Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study (original) (raw)
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Population Health Management, 2010
''Optimal lifestyle,'' comprising abstinence from smoking, adequate physical activity, eating 5 servings of fruits and vegetables each day, and consuming limited or no alcohol, is associated with low risk of chronic disease when unselected populations are observed for long periods of time. It is unclear whether these same associations are present when observation is limited to employed individuals followed for a brief period of time. The purpose of this investigation was to study the association between adherence to optimal lifestyle and the incidence of chronic conditions among employees over a 2-year period. Logistic regression was used to assess the association between employees' (N ¼ 6848) adherence to optimal lifestyle and the incidence of diabetes, heart disease, cancer, hypertension, high cholesterol, and back pain during a 2-year period. All data were self-reported. Adherence to any 3 components of the optimal lifestyle was associated with a significantly lower near-term incidence of diabetes (odds ratio [OR] ¼ 0.56; 95% confidence interval [CI] ¼ 0.31-0.97) and back pain (OR ¼ 0.69; 95% CI ¼ 0.53-0.92). Adherence to all 4 optimal lifestyle components was significantly associated with lower near-term incidence of back pain (OR ¼ 0.44; 95% CI ¼ 0.26-0.76). Physical activity was associated with significantly lower near-term incidence risk of heart disease (OR ¼ 0.60; 95% CI ¼ 0.38-0.95), high cholesterol (OR ¼ 0.80; 95% CI ¼ 0.66-0.99), and diabetes (OR ¼ 0.51; 95% CI ¼ 0.30-0.86). Adherence to optimal lifestyle, in particular adequate physical activity, is associated with lower near-term risk of developing several chronic conditions. Employers and payers should consider this fact when formulating policy or allocating resources for health care and health promotion.
Journal of Occupational and Environmental Medicine, 2014
Objective: To examine employees' self-reported physical activity and metabolic syndrome (MetS) risks and their association with health-related workplace outcomes. Methods: Employees participated in a health risk appraisal in 2010. Generalized Linear Modeling was used to test the association between MetS risk factors, physical activity, and the outcome measures while controlling for confounders. Results: MetS was found in 30.2% of employees. Health care costs for employees with MetS who reported sufficient exercise (150 or more minutes/week) totaled 2770comparedwith2770 compared with 2770comparedwith3855 for nonsufficient exercisers. The percentage of employees with MetS who had absenteeism and presenteeism was also significantly lower for employees achieving sufficient physical activity. All risk factors for MetS were mitigated for regular exercisers. Conclusions: Employers should consider programs and services to support regular aerobic exercise to address the growing prevalence and costs of MetS in the workforce.
Building Healthy Academic Communities Journal, 2021
Background: Cardiovascular disease (CVD) is the number one cause of death in the United States with risk factors including hypertension, hyperlipidemia, diabetes, obesity, smoking, physical inactivity, age, genetics, and unhealthy diets. A university-based workplace wellness program (WWP) consisting of an annual biometric screening assessment with targeted, individualized health coaching was implemented in an effort to reduce these risk factors while encouraging and nurturing ideal cardiovascular health.Objective: The purpose of this study was to examine and describe the prevalence of single and combined, or multiple, CVD risk factors within a workplace wellness dataset.Methods: Cluster analysis was used to determine CVD risk factors within biometric screening data (BMI, waist circumference, LDL, total cholesterol, HDL, triglycerides, blood glucose age, ethnicity, and gender) collected during WWP interventions.Results: The cluster analysis provided visualizations of the distribution...
Clustering of lifestyle risk factors in employees: A quasi-experimental study in Sousse, Tunisia
Medical Research Archives, 2017
Background: A better understanding of the prevalence and clustering patterns of multiple lifestyle-related health factors may support efforts to handle efficiently chronic diseases, reduce their incidence and improve overall health outcomes. This study aimed to evaluate the effectiveness of a three-year based intervention in the workplace on clustering of non-communicable diseases' risk factors. Methods: We based our study on a quasi-experimental intervention study (pre and post assessments with intervention and control groups) between 2010 and 2014 in two districts in the governorate of Sousse. The evaluation before and after the intervention focused on the attitudes and behaviors of participants. The intervention program team conducted several actions for the employees at the workplace focusing on physical activity, healthy diet promotion and smoking cessation. Results: In the intervention group, participants who had no risk factor increased significantly from 5.9% to 10.3% (p<0.001) but not significantly in the control group from 9.5% to 12.5 (p=0.064). Those who had only one risk factor increased significantly from 24.8% to 29.2% (p=0.03) in the intervention group but decreased in the control group from 32.2% to 28.8% (p=0.14). Furthermore, the proportion of employees who had 4 risk factors increased in the control group significantly, from 3.3% to 6.8% (p<10-3). Conclusion: The positive co-variation represents one novel approach in which effective action on one handled behavior increases the odds of effective change on a second targeted behavior. Hence, the concept of intervening simultaneously on multiple risk behaviors might be a focus of attention as a means of preventing chronic diseases.
BMC Public Health
Background Identify and compare health risk indicators for common chronic diseases between different occupational groups. Methods A total of 72,855 participants (41% women) participating in an occupational health service screening in 2014–2019 were included. Occupation was defined by the Swedish Standard Classification of Occupation, and divided into nine major and additionally eight sub-major groups. These were analysed separately, as white- and blue-collar occupations and as low- and high-skilled occupations. Seven health risk indicators were self-reported: exercise, physical work situation, sitting at work and leisure, smoking, diet, and perceived health, whereas cardiorespiratory fitness, BMI and blood pressure were measured. These were further dichotomized (yes/no) and as clustering of risk indicators (≥3 vs. <3). Results The greatest variation in OR across sub-major and major occupational groups were seen for daily smoking (OR = 0.68 to OR = 5.12), physically demanding work...
BMC Public Health, 2011
Background: Workplace health programs have demonstrated improvements in a number of risk factors for chronic disease. However, there has been little investigation of participant characteristics that may be associated with change in risk factors during such programs. The aim of this paper is to identify participant characteristics associated with improved waist circumference (WC) following participation in a four-month, pedometer-based, physical activity, workplace health program. Methods: 762 adults employed in primarily sedentary occupations and voluntarily enrolled in a four-month workplace program aimed at increasing physical activity were recruited from ten Australian worksites in 2008. Seventy-nine percent returned at the end of the health program. Data included demographic, behavioural, anthropometric and biomedical measurements. WC change (before versus after) was assessed by multivariable linear and logistic regression analyses. Seven groupings of potential associated variables from baseline were sequentially added to build progressively larger regression models. Results: Greater improvement in WC during the program was associated with having completed tertiary education, consuming two or less standard alcoholic beverages in one occasion in the twelve months prior to baseline, undertaking less baseline weekend sitting time and lower baseline total cholesterol. A greater WC at baseline was strongly associated with a greater improvement in WC. A sub-analysis in participants with a 'high-risk' baseline WC revealed that younger age, enrolling for reasons other than appearance, undertaking less weekend sitting time at baseline, eating two or more pieces of fruit per day at baseline, higher baseline physical functioning and lower baseline body mass index were associated with greater odds of moving to 'low risk' WC at the end of the program.
Bangkok Medical Journal, 2021
OBJECTIVES: To assess physical activity at work of hospital employees in order to identify association between physical activity at work and risks for cardiovasculardiseases MATERIAL AND METHODS: From 3,383 employees of a private hospital in Thailand in 2017, 12 percent were randomly selected based on a ten percent sample size with two percent compensation to represent eight strata of job types. After screening and exclusion, 301 subjects remained in the study. Each subject was asked to fill in the International Physical Activity Questionnaire (IPAQ) and was assessed for body fat composition using an Inbody Bio-electric Impedance Analysis (BIA) R20 model at the initiation. Each subject was equipped with an activity tracker device “Feelfit” for five days during work hours to estimate Metabolic Equivalent of Task (MET) and MET minutes per person per work week. Relevant laboratory data were extracted from annual health checkup database for the assessment of cardiovascular risk factors. Statistical analysis was conducted using STATA version 15. RESULT: The majority (85.4%) of 301 subjects were female and a little more than half (53.5%) were older than 35 years. Data from Feelfit showed 257/301 (85.4%) employees had sufficient (i.e. 600 or more MET minutes per week) physical activity (PA) at work. Operational or clinical employees were 9.8 times more likely to have adequate PA (OR 9.8, 95%CI 4.3 to 22.4). Associations between adequate PA and Body Mass Index (BMI) and waist circumference were in a different direction. Subjects with high BMI (>23 Kg/sq.m.) were more likely to have adequate PA at work (OR 3.3, 95%CI 1.0, 10.5), while those with abnormal waist circumference were less likely to have adequate PA at work (OR 0.8, 95% CI 0.2, 2.5). Around one-third of our subjects had “normal BMI obesity”, i.e. 54 (34.6%) of 156 normal BMI subjects had high body fat composition. Laboratory findings were inconclusive to demonstrate an association with adequate PA. CONCLUSION:Although most hospital employees had adequate physical activity at work, one-third of subjects still had high fat composition regardless of normal BMI. Back office subjects were almost ten times less likely to have sufficient PA at work, suggesting urgent interventions for them. Relationship between impulsivity and PA was inconclusive, suggesting a larger study with greater sample size.
Journal of osteopathic medicine, 2017
Context: The burden of cardiovascular disease (CVD) continues to be a public health concern. Workplace interventions that focus on modifying lifestyle habits may reduce CVD risk factors in people at risk. Objective: To determine the effectiveness of a comprehensive lifestyle intervention program that integrated dietary modification, physical activity, stress management, and behavior modification counseling to reduce the risk of CVD in at-risk adults. Methods: Twelve 1-year cohorts who participated in a comprehensive employersponsored lifestyle intervention program targeting diet, exercise, behavior modification, and stress management between 2006 and 2010 at a rural university in Appalachian Ohio were studied. Body composition, fasting glucose and lipid levels, and maximal oxygen consumption were measured at baseline, after 100 days, and at 1 year. Repeated-measures analyses of variance were conducted to compare measures at baseline with measures at 100 days and at 1 year. Results: Seventy-four participants (57 women [77.1%], 17 men [22.9%]) of 97 completed the program (76.3% completion rate). Body weight (P<.001); percentage of body fat (P<.001); fat mass (P<.001); body mass index (P<.001); waist circumference (P<.001); blood levels of high-density lipoprotein (P=.035), low-density lipoprotein (P=.011), and glucose (P=.008); serum triglyceride levels (P=.019); blood pressure (systolic P=.028; diastolic, P=.001); and maximal oxygen consumption (P<.001) improved from baseline to 1 year after the intervention. Lean body mass (P=.111) and total cholesterol (P=.053) did not improve. Conclusions: This employer-based lifestyle intervention program was effective in reducing CVD risk factors after 1 year of treatment. Future studies should examine the effects of the intervention at 2 and 5 years to further assess long-term adoption of the lifestyle changes and maintenance of health promoted by this program.
Impact of a pedometer-based workplace health program on cardiovascular and diabetes risk profile
Preventive Medicine, 2011
Objective: To assess the prevalence of risk factors and risk for cardiovascular disease and Type 2 diabetes in employees with sedentary occupations enrolled in a workplace health-promotion program. Methods: Participants (n = 762) were recruited from ten Melbourne workplaces, participating in a physical activity program. Demographic, behavioral, biomedical, and physical measurements were collected. Results: The majority of employees were not meeting recommended guidelines for physical activity (62%), fruit intake (70%), vegetable intake (86%), body mass index (58%), or waist circumference (53%). Most had intermediate (53%) or high (7%) risk of developing Type 2 diabetes. Conclusions: The majority of Australian adults in sedentary occupations were not meeting guidelines for a number of chronic disease risk factors and a substantial proportion were unaware of their increased risk. This study supports the potential of chronic disease risk factor detection and intervention programs in the workplace.