June 18-19, 2009 | Hyatt Regency Chicago

Sponsored by

Global Health is Global Wealth

Michael Taylor, MD, FACPMedical Director for Health Promotion, Caterpillar IncLinda Gzehoviak, Corporate Global Resources, ACS

Projected Deaths for Selected Causes

In 2010, cancer will become the world’s leading cause of death

Tobacco: 1 billion Lives

Obesity • Overweight and obesity:

1 billion (increasing)

• Obesity is quickly replacing malnutrition as the critical nutrition-related health challenge in many emerging economies like China

• Mexico has second highest obesity rates in the world (first is U.S.)

Tobacco Quitlines • Publicly financed quitlines exist in the following

countries:– Brazil– Iran– New Zealand– South Africa– Europe: at least 27 countries– Asia: Hong Kong, Taiwan, Thailand, Malaysia, Singapore– Australia– Canada– U.S.

• Quitlines vary in scale and sophistication.

Costs to Employers - Direct versus Indirect

• Most countries have government sponsored health care

• In some of those countries, individual co-pays remain so high that companies provide additional coverage

• Access to care is “the issue” in most of the developing world

• Myth plays a huge role in early detection

The Role of Myth

• Belief in survivorship – must be fostered• Education that cancer is preventable through-

nutrition, physical activity, and tobacco • No one deserves cancer-but many believe they

have caused their own cancer• Financial concerns – would rather not know

Myths - Around the World• In Malaysia, many men abandon or abuse a wife with

breast cancer. • Quote from African patient: “A short man with an

arrow shoots you and you get cancer. Sometimes his wife can stop him and then you don’t”

• Quote from Indian Cancer Expert: “Even my mother didn’t want me to share my breast cancer experience. Her fear was that I would not find a husband”

Why is Cancer So Devastating in the Developing World

• Access to care• Guidelines must match the resources to

follow them • No global cancer “wiki”• Lack of translated materials to educate

around cancer • Lack of government policy

Employer Challenges• Traditional view of global health

– Health benefits as a direct cost– Federal funding “covers” the issue

• Reality– Poor health= productivity loss– Indirect cost is a concern– Global employees need to be:

• Healthy• Well trained• Engaged

Impact on Employers• Issue is productivity loss

– Absence due to illness• Presenteeism • Training cost of replacement employees• Retention• Global competitiveness

Caterpillar- Principles of Global Health Promotion

– Healthy employee is a competitive business advantage

– Corporate Medical Department• Set overall direction• Help identify the needs• Broker local resources• Solution is local

Caterpillar- Principles of Global Health Promotion

– Local needs vary• India• China• Mexico• Europe

Caterpillar- Principles of Global Health Promotion

– Successes• Aligning diabetes data in India• Some traction around smoking policies in

China• Brazil

– 50 year history of worksite wellness– Onsite MDs, dentists– Physical therapy– Highest engagement scores at Caterpillar

Examples of Workplace Wellness Programs

TOBACCO CONTROL• Quit lines

• In-person Counseling: individual & group (e.g., Freshstart)

• Smokefree worksite polices

• “No Tobacco” days

Examples of Workplace Wellness Programs

DIET & PHYSICAL ACTIVITY

• Physical activity programs offered in the workplace, e.g., RFL

• Onsite exercise facilities or sponsored gym memberships

• Encourage active commuting and discourage motorized transport, using price and other incentives

• Encourage use of stairs

• Healthy onsite food options: cafeterias, vending machines

Findings to Date

Key Findings from the 2009 ACS Global Workplace Wellness Program Feasibility Study:

Survey of Employers• Demand for programs is broad based: corporate management,

employees

• There is need for employers and employees to understand the value of wellness programs - better documentation of ROI is needed

• There is demand for ACS EI programs, and companies are willing to work with ACS directly and/or collaborate with partners selected by ACS. Many companies have partnered in the past

• Most either have existing programs or plan to implement a wide range of programs in the near future

Key Findings from the 2009 ACS Global Workplace Wellness Program Feasibility Study:

Survey of Employers• The majority of companies either have or are working on a global program

• Most companies have long-term objectives but are approaching them using sort-term programs based on local demand and resources

• Challenges include global consistency, privacy laws, resource allocation, local management buy-in, translation, cultural appropriateness, funding

• The global economic recession has served to emphasize the importance of maintaining health and most companies surveyed report pressing ahead with plans

Key Findings from the 2009 ACS Global Workplace Wellness Program Feasibility Study:

Survey of Academic Community

• Awareness would need to be created to facilitate buy-in and ensure program success

• Lack of existing infrastructure is a challenge, for tobacco cessation, cancer screening and treatment, and NCD management

• Cultural issues can present challenges. They include fatalism, cultural acceptance of tobacco use, KABs on physical activity, diet and weight

Key Findings from the 2009 ACS Global Workplace Wellness Program Feasibility Study:

Survey of Academic Community• Programs should focus on: tobacco, cancer, diet, physical activity,

and obesity

• Main recommendations for ACS involvement are corporate level policy (e.g., smokefree worksites) & program design and planning

• Program delivery should involve partnering with local organizations and entities

• It is important to consider local laws and policies

ACSU for Global Employers

• More than 30 participants from across the globe came to Boston in August

• Topic - global engagement around chronic disease prevention. • Confirmed large gaps in global employee services

• .. it is a beginning to a long journey. Thank you and good luck!• Increase participation from Latin America, Asia, and Africa. Because that where

the issues are burning and need focus. Thank you!!! This has been a great effort!!!

• I enjoyed this opportunity and hope to implement some of the great information I learned. This was perfect timing since my company is in the process of building our global wellness strategy.

• This was an excellent opportunity and extremely valuable. It was great to meet lots of new companies and contacts. I liked it. Was a good mix of MDs and other allied health and benefits people.

• Need to run ACSU 2-3 times per year to allow companies to get others involved. This presents a great opportunity for networking. Need more participation from employers outside the U.S.

• GEHC: I would like to do this for all of my medical officers worldwide• Thanks!

ACSU Global Employer Program: Evaluation

ACS approach to Comprehensive Employee Health & Wellness

Maximize Human ResourceThroughput

Corporation

Tobacco-free Workplace

Healthy & ActiveWorkplace

Socially ResponsibleWorkplace

1. Complete ban on tobacco use2 Freshstart & Quitline3. Communications4. Coverage for NRT & cessation medication

1. Caloric value on foods, subsidize healthyoptions, healthy catered food2 Active for Life /3. Communications4. Subsidize memberships to health clubs

1. Support local NGOs and community initiatives2 Employee giving / participation3. Communications4. Provide coverage for prevention and earlydetection services / screenings for chronic

Corporate Initiatives Comprehensive Solution Maps

Employers Need… • Wellness services/programs that are global in scope but adaptable to

local conditions; 80-20 Ikea rule

• Public-private partnerships: effective coordination of efforts among stakeholders in the for-profit, non-profit and public sectors

• Assets: NCD and tobacco cessation resources, including vendors and NGOs, by country

• Translated materials on chronic disease prevention

• Better data to make the case

Collaboration

Collaboration • World Economic Forum• World Health Organization • UICC-World Heart-IDF • Universities: Emory, Harvard School of Public

Health • Mercer and other HR consultancies

Global Agenda Council of World Economic Forum: Working Towards Wellness

Areas of Focus – Economic impact on health systems– Importance of corporate role and supporting behavioral changes amongst business

leaders– A “marketplace” of new ideas– Acting as an advocacy group– Bridging of the science gaps– Tackling the non-inclusion of chronic diseases in the Millennium Development Goals– Developing partnerships and finding out what we know and what we don’t know

Channels– Regional Forums– Davos– Corporate Partners

Country Partners• Public Health Foundation of India• China, CDC, CACA, CPMA, WHO• Brazil – Chronic Disease Prevention Groups

and NCI• Africa – AORTIC, ACRE

ACS Role ?

ACS EI Role by Geography

Building Platforms for Survivor Voices - International Relay For Life

Now available for NCTP Companiesat www.relay.org/relay

Dow, JBS, Tata

McMurdo, Antarctica

Advocacy: Tobacco Control

Capacity Building: ACSU and Seed Grants

Corporate Outreach: Beijing Olympics

• Reach out to companies around smokefree worksites in China

• Media event August 9 and platform for engagement with Chinese operations of multinational companies

Regional Engagements

Greater China• Capacity Building:

breast cancer programs, patient services, government

• Tobacco control: cessation and smokefree worksites project

• Work in Mainland China, Hong Kong and Taiwan

Africa • North Africa Tobacco Control

program, including smokefree worksites

• Africa Tobacco Control Research Initiative

• ORACLE Five County Cancer Information and Capacity Project, including worksite engagement

Mexico • With one in nine

Americans of Mexico descent, this is a priority country!

• Infocancer is modeled after ACS Patient Navigation

• Support from Midwest Division, Pfizer Mexico, GEHC, and partnership with Mexican NCI

Malaysia Relay For Life

Sponsored by