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Research & Evidence
The high prevalence of overweight and obesity in the United States will continue to contribute to increases in health consequences related to obesity, including cancer. Nonetheless, cancer is not inevitable; it is possible that many cancers related to overweight and obesity could be prevented...
Excessive Weight Gain, Obesity, and Cancer
Fabius, Raymod, MD; R. Dixon Thayer, BA, Doris L. Konicki, MHS, Charles M. Yarborough, MD, Kent W. Peterson, MD; Fikry Isaac, MD; Ronald R. Loeppke, MD, MPH; Barry S. Eisenberg, MA; and Marianne Dreger, MA. "The Link Between Workforce Health and Safety and the Health of the Bottom Line: Tracking Market Performance of Companies That Nurture a “Culture of Health”." Journal of Occupational and Environmental Medicine, September 9, 2013.
A growing body of evidence supports the concept that focusing on the health and safety of a workforce is good business. Engaging in a comprehensive effort to promote wellness, reduce the health risks of a workforce, and mitigate the complications of chronic illness within these populations can produce remarkable effects on health care costs, productivity, and performance. The literature is replete with examples demonstrating that the health of employees impacts their performance and productivity. In addition, for the majority of the employers who pay for the cost of health care provided to their employees, there is a direct impact on the bottom line.
Henke, Rachel, PhD; Ron Z. Goetzel, PhD; Janice McHugh;Deborah Gorhan; Malinda Reynolds; Jaclyn Davenport; Kate Rasmussen; and Fikry Isaac, MD. "Employers' Role in Cancer Prevention and Treatment—Developing Success Metrics for Use by the CEO Roundtable on Cancer." Population Health Management, August 13, 2013.
As evidence accumulates on the risk factors for cancer, it is becoming clearer that employers can play a significant role in the fight against the disease by creating a workplace conducive to lowering health risks. The CEO Roundtable on Cancer’s CEO Cancer Gold Standard Program defines what companies can do to prevent cancer, detect it early, and ensure access to the best available treatments for those who are afflicted with the disease. This article describes how Johnson & Johnson incorporated the Cancer Gold Standard Program into its existing health promotion initiatives.
Goetzel, Ron. "Structuring Legal, Ethical, And Practical Workplace Health Incentives: A Reply to Horwitz, Kelly, And DiNardo." Health Affairs | Blog, April 23, 2013.
This commentary is in response to the March 5, 2013 Health Affairs article, "Wellness Incentives in the Workplace: Cost Savings through Cost Shifting to Unhealthy Lifestyles." In that article, Jill Horwitz and coauthors express concerns about new rules governing workplace health promotion (wellness) programs due to take effect in 2014 as part of the Patient Protection and Affordable Care Act of 2011, Public Law 111-148 (“ACA”).
In this post, I explain how well-designed wellness programs can benefit both employers and employees, and I offer some suggestions to ensure that such programs are both effective and fair.
Lee, Joseph G L, Leah M Ranney, Adam O Goldstein. "Cigarette butts near building entrances: what is the impact of smoke-free college campus policies?." BMJ Journals, February 15, 2013.
Background Indoor and outdoor tobacco-free campus policies for schools, hospitals and universities are increasingly being adopted. Yet, little direct evidence exists on the impact of tobacco-free campuses on tobacco outcomes.
Objectives To identify differences in cigarettes smoked at main campus building entrances by campus policy strength.
Methods Researchers collected cigarette butts (n=3427) at main building entrances (n=67) at baseline and follow-up on 19 community college campuses stratified by strength of campus outdoor tobacco policy (none, perimeter/designated area, 100% tobacco free). Outcome measures included the number of butts per day at building entrances averaged to create a campus score. Analysis of variance techniques examined differences in scores by the strength of campuses' outdoor tobacco policy.
Results One hundred per cent tobacco-free community college campuses had significantly fewer cigarette butts at doors than campuses with no outdoor restrictions. Butts on community college campuses with partial policies were not statistically different from campuses with no policy or campuses with a 100% tobacco-free policy but indicated that a dose–response relationship may exist.
Conclusions This study provides some of the first evidence on the impact of 100% tobacco-free outdoor policies on college campuses using an objective and reproducible measure. Such policies likely provide a more healthful environment for students, staff, faculty and visitors.
"The Role of Obesity in Cancer Survival and Recurrence - Workshop Summary." Institute of Medicine, April 1, 2012.
Recent research suggests that obesity and excess weight can play a prominent role in the incidence and progression of various cancers.
"Preventing Tobacco Use among Youth and Young Adults: A Report of the Surgeon General." US Department of Health and Human Services, 2012.
Tobacco is the leading cause of preventable and premature death, killing an estimated 443,000 Americans each year. Cigarette smoking costs the nation $96 billion in direct medical costs and $97 billion in lost productivity annually. In addition to the billions in medical costs and lost productivity, tobacco is enacting a heavy toll on young people.
Each day in the United States, over 3,800 young people under 18 years of age smoke their first cigarette, and over 1,000 youth under age 18 become daily cigarette smokers. The vast majority of Americans who begin daily smoking during adolescence are addicted to nicotine by young adulthood. Despite the well-known health risks, youth and adult smoking rates that had been dropping for many years have stalled. When this Administration took office, we decided that if these numbers were not changing, we had to do something. We accelerated our efforts to fight tobacco by helping Americans stop smoking and protecting young people from starting to smoke.
"Position Statement on Tobacco on College and University Campuses." American College Health Association, November 2011.
The American College Health Association (ACHA) acknowledges and supports the findings of the Surgeon General that tobacco use in any form, active and/or passive, is a significant health hazard...ACHA joins with other professional health associations in promoting tobacco-free environments.
Smith Carls,Ginger, PhD, Ron Z. Goetzel, PhD, Rachel Mosher Henke, PhD, Jennifer Bruno, BS, Fikry Isaac, MD, and Janice McHugh, DBA, RN, COHN-S. "The Impact of Weight Gain or Loss on Health Care Costs for Employees at the Johnson & Johnson Family of Companies." Journal of Occupational and Environmental Medicine, January 2011.
Objective: To quantify the impact of weight gain or weight loss on health care costs.
Conclusions: Preventing weight gain through effective employee health promotion programs is likely to result in cost savings for employers.
Berry, Leonard L.; Ann M. Mirabito and William B. Baun. "What’s The Hard Return on Employee Wellness Programs?." Harvard Business Review, December 1, 2010.
The ROI data will surprise you, and the softer evidence may inspire you.
Steven A. Schroeder, M.D. and Kenneth E. Warder, PhD. "Don’t Forget Tobacco." New England Journal of Medicine, July 15, 2010.
At a time when all eyes are focused on health care reform, escalating medical costs, and childhood obesity, cigarette smoking remains by far the most common cause of preventable death and disability in the United States.
Katherine Baicker, David Cutler, and Zirui Song. "Workplace Wellness Programs Can Generate Savings." Health Affairs, February 1, 2010.
Amid soaring health spending, there is growing interest in workplace disease prevention and wellness programs to improve health and lower costs. In a critical meta-analysis of the literature on costs and savings associated with such programs, we found that medical costs fall by about $3.27 for every dollar spent on wellness programs and that absenteeism costs fall by about $2.73 for every dollar spent.
David P. Hopkins, MD, MPH, Sima Razi, MPH, Kimberly D. Leeks, PhD, MPH, Geetika Priya Kalra, MPA, Sajal K. Chattopadhyay, PhD, Robin E. Soler, PhD. "Smokefree Policies to Reduce Tobacco Use: A Systematic Review." American Journal of Preventive Medicine, February 2010.
In 2001, a systematic review for the Guide to Community Preventive Services identified strong evidence of effectiveness of smoking bans and restrictions in reducing exposure to environmental (secondhand) tobacco smoke. As follow-up to that earlier review, the focus here was on the evidence on effectiveness of smokefree policies in reducing tobacco use. Smokefree policies implemented by worksites or communities prohibit smoking in workplaces and designated public areas. The conceptual approach was modified for this review; an updated search for evidence was conducted; and the available evidence was evaluated. Published articles that met quality criteria and evaluated changes in tobacco-use prevalence or cessation were included in the review.
Mehnert, Anja. "Employment and work-related issues in cancer survivors." Critical Reviews in Oncology and Hematology, January 6, 2010.
Purpose of this systematic literature review was to identify current knowledge about employment in cancer survivors. Sixty-four studies met inclusion criteria that were original papers published between 01/2000 and 11/2009. Overall, 63.5% of cancer survivors (range 24–94%) returned to work. The mean duration of absence from work was 151 days. Factors significantly associated with a greater likelihood of being employed or return to work were perceived employer accommodation, flexible working arrangements, counseling, training and rehabilitation services, younger age and cancer sites of younger individuals, higher levels of education, male gender, less physical symptoms, lower length of sick leave and continuity of care. Cancer survivors had a significantly increased risk for unemployment, early retirement and were less likely to be re-employed. Between 26% and 53% of cancer survivors lost their job or quit working over a 72-month period post diagnosis. Between 23% and 75% of patients who lost their job were re-employed. A high proportion of patients experienced at least temporary changes in work schedules, work hours, wages and a decline in work ability compared to non-cancer groups.
Charles E. Kupchella, PhD. "Colleges and Universities Should Give More Broad-Based Attention to Health and Wellness-At All Levels." Journal of American College Health, September 1, 2009.
Higher education needs to give more broad-based attention to health and wellness. Our graduates will all have to deal with the facts that the general state of health of Americans is not good and our national health care system is badly in need of reform. We should offer innovative approaches to helping our graduates establish positive, lifetime health habits and we should demonstrate to them our own model approaches to promoting health and wellness through more effective health insurance and worksite wellness programs.
Mello, Michelle M., JD, PhD; Meredith B. Rosenthal, PhD. "Wellness Programs and Lifestyle Discrimination - The Legal Limits." New England Journal of Medicine, July 10, 2008.
In this article, we examine the extent to which employers and health plans can provide rewards or otherwise adjust individual health insurance costs based on the steps employees or plan members take to reduce their health risk.