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SpecialtyHealthOBESITY IN THE WORKPLACE

HEALTH CARE U.S.A.

Why Does the U.S. Spend More / PersonAnnually on Healthcare Than Any Other Nation? 9,523SwitzerlandNetherlandsU.S. POPULATION 321 MILLION2017 5,144 4,914 10,000

Healthcare Cost In AmericaPreventable Illness Makes Up 90%of the Healthcare Cost in the U.S.PreventDisease.com 1999-2016 All Rights Reserved All Content on this site may be copied.

“Budget busting U.S. Obesity CostClimb Past the 300 Billion!”New Lifetime Estimate of Obesity Costs: 92,235 Per PersonIn Additional Healthcare Cost(http://www.thefiscaltimes.com/Articles 2014/06/19Budget

The Problem Affecting 72% of our Population !The Whole Is Greater Than The Sum of Its Parts!Obesity In the America is NOTcaused by Gluttony; Lack ofWillpower, or a Bad Childhood!

The Health of AmericaOverweight / Obese72%Extremely Obese35%Insulin Resistance40%Pre-diabetic37%Diabetic10% - 15%)10%0%10%20%30%40%50%60%70%80%

How Many Million?DESCRIPTIONOverweight / ObeseExtremely ObeseType 2 Diabetes (DM2)Insulin Resistance / PreDiabeticObese ChildrenPOPULATION177.4 Million Adults86.2 Million Adults32 Million Adults / Children128.0 Million Adults /Children17.6 Million Children

OBESITY IN U.S.

Packing on the PoundsHistory of Obesity in U.S 986-19901991-199533%10%0%72% overweight / obese1996-20002001-20062006-2016

Who’s to BlameHigh Costs & Obesity EpidemicFood IndustryTo o M u c h S u g a rBeverage Sugar DrinksBig PharmaFa s t F o o d I n d u s t r yGovernment

The Food Controversy

CAUSE & EFFECTDM2 is at Epidemic Levels!Pre-diabetes / Insulin Resistance Convert toDM2 5-20 X HigherThan Those Without Insulin Resistance!

Insulin Resistance / Pre-diabetes

Extreme hungerFatigueBellyFat&FattyLiverFat StorageB e l l y F a t i s To x i cSecreting substances causingchronicinflammationCarbohydratesINSULINR E S I S TA N C EInsulinReleased(fatregulator)Blood Sugar Goes UP

Calculating % fatBody Mass Index (BMI)Normal 24.9Overweight 25 to 29.9Obese30 – 39.9Ext. Obese 40 plusWaist MeasurementHigh Metabolic RiskWomen 35 inches or moreMen40 inches or more

Remember These Things!D M 1 – To o L i tt l e I n s u l i nD M 2 – To o M u c h I n s u l i nInsulin ResistanceChronic InflammationBelly Fat sends out toxic substancesInsatiable hungerHeart DiseaseHigh Blood PressureOsteoarthritisDegenerative Joint DiseaseAnd many other chronic diseases

Osteoarthritis,inflammation, DJD

Obesity in theWork Place

OBESITY IN THE WORKPLACEProblems with Obesity: workplace impactObese workers have 30% to 50% more chronic healthissues than heavy smokers or heavy drinkers. Excessive Lost Work Days due to sick days, doctor visits and longterm absences due to disease treatment and work injuries.File more workers’ compensation claims,Higher medical and indemnity cost / claimHigher TTD due to delayed recovery from a work place injuryHR and Employers Law News, July 18, 2012 Problems with Obesity in the Workplace.

Wo r k P l a c e I n j u r i e sFACT SHEETOve r we ig ht / o b e se wo rke rs f ile mo re c la ims a c co rd in g to a D u keU n i v e r s i t y s t u d y. O b e s e w o r k e r s f i l e 1 1 . 6 5 c l a i m s / 1 0 0 m o r e c l a i m scompared to normal weight workers who file 5.8 / 100Health Risks associated with obesity are numerous and costly toe m p l o y e r s ; i n c r e a s e m e d i c a l a n d d i s a b i l i t y c o s t , l o s t p r o d u c t i v i t y,absenteeism!Each overweight employee can cost an employers 17,000 a year inextra absences, healthcare expense and presenteeism (too tired towork effectively)A 5% to 10% weight loss can significantly decrease medical benefitcosts.

Employer Costs Continue to Rise 250 Billion, Cost due to overweight /obese workers! 183 Billion in Lost Productivity 67 Billion in Medical Cost associatedwith workplace injuriesPosted January 2013 by Paul Leigh; Working Economics Blog

Case Study : slip and fall – knee injuryTw o C a s e s ; b o t h s l i p a n d f a l l i n j u r y t o k n e e ; b o t h r e c e i v e d a narthroscopy; Case #1 Closed; Case #2 Open still on TTD; casesubject to a PPDCase Study 80,000 67,707 60,000 40,000 20,000 34,231BMI 35BMI 26 0Case #1Incurred CostCase #2

O b e s i t y a n d J o i n t P a i n Fa c t sMost prevalent in Working populatio n40-60 years of age!!!! Obesity contributes to increased complaints of pain due to osteoarthritisrelated to insulin resistance (IR) Pain is also related to increased loading on weight baring joints due to theincrease weight ( obesity) An obese person is 6 X more likely to have Osteoarthritis; for every 8#increase in weight there is a 40% increase in osteoarthritis of the weightbearing joints (ankles, knees, hips, SI joint (lumbar spine)

Case Study : Lifting Injury to ShoulderTw o C a s e s ; b o t h L i f t i n g i n j u r y t o s h o u l d e r ; b o t h r e c e i v e d a narthroscopy; Case #1 Open 10 months; working LD; Case #2Open 7-months still on TTD 16,747; both cases still open!Case Study 200,000 148,866 150,000 100,000 50,000BMI 36 61,855BMI 28 0Case #1Incurred CostCase #2

DM2 increase 41% over 5 - yearsAn estimated 350 Billion Annually 245 Billion Dollars on Direct Care(Hospital 43%, Diabetic Supplies 12%,RX for Complications 18%) 101 Billion spent on Reduced ProductivitySide Note: Uninsured DM2 patients have a 55% increase in Emergency Room VisitsNote; estimated based on 2012 statistics (2012) 245 Billion

Type 2 Diabetes 600,000 500,00041% in 5 years!Workers’ compensation COST(3) DIABETIC CASES 484,160 400,000 300,000 200,000 100,000 0 82,000 97,397BMI 40BMI 38#1#2BMII 34#3

S P I N E C A R E I N U. S . 2 . 2 Tr i l l i o n D o l l a rsPain related to metabolic factors (IR) (inflammation) plusincreased loading on facet joints due to obesity

Case Study; Lumbar Strain: Cost 97,391Male, Age 40; BACK STRAINChief complaint: Back Pain due to slip and fallHistory of DM2 with an A1C – 12 (normal range is 5 -6)BMI 38 (obese)Failed conservative care; claim open 1 year complains ofback painC o s t a s o f To d a y ; 9 7 , 3 9 1 ; w a i t i n g b a c k s u r g e r yOff work waiting for blood sugar control before surgeryL4-L5L5-S1

CASE STUDYHEART / LUNG CLAIM 1.8 MillionM a l e . A ge 5 0 , P u b l i c S a fet y O ff i c e r H EA RT AT TAC KBMI 30.6BP 122/90N o n - s m o ke rC h o l e ste ro l 1 9 8 ( n o r m a l )B l o o d S u ga r 1 0 0 ( P re - d i a b et i c )I n s u l i n Re s i sta n c e S co re 7 . 1 ( 3 . 0 n o r m a l )M eta b o l i c Sy n d ro m e ( 5 ) m a r ke rs

Case Study - Before50

Case Study – Results.Case Study

O u r F u t u r e Wo r ke r s o f A m e r i c 2012/04/SugarChart3-1024x773.jpg

Future Workers of AmericaChildren are 23% of the U.S. Population24.3 Million children (1 out of 3) are overweight or obese14.6 (Million(1 out of 6) are excessively obese12.9 Million children Poverty42.3 Million children low income familiesPoverty and Low Income families are at increase risk forobesityNevada has the highest rate of uninsured children 14.9%P opulation in U.S.; Children 73,620,779 (23%); insulin resistance and DM2 more prevalent in low income children

WHAT IS THE ANSWER?HumanResources /EmployeeBenefitsWo r ke rs ’Compensation /Wo r k p l a c e S a fet y

We l l n e s s A n d P r e v e n t i o n P r o g r a m sWORKI NG TOGETHERHuman Resources / Benefits with OccupationalH e a l t h a n d S a f e t y W o r k i n g To g e t h e r !

THANK YOU!

Overweight / obese workers file more claims according to a Duke University study. . employers; increase medical and disability cost, lost productivity, absenteeism! Each overweight employee can cost an employers 17,000 a year in extra absences, healthcare expense and presenteeism (too tired to . (Hospital 43%, Diabetic Supplies 12%, RX for .