancements, social improvements and technological developments, these diseases have been controlled and pose a much smaller threat to the health of our nation. This same accomplishment is possible for chronic disease states. As a nation, we have the need, the capability and the expertise to meet the unique challenges we face in this battle against the current leading causes of death, disease and disability.

Why Does Wellness Make Sense In The Worksite?

Worksite wellness is defined as an organized program in the worksite that is intended to assist employees and their family members (and/or retirees) in making voluntary behavior changes which reduce their health and injury risks, improve their health consumer skills and enhance their individual productivity and well-being.

Over the last decade, wellness programs in the workplace have begun to assume a new significance – particularly with the intense pressure to prevent large increases in annual health care costs. As a consequence, health promotion in the workplace continues to grow and spread rapidly. Roughly 80 percent of all employers with 50 or more employees now offer some form of health promotion program.

Why Should U.S. Companies Invest In Work-Site Wellness Programs?

A healthy, motivated workforce is vitally important to a company as a whole and has a significant impact on the bottom line.

Employers today have a vested interest in health-related issues and reducing unnecessary medical costs that consume corporate profits and employee paychecks. Through worksite wellness programs companies can increase productivity, lower health care costs and reduce time lost to illness or injury. Approximately 131 million adults over the age of 18 are employed in the American workforce, and another 55-65 million are linked through family relationships or retirement. This puts employers into an extremely influential role as it relates to health and wellness issues for approximately 80% of the U.S. population.

In conclusion, worksite wellness programs can provide employees with a consistent, comprehensive and powerful level of health awareness and education that they have probably not been exposed to at home, school  or even their Primary Care Provider’s office. In addition, companies have much at stake, given that they bear the responsibility to protect and nurture their greatest asset – their employees.

by Matthew McMillin,

MD, FAAFP