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Well-Designed Health and Wellness Programs are Cost-Effective

By John T. Kelly, M.D.

Nobody ever asked me if emergency rooms were effective or cost-effective when I practiced emergency medicine. Since I began managing health and wellness programs, I am frequently asked if these programs are effective (“do they work?”) and if they are cost-effective (“are they good investments?”). Preventable health and wellness risks, such as obesity, physical inactivity, unhealthy eating, high blood pressure and tobacco use, which are common among drivers, directly affect costs, productivity and safety in the trucking industry.

Many scientific studies have demonstrated that preventable health and wellness risks are responsible for approximately 40 percent of premature deaths, two-thirds of cancers and three-quarters of heart and other cardiovascular diseases. Many other studies estimate that preventable health and wellness risks cause approximately 25 percent to 35 percent of medical costs.

Among approximately one thousand drivers who participated in recent health screenings sponsored by the Healthy Trucking Association of America, 49 percent were obese, 39 percent were overweight, and 31 percent had high blood pressure.

Among approximately 3,000 drivers for a large national trucking company in a recent scientific study, 55 percent of drivers were obese and 30 percent were overweight. High blood pressure was more common among drivers who were obese and overweight. Just over half of obese drivers had high blood pressure, 31 percent of overweight drivers had high blood pressure and 21 percent of normal weight drivers had high blood pressure.

Medical costs are significantly higher for obese and overweight drivers than drivers who are normal weight. In the above study, medical costs were 72 percent more for obese drivers and 55 percent more for overweight drivers than medical costs for normal weight drivers.
Although most drivers are obese or overweight and many drivers have high blood pressure, obesity, overweight, high blood pressure and many other health risks are preventable.

Among approximately 500 drivers who participated in a high blood pressure prevention program, the number of drivers with high blood pressure declined from 26 percent to 17 percent in a recent scientific study. This high blood pressure prevention program saved the company $542 per year per employee.

Elimination of preventable health risks protects drivers from developing health conditions that might prevent them from meeting FMCSA requirements and prevents health-related events, such as heart attacks, which can cause accidents.

Although modification of preventable health and wellness risks presents significant challenges in the trucking industry, many effective health and wellness programs are available to support weight reduction in obese or overweight persons, management of high blood pressure and elimination of other preventable health risks. A recent comprehensive review of more than 375 scientific studies of health and wellness programs identified the characteristics of effective programs and demonstrated that well-designed programs improve health knowledge, health behaviors and health.
Many effective health and wellness programs can be implemented for significantly less than the cost of preventable health risks such as obesity, overweight and high blood pressure. A review of 10 scientific studies of health and wellness programs demonstrated that the average return on investment was approximately $4 in savings in medical costs for every dollar spent on health and wellness programs.

Because preventable health and wellness risks have a major adverse impact on cost, productivity and safety in trucking, and because many health and wellness programs are effective and cost-effective, I recommend that trucking companies:

• Implement well-designed cost-effective health and wellness programs
• Integrate health promotion into the worksite and culture
• Encourage behavior change to reduce preventable health risks
• Provide scales and blood pressure monitors at terminals and other appropriate locations

As these efforts are successfully implemented, companies should:

• Improve health, well-being and morale
• Enhance productivity and safety
• Achieve positive financial return on their investments.

John T. Kelly, M.D., chairman of the medical advisory board for the Healthy Trucking Association of America, is chief medical officer of Lifeclinic International, which manufactures blood pressure and weight monitors located in many trucking locations. Dr. Kelly was previously chief health and medical officer of Union Pacific Railroad and a practicing emergency physician.

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