If trends around childhood obesity stay on their current course, for the first time in US history we may see life expectancy start to fall. There are some scary statistics on the topic:
- More than one third of children and adolescents are overweight or obese.
- Childhood obesity is now the No. 1 health concern among parents in the United States, topping drug abuse and smoking.
- More than 30% of children eat fast food on any given day.
- Overweight children miss four times as many school days as children of a healthy weight.
- Of overweight high school students, 58% of boys and 63% of girls report daily teasing, bullying, or rejection because of their size. Being the target of this kind of behavior can lead to school delinquency, self-harm, depression, and anxiety disorders.
- Many parents with overweight or obese children underestimate their child's excess weight.
The head of the CDC, Tom Frieden, has said that combating childhood obesity is one of his top priorities. As awareness of the problem has grown, we’re seeing signs that public and private efforts to improve children’s nutrition and promote physical activity are having an effect. Nationwide, there’s been a decline in obesity among very young children (ages 2-5), and some cities, like New York and Philadelphia, and even some states, like Mississippi and California, have reported improvements in obesity rates among schoolchildren in various grades.
Hoping to be part of the solution, Mercer recently formed an alliance with Kurbo Health, a Silicon Valley start-up that has created a compelling offering combining an intelligent mobile food and activity app, real-time feedback and one-on-one support from coaches. I’m excited by their ability to engage children in their health -- 88% reduce their BMI -- and even more intrigued by their ability to engage parents to lose weight as well -- 55% of parents reduce their own BMI! It’s a neat example of a positive side effect that goes beyond the initial focus of a solution.
If you’ve been less than satisfied with efforts to promote weight loss among your workers, maybe shifting the focus to improving the health of the whole family is something to consider. Meanwhile, here are a couple of interesting tidbits I turned up in my research:
- Kids who have a younger brother or sister before preschool have a lower risk of becoming obese
- Peanut butter may help prevent childhood obesity, while fish may cause it.
Ok, maybe that last one needs more research!
A scan of news headlines from the past couple of months netted articles discussing genetic links to anxiety, glaucoma, weight gain, intelligence, athletics, cancer, and smoking. It’s not unimaginable that genetics could play a role in managing every aspect of our health. The trick will be figuring out how to counterbalance genetic predisposition with behavioral changes and clinical support.
Genetic testing companies fall into different buckets, based on whether they’re focused on the past, present, or future:
- PAST: To help you determine your ancestral origins, trace your lineage and find new genetic relatives, there are tests with a genealogical focus offered by Family Tree DNA, 23andMe, and Ancestry DNA.
- PRESENT: Genetic screening is being used to determine genetic variations and personalize recommendations and coaching based on your specific needs. As an example, Newtopia tests for genetic variations affecting body fat, eating behavior, and appetite, and adapts its program based on your results.
- FUTURE: Some companies focus on DNA screenings for the important moments in your life; for example, Counsyl and Color Genomics offer tests aimed at family planning, pregnancy, and cancer screening.
With the ability to test potential parents for inheritable conditions like cystic fibrosis, or risk for diseases like Parkinson’s, genetic testing may one day become the expected standard for care delivery. In the meantime, there are still some privacy concerns. While the Genetic Information Nondiscrimindation Act (GINA) bars health insurance companies from denying coverage to those with risky gene mutations, the law doesn’t extend to life insurance companies, long-term care, or disability insurance.
Speed of testing, accuracy, financial cost, counseling support, and privacy are all factors that should be considered when evaluating services in this space. But the possibilities certainly seem to warrant discussion. Are you starting to think about these new types of services and how they might benefit your workforce?
Telehealth offers health care consumers greater convenience and the chance to save money -- but it only works if the provider speaks the patient’s language. To that end, Mercer has formed an alliance with ConsejoSano to bring telehealth services to the Spanish-speaking population. ConsejoSano provides consumers with instantaneous access to Spanish-speaking doctors, mental health specialists, and nutritionists.
Many groups have been looking at the health differences between racial, ethnic, and socioeconomic groups:
- The most recent National Healthcare Quality and Disparities Report reveals that the Hispanic population has triple the rate of uninsurance and worse access in 14 of 21 access-to-care measures.
- The CDC reports higher rates of obesity, diabetes, and hypertension in the Hispanic population.
- The U.S. Department of Health and Human Services: Office of Minority Health has stressed the importance of cultural and linguistic competency to provide respectful and responsive health services.
- According to the Census Bureau, Hispanics are the least likely racial or ethnic group to seek medical care, with 42% having not visited a provider during the past year.
On the plus side, there’s growing recognition of the importance of supporting these unique segments within our population. Interestingly, the conversations around diversity and inclusion within the workplace are starting to transform into diversity and innovation:
- The first phrase within Apple’s Diversity vision states that “Inclusion inspires innovation.”
- Merck’s Center of Talent Innovation recently reported that companies that attach a high degree of importance to diversity are demonstrably more innovative than companies with a more homogeneous workforce.
- Harvard Business Review reported on two types of diversity classifications: inherent (such as gender, ethnicity, and sexual orientation) and acquired (such as the experience of living in another country). Companies/leaders with at least three inherent and three acquired diversity traits showed 45% greater likelihood for market-share growth.
- Johnson & Johnson’s Global Head of Research & Development, Martin Fitchet, has presented on his viewpoints that diversity and innovation are inseparably linked, which dovetails with J&J’s mission to cultivate a diverse workforce and unleash innovative thinking.
Has your organization recognized that ethnic/racial health disparities exist, and thought about a response? Framing the conversation in terms of diversity and innovation might clarify the business case for action.
Employee Benefit News recently recognized 50 visionaries who are “driving technology innovation, overcoming organizational and technology barriers, deploying leading-edge technology, and shaping benefit technology regulation and policy” – including our own Dr. David Kaplan, leader of Mercer’s Innovation LABS team. More than ever before, employers are keenly interested in the latest innovations as they realize the value of creativity and forward-thinking solutions to stay competitive in this tight labor market. Mercer’s LABS team has worked with quite a few innovative companies this past year – Rethink Benefits, Kurbo Health, and ConsejoSano, to name a few – to facilitate the process of bringing their solutions to market. Innovation is more than just a buzzword, and the latest benefits and perks aren’t just for Silicon Valley start-ups. Innovation is absolutely key for any organization when it comes to talent attraction and retention; your organization’s value proposition needs to reflect the expectations and dynamics of today’s workforce and their families.
We caught up with Dr. Kaplan for a quick conversation on how innovation – in particular, technological – will change the employee benefits landscape over the next 10 years.
Dr. Kaplan: Digital technology will allow employers to offer personalized benefits that are both broader and more meaningful than the benefits offered today. Despite the huge financial commitment that employers have made in benefits, they too often go underappreciated by participants.
Us: How so?
Dr. K: The classic scenario for this underappreciation is when a specific benefit configuration does not cover an individual’s most important issue and is therefore viewed as an “inadequate” benefit program despite the “value” of the coverage. For example, if an employee has a child with autism and an employer offers nothing to support a family facing this challenge, the employee may not feel like they have “good benefits”.
Us: What’s the role of technology in addressing this problem?
Dr. K: Over the next 10 years, digital technology will make personalization of benefits possible through two mechanisms. The first is administrative simplification which allows employers to offer much more complex and flexible plans including true “flex” plans that will allow employees to choose the coverages that matter most to them. The second is digitalization which will empower the development of a much broader range of point solutions that can be offered at an attractive price point for employers and employees alike.
April is Autism Awareness month. More than 3.5 million Americans live with autism spectrum disorder, including about one in 45 children, according to a new U.S. Centers for Disease Control and Prevention survey of parents. Autism has been associated with intellectual disability, difficulties with motor coordination, sensory processing, attention, and sleep and gastrointestinal issues. Many on the autism spectrum have difficulty processing everyday sensory information and can become overwhelmed, leading to stress, anxiety, and even physical pain.
Autism can be a sensitive subject and because I haven’t had much exposure, I’ve been hesitant to write about it. But as I’ve learned more, I’ve been struck by the important implications for employers. Many autistic people are uncomfortable with person-first language (such as “person with autism”) rather than identity-first language (“autistic person”). This is because autism affects who individuals are and how they see the world; they would not be the same person without it. The same goes for “high functioning” and “low functioning” labels, as function can vary based on the type of task and even throughout the day.
As employers look to diversify and be more inclusive, we’ve seen a growing number identify positions at which people on the spectrum can excel. Advocates say that placing individuals with autism alongside other team members helps to foster creativity and project innovation. Recognizing the value of neurodiversity in the workplace prompts employers to focus attention on differences, not disabilities, and in the process discover the assets of employees with ADHD, autism spectrum disorder, dyslexia, and other brain differences. Individuals with autism tend to be good at focusing on small details rather than the big picture. Where they may struggle with interpersonal relations, they are great at working with systems. Employees with ADHD will do best in roles that involve movement, novelty, frequent changes in activity level, and creative problem-solving. Individuals with dyslexia can look for opportunities that involve visualization, out-of-the-box thinking, and intuition, rather than a lot of reading and writing.
Mercer recently announced an alliance with Rethink Benefits to provide employers and their working parent workforce with tools and resources to care for children with developmental disabilities such as autism. Rethink offers members access to a comprehensive video-based treatment program, sophisticated behavior intervention planning tools, training for caregivers, individualized assessments, online skills-based activities and access to remote, clinician-led consultation for personalized treatment guidance and care.
To learn more, please join Mercer and Rethink on April 19th, from 1:00 to 1:45 PM EST for a special Autism Awareness Month themed webinar event that asks if you doing enough to support your employees who are caring for a child with special needs. It’s hosted by Rethink’s clinical expert and Board Certified Behavior Analyst Dr. Patricia Wright and Mercer’s Dr. David Kaplan, Pediatrician, Senior Partner and leader of the Mercer Health Innovation LABS. The webinar will cover:
- How to think about childhood developmental diseases and its impact on a company
- The life-long impact on employees who are caring for a child with special needs
- De-stigmatizing care and increasing awareness
- Delivering innovative solutions to holistically supporting this growing need
Register here: http://go.rethinkfirst.com/Mercer
Mercer recently announced a strategic alliance with Progyny, in support of fertility and women’s health. I’m excited by this organization’s innovative solutions that expand access to fertility services, improve clinical quality, and reduce maternity-related costs — as well as the work we’ve done together to refine their program for employers. More broadly, I’m proud of the work that Mercer has conducted in support of gender diversity and women in the workplace. The topic is very current in American society, so I’ve compiled a number of notable items:
- The Shriver Report has called the female labor force America’s most underutilized resource.
- Woman may not reach boardroom parity for another 40 years.
- Paula Johnson spoke at TED about his and her health, specifically citing examples about how lung cancer and heart disease express themselves very differently in women versus men, yet most research studies do not differentiate between genders.
- Women are twice as likely as men to be diagnosed with clinical depression.
- Two-thirds of the five million people diagnosed with Alzheimer's disease in the US are women.
- Women who report higher levels of body shame have worse physical health than others — it’s notable that Women’s Health magazine is now retiring the term “bikini body.”
- Nearly 20 percent of American women have been raped, almost a third have been a victim of domestic violence, and three a day are killed in a domestic homicide.
- More women in the United States are dying more from pregnancy and childbirth complications now than they were a decade ago (60,000 women every year).
- One in eight couples has trouble getting pregnant or sustaining a pregnancy.
During my first year at Mercer, one thing that stood out for me is how serious the company is about supporting women in the workplace, with initiatives such as Women@Mercer and others focused on specific women’s health issues. I’ve also been pleasantly surprised by the number of internal strategy discussions in which I’ve participated as part of a male minority.
I recently had a conversation with a female coworker on the subject of women’s health. When I commented that I felt a little bit like an imposter for speaking on the subject, not being a woman, my colleague disagreed. She felt that the support of advocates who are outside of the group can be just as strong as of those from within.
And you know what? She’s right. It’s also the right approach for other constituencies, such as ethnic minorities and the LGBT community.
So that leads to my challenge for all of my male counterparts: Learn about the inequities that women in the workplace face — as you can see from the list of statistics above, it goes deeper than pay. Learn about ethnic health disparities and challenges in the LGBT community or others that you don’t count yourself a part of. If we go beyond the headlines and learn the details, perhaps we can start improving some of those statistics.
After the events in Paris and Beirut last week, every one of your screens – from TVs to tablets, phones to laptops – was probably like mine, filled with stories and images of tragedy and human loss. For better or worse, the speed and connectedness of our social world allow us to feel and experience events throughout the globe, via tweets, timelines and newsfeeds, all updating around the clock. As we process and digest the events, we’re asked to try to continue normal daily life in our homes, our workplaces, and our communities.
Tara Haelle wrote a nice piece for Forbes, talking about the effects of disaster news fatigue and pointing to examples from the Oklahoma City bombing, Hurricane Katrina, September 11th, and the Boston Marathon. She also addresses the importance of knowing how to speak to children about these events, and the images they may be witnessing for the very first time in their lives. And Carol Harnett discusses appropriate employee communications in HRE Online.
Much of health care innovation has been focused on physical health, but we’re seeing a number of interesting trends and developments within the emotional health space:
- A new behavioral health start-up called Lyra Health (launched by former Facebook CFO David Ebersman), focused on helping those with depression, anxiety, or substance abuse issues.
- Wearables like Spire, which analyze breathing rates to determine levels of tension, calm, or focus.
- New technology companies like Lantern, Calm, and Cope, all aiming to increase access and digitize therapies for emotional health.
- Virtual reality therapy to help treat anxiety, phobia, addiction, and PTSD.
And Alphabet, the parent company of Google, has hired the former Director of the National Institute of Mental Health (NIMH), Thomas Insel, for its Life Sciences group. We’ll be interested to see where that leads.
We’re hearing more companies speaking out about holistic wellbeing, which includes physical, mental, and financial aspects. As you think about the dynamic world around us, do you think that social attitudes and stigmas towards emotional health are changing? Are we more receptive to therapy, resiliency, mindfulness, and meditation? Do you see regular practice of these activities within the workplace? Please leave a comment with your thoughts.
I recently painted this piece in celebration of the changing seasons -- with 75 spray-painted leaves! It made me reflect how the health care world is undergoing a season of change as well. Here are a few of the recent developments:
- Healthcare.gov reopened this week, with some improvements, to kick off open enrollment.
- Ten nonprofit health insurer co-ops (consumer-operated and -oriented plans), out of the 23 originally established by the ACA, have closed this year due to weak balance sheets.
- The annual Top 50 in Digital Health survey just opened, querying public perceptions around the fastest-growing start-ups, disruptive founders, inventions of the year, and thought leaders, among other categories.
- The presidential political climate renewing debate focused on several options for the evolution of health care reform: single payer (Sanders), repeal and replace (Republicans) and refinement of the status quo (Clinton).
- Wearable tech and emerging smart home electronics -- both with health-care-related sub-segments -- are expected to be big sellers this holiday season.
- 224 data breaches involving 500 or more individuals were reported this year, as required, to the Department of Health and Human Services’ Office for Civil Rights.
- We’re seeing significant M&A activity among payers (Aetna/Humana, Anthem/Cigna), consumer brands (Walgreens/Rite-Aid, CVS/Target Pharmacy) and health systems (70 this year so far), as well as sizable funding for new entrants into the marketplace like Collective Health and Oscar Health.
That’s quite a long list of health care activity that’s of interest to me -- and I’m sure I’ve left out some things that are relevant to you. As you read through this list and think about the season of change that we’re undergoing, what stands out? Or what would you add?