December 2016

In an article that appeared in the December 2016 Journal of Occupational and Environmental Medicine authored by Dr. Caretto and others entitled “Association Between Exercise Frequency and Health Care Costs Among Employees at a Large University and Academic Medical Center”, the research clearly shows a strong association between the level of physical activity and medical/pharmacy costs. Bottom line is that individuals that complete at least 30-minutes of aerobic exercise 4-5 times per week have the lowest medical and pharmacy costs. They are healthier individuals.

Individuals with a Body Mass Index (BMI) of 35 or more had the greatest costs associated with medical and pharmacy claims. However, if an obese person exercises 4-5 times per week, they have lower medical/pharmacy costs compared to other obese individuals within the same obese category. Individuals with Body Mass Indexes less than 30 had the lowest medical and pharmacy costs. Individuals across all Body Mass Index groups who exercised 0-1 time per week had the highest medical/pharmacy costs.

Why is this important to know? In a recent blog, I wrote about the first increase in the annual deaths due to heart disease and stroke in 2015 since 1969. The research mentioned above speaks to the issue of obesity as a co-morbidity as well as physical inactivity and the impact of these two factors on increasing the risk for heart disease, cerebrovascular disease, diabetes and hypertension. There is also a strong association with obesity/physical inactivity with risk for injury.

Within the research article stated above, the critical factor resulting in higher medical/pharmacy costs and therefore poorer health was physical inactivity. Ironically, as a country, we are moving the wrong direction- more sedentary activity than physical activity. This will only lead to more deaths, healthcare and workers’ compensation costs until the time comes when physical activity is put back into our daily routines.

It is difficult for industry to provide activity sessions in the workplace. Perhaps the best action that industry can take is to offer incentives built into the employees’ health plan to become more physically active. Legally, offer lower deductibles for those who are more physically active as supported by healthier biometric measures including physical strength.

IPCS is working with several clients who have done this and they are now realizing significant savings in medical, pharmacy and workers’ compensation costs.

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Some disturbing news was released by the Centers For Disease Control and Prevention (CDC) and reported in the Wall Street Journal, December 8, 2016, showing that deaths caused by heart disease in the U.S. increased by 0.9% in 2015 and death by stroke increased 3%. This is the first increase since 1969.  These two statistics also resulted in the first time in many years a decrease by one-tenth of a percentage point in life expectancy.

It appears that obesity and diabetes are the two main contributing factors to the increase in death due to heart disease. As we become more automated both at work and at home, the level of physical activity each American has each day diminishes unless a deliberate effort is made to remain physically active.  The largest organ in the body is muscle and muscle is made to work.  Sedentary lifestyles (low levels of physical activity) increases risk for diabetes, obesity and loss of muscular strength.  The heart too is a muscle and it too responds favorably to physical activity.

The IPCS database shows that obesity (as measured by a Body Mass Index – BMI – of 30 or more) over the past 3-years has leveled off at 41% of each year’s pool of new hire applicants. However, the bad news is that the IPCS data shows that the obese are becoming more obese.  Since 2006 through 2015, the percentage of morbid (BMI 40-49.9) and extreme morbid (BMI 50 and more) increased from 4.6% to 7.6% which, statistically, is a 65% increase.

The IPCS data also shows that the new hire applicant from 2006 to 2015 weighs 13 pounds more, has 18% less absolute shoulder strength and 23% less absolute knee strength. This puts the applicant at greater risk for injury and disease.  There is a number of research studies that clearly shows low muscular strength can increase the risk for the Metabolic Syndrome, Diabetes and Cardiovascular Disease.

I have stated this many times – fifty years of research by the American College of Sports Medicine clearly show that physically active individuals are healthier individuals. Maintaining a strong and healthy muscle mass is critical to good health.  The IPCS PCE is a good tool to measure muscular strength as it relates to disease and safety.