Changes in lifestyle and behavior involving exercise, stress, and tobacco use could save employers and managed care organizations money, according to a study of more than 46,000 individuals.
"Health promotion programs that address stress and other high-cost risk factors may be beneficial for employees and sponsoring employers," said co-author R. William Whitmer, President and CEO, Health Enhancement Research Organization.
Whitmer and colleagues examined the health records and health care expenditures of employees of six large companies. These individuals had participated in a health-promotion program for which data were collected on their exercise habits, alcohol and tobacco use, nutrition, weight, cholesterol, stress levels, depression, blood sugar, and blood pressure.
Study participants were categorized as at high or lower risk for each of the 10 factors. Those who fell into the high-risk group for fitness rarely exercised; high risk alcohol users had five or more drinks two or more days a week; and those at high risk from stress rated life as "quite or extremely stressful" and indicated that they weren’t effective in coping with stress.
About 25 percent, or $20 million, of the study participants’ total annual health care expenditures of $80 million were attributable to the 10 health risks. Each of these risks may be modified through lifestyle or behavior changes, and in some cases through medication, according to the study.
"These results highlight the major impact of modifiable health risks on health care costs," said Whitmer. The study findings appear in the September/October 2000 issue of the American Journal of Health Promotion.
Being at high risk for stress-related problems emerged as the costliest risk factor -- it accounted for more than $6 million, or 7.9 percent, of total expenditures. Other costly risk factors included being a current or former smoker, being overweight, and having a sedentary lifestyle.
The researchers noted their findings probably underestimate the impact of modifiable risk factors on health care expenses since they studied only a limited number of risk factors. Also, since the study participants volunteered to participate in a health promotion program, they may have been more healthy.
Future research should examine the long-term impact of health risks like high stress, excess weight, and a sedentary lifestyle on health care expenditures. Such research should also examine how changes in these risk factors affect expenditures, according to the study.
"If these costs can be affected by worksite health promotion programs or by other risk reduction interventions, the potential impact on health care costs may be substantial," Whitmer concluded.
This study was funded by the Health Enhancement Research Organization, Birmingham, Alabama, and The StayWell Company, San Bruno, California.
The American Journal of Health Promotion is a bimonthly peer-reviewed journal dedicated to the field of health promotion. For information about the journal call 248-682-0707 or visit the journal’s website at http://www.healthpromotionjournal.com .
Posted by the Center for the Advancement of Health http://www.cfah.org . For information about the Center, call Petrina Chong, pchong@cfah.org 202-387-2829.
Journal
American Journal of Health Promotion