Trends shaping corporate health in the workplace 

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Original Article

Trends shaping corporate health in the workplace

Rohin Rameswarapu a,*, Sameer Valsangkar b, Ariz Rizvi c,Upasna Kamineni d

a Technical Consultant, Apollo Life, Indiab Public Health Consultant, Indiac Head, Institutional Business, Apollo Life, Indiad Executive Director, Apollo Life, India

a r t i c l e i n f o

Article history:

Received 17 July 2014

Accepted 26 July 2014

Available online xxx

Keywords:

Occupational health

Health promotion

Wellness

Non-communicable diseases

* Corresponding author. Tel.: þ91 998970960E-mail address: dr.rohin.r@gmail.com (R.

Please cite this article in press as: Rames(2014), http://dx.doi.org/10.1016/j.apme.2

http://dx.doi.org/10.1016/j.apme.2014.07.0100976-0016/Copyright © 2014, Indraprastha M

a b s t r a c t

Background: The paradigm for corporate health is morphing from traditional curative ser-

vices to health protection and promotion. An epidemic of “lifestyle diseases” has developed

in the India which warrants an organized integration of company's health, safety and

environment policy through a directed wellness program. The current study explored the

burden and determinants of lifestyle diseases among an organization.

Material and methods: A cross sectional study was conducted over 3 months among em-

ployees' at a multinational organization in the field information and technology across 10

cities in India. Data was gathered through a semi-structured questionnaire with socio-

demographic details (age, sex) and occupational characteristics such as duration of

working hours. Biometric measurements such as body mass index, blood pressure, total

cholesterol and random blood sugar were documented. Statistical measures obtained

included descriptives including means, proportions and percentages.

Results: A total of 30,134 employees participated in the study comprising of 16,652 (55.3%)

males and 13,482 (44.7%) females. 15,177 (50.3%) belonged to the age group 18e25 years.

24,414 (81%), 4745 (15.7%), 975 (3.2%) had normal, borderline and high risk values respec-

tively for serum cholesterol. 27,660 (91.8%) had blood glucose under normal range, while

2474 (8.2%) were found to be having abnormal blood glucose values.

Conclusion: Wellness clinics and occupational health centres act as a fulcrum and since

most of the non-communicable diseases could be prevented by modifying the lifestyle

factors and the clinics can provide health coaching, tobacco cessation programmes,

nutrition, disease management programs.

Copyright © 2014, Indraprastha Medical Corporation Ltd. All rights reserved.

1. Introduction

Health protection and promotion have been traditionally

confined to healthcare settings (e.g. hospitals, dispensaries,

4.Rameswarapu).

warapu R, et al., Trends014.07.010

edical Corporation Ltd. A

nursing homes and clinics). But in the recent years there has

been a paradigm shift in the concepts of healthcare and

health promotion activities have been initiated at workplace

through medical rooms or wellness centres. A medical room

shaping corporate health in the workplace, Apollo Medicine

ll rights reserved.

a p o l l o m e d i c i n e x x x ( 2 0 1 4 ) 1e52

or occupational health centre or wellness centre is essen-

tially a space located inside of the client establishment

which is created to cater to health needs of the employees'working in that organization. The medical rooms are

equipped to handle curative component and creates a plat-

form to generate awareness about the preventive compo-

nent of chronic lifestyle diseases. The medical room is

typically staffed by a medical doctor and paramedics who

are available to offer services during the work hours. The

medical room is stocked with basic medications, antibiotics

and emergency drugs which can handle the out-patient

department and treat surgical or medical emergencies. Or-

ganizations both small and large can have employee well-

ness and occupational health awareness programs which

can engage employees in this strategy to enhance their

ability to have a healthier lifestyle (primary prevention),

early diagnosis and treatment (secondary prevention),

identify occupational health hazards and prevent occupa-

tional health injuries, emergency preparedness and promote

healthy work environment. Health promotion and protec-

tion activities have been planned and operated indepen-

dently of each other at workplace, which has led to limited

effectiveness of the program.1 Workplace health protection

and promotion is organized integration of company's health,

safety and environment policy. This is more so evident

among employers' hazardous industries, where occupational

health centres are statutory requirements under Section 41-

C, Factories Act, 1948.2 Workers in hazardous industries are

frequently exposed to chemicals, solvents, toxic fumes,

extreme temperature, repetitive strain injuries and noise

which can cause detrimental health effects and irreversible

damage to health of the workers.

India, is passing through the phase of epidemiological

transition, over the decade, an epidemic of “lifestyle diseases”

has developed in the India. This could be attributed to

sedentary lifestyles, poor nutrition, dependency on alcohol

and substance and work related stress are driving the inci-

dence of non-communicable diseases (diabetes, cardiovas-

cular diseases, stroke, cancer and chronic respiratory

diseases).3 A recent study revealed that tobacco use, hyper-

tension and physical activity were more prevalent in lower

education groups.4

In addition, these medical conditions once thought to be a

problem of geriatric age group is seeing a paradigm shift to-

wards young urban population which is resulting in illness

related loss of productivity due to absenteeism.3 In addition of

the above mentioned, gender distribution has shown rise

among female employees' in the past years. The nature of

occupational health injuries varies with the gender of em-

ployees'; female employees are more prone for injuries about

68.4%.5 These chronic diseases have become a major burden,

as they lead to impaired quality of life, premature death and

disabilities and exponential rise in healthcare expenditure.6

The projected loss of national income attributable to heart

disease, stroke and diabetes in India from 2005 to 2015 is

around 236.6 billion (1.5% of the GDP) international dollars. In

addition to the later, WHO's Global Plan of Action onWorkers'Health 2008e2017, states that “Health promotion and pre-

vention of non-communicable diseases should be further

stimulated in the workplace, in particular by advocating

Please cite this article in press as: Rameswarapu R, et al., Trends(2014), http://dx.doi.org/10.1016/j.apme.2014.07.010

healthy diet and physical activity among workers and pro-

moting mental health at work”.7

Apollo Life, as an organization is conscientiously focussed

on providing solutions on integrative health and wellness

services for manufacturing and IT sector organizations across

India through occupational health centres and wellness

clinics respectively.

The present article focuses on workplace health concerns

and expounds the benefits of having health promotion mea-

sures at work place.

2. Materials and methods

The present study was conducted at a multinational organi-

zation having a large presence in India, in the field informa-

tion and technology.

A cross sectional study of 3 months duration from

December, 2013 to February, 2014 was undertaken with em-

ployees working with the organization. Consent was obtained

from the concerned department of the organization and the

sample subjects. Professionals working in different de-

partment's such as human resource, software development,

service providers were included in the study. All the em-

ployees' were explained about the purpose of the study and

confidentiality was ensured.

Inclusion criteria: for the study subjects were 1) individuals

who were working as a permanent employee, since past 1

month. 2) Individuals who had given verbal consent were

included in the study sample.

The study was conducted across 10 locations in India

(Hyderabad, Chennai, Bengaluru, Gurgaon, Kolkata, Kochi,

Coimbatore, Mangalore, Mumbai and Pune).

The cross sectional study included questionnaire with

socio-demographic details (age, sex) as well as duration of

working hours. Biometric measurements such as body mass

index, blood pressure, total cholesterol and random blood

sugar were documented. The samples were obtained on-site

in the client organization office space and analysed at a cen-

tral lab at the each location. The reports were also handed

over to the employees and the management.

Statistical analysis was conducted using Statistical Prod-

ucts and Service Solutions (SPSS) version 20. Data was

appropriately coded and entered and numerical data was

entered as such. Statistical measures obtained included de-

scriptives including means, proportions and percentages.

3. Results

A total of 30,134 employees participated in the study.

The study sample consisted of 16,652 (55.3%) males and

13,482 (44.7%) females Tables 1 and 2.

Majority of the subjects 15,177 (50.3%) belonged to the age

group 18e25 years, followed by 7949 (26.3%) of the subjects

belonging to the age group 26e30 years. 4901 (16.2%) re-

spondents belonged to age group 31e35 years, while 1610

(5.3%) subjects belonged to the age group 36e40 years and 497

(1.6%) respondents belonged to the age group of 40 years and

above Table 3.

shaping corporate health in the workplace, Apollo Medicine

Table 1 e Gender distribution.

Gender Count Percentage (%)

Male 16,652 55.3

Female 13,482 44.7

TOTAL 30,134 100

Table 3 e Age group distribution.

S.no Age group in years Count Percentage (%)

1 18e25 15177 50.4

2 26e30 7949 26.4

3 31e35 4901 16.3

4 36e40 1610 5.3

5 >41 497 1.6

TOTAL 30134 100

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About 963 (3.1%) respondents had a history of smoking and

2762 (9.1%) had accepted the fact that they were exposed to

second hand smoke. 531 (1.7%) were on treatment for

hypertension.

2017 (6.7%) of the respondents were underweight, 7423

(24.6%) had normal values. 14753 (49%) subjects were over-

weight, while 5111 (17%) subjects were obese and 830 (2.7%) of

them had Grade II obesity.

2202 (75%) employees' recorded normal blood pressure.

6160 (20.4%) were high normal and 1372 (4.6%) were

hypertensive.

For total cholesterol 24,414 (81%), 4745 (15.7%), 975 (3.2%)

had normal, borderline and high risk values respectively.

When checked for random blood sugar 27,660 (91.8%) had

sugars under normal range, while 2474 (8.2%) were found to be

having abnormal blood sugar values Table 4.

4. Discussion

The present study was conducted across 10 locations across

India among 30,134 corporate employees.

Majority of the employees 16,652 (55.3%) belonged to male

gender.6 About 23,126 (76.8%)were 30 years or below.8 A report

on Global Disease Burden, 2010 mentioned that there is a

shifting pattern of disease with increase life expectancy.

Report states that this is associatedwith people suffering from

disability due to non-communicable diseases for a longer

period starting at younger ages.9 When measured their body

mass, index, the study observed thatmajority 20,694 (68.7%) of

the respondents were overweight and obese. Obesity has been

an important precursor for developing diseases like diabetes

mellitus, hypertension, dyslipidaemia and ischaemic heart

Table 2 e Location wise gender distribution of employees'.

S.no Location

Male

Count Pe

1 Kochi 303

2 Coimbatore 1467

3 Mangalore 186

4 Chennai 4279

5 Pune 2548

6 Kolkata 1799

7 Gurgaon 272

8 Hyderabad 1908

9 Mumbai 492

10 Bengaluru 3398

TOTAL 16652

Please cite this article in press as: Rameswarapu R, et al., Trends(2014), http://dx.doi.org/10.1016/j.apme.2014.07.010

disease. High mortality rates have been associated with high

degree of obesity.10 Our study findings showed that 7532 (25%),

975 (3.2%) and 2474 (8.2%) of subjects showed elevated levels

in blood pressure, cholesterol and blood sugars respectively.

These parameters are crucial for cardiometabolic risk, espe-

cially among south Asians; starting at an early age.11 Em-

ployers have understood the course of chronic lifestyle

diseases and the long latent period between exposure and

onset of pathological changes. This phenomenon could only

be prevented by placing primordial and primary prevention

strategies, which can build healthier workforce and to contain

direct medical costs. World Economic Forum Report in

collaboration with World Health Organization, states that

Workplace Health Promotion (WHP) programmes are needed

to contain these medical conditions and improving health

related outcomes.12 It is important to note that even small

changes in behaviour, observed across entire populations, are

likely to show significant effects on disease risk.13 In soaring

trend of health spending, employers are showing interest in

health promotion and preventative activities in methods of

improving health, while reducing the associated costs. Many

studies have concurred with the findings that every dollar

invested in the program, the employer saves more than the

dollar spent.14 Many research studies indicate towards the

fact that incentives would increase the employee participa-

tion rates.15

4.1. Way forward

The wellness clinics or occupational health centres act a

fulcrum to implement these strategies in workplace.

Gender distribution of employees'

Female

rcentage (%) Count Percentage (%)

1 240 0.7

4.8 1342 4.4

0.6 103 0.3

14.1 6596 21.8

8.4 1059 3.5

5.9 520 1.7

0.9 74 0.2

6.3 879 2.9

1.6 761 2.5

11.2 1908 6.3

100 13482 100

shaping corporate health in the workplace, Apollo Medicine

Table 4 e Clinical parameters.

S.no Parameter Category Count Percentage (%)

1 Body mass index Underweight 2017 6.7

Normal 7423 24.6

Overweight 14753 49

Obese 5111 17

Grade II obesity 830 2.7

2 Blood pressure Normal 22602 75

High normal 6160 20.4

Hypertension 1372 4.6

3 Total cholesterol Normal 24414 81

Borderline 4745 15.7

High risk 975 3.2

4 Random blood sugar Normal 27660 91.8

Abnormal 2474 8.2

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Since, most the non-communicable diseases could be

prevented by modifying the lifestyle factors, the clinics

can provide health coaching, tobacco cessation pro-

grammes, nutrition, disease management programs, acute

medical and surgical management and vaccinations. The

success of the wellness programs is multifactorial and

depends upon

1. Leadership e employee driven health initiatives

2. Wellness committees e to form and exchange ideas

3. Communication e E-flyers, emails, stairwell messages

4. Supportive environment e healthier food at cafeteria,

physical activity promotion.

5. Incentives e to increase participation, build and maintain

motivation of employees'.6. Monitoring and evaluation e to strengthen the wellness

programs

4.2. Recommendations

To alter the course of lifestyle diseases, it necessary to

intervene and deploy measures to increase physical activ-

ity, proper nutrition, weight loss and combat work stress.

Workplace wellness takes advantage of employers' accessto employees at an age when interventions can still change

their long-term health trajectory. Although majority of or-

ganizations are complying with the Factories Act, 1948

with regards to biometric screening annually or biannually,

there has been little effort by the employers in preventing

health and wellness. Our experience as an organization in

preventive and promotive healthcare shows that there is

large gap which could be utilized to prevent the lifestyle

diseases. Understanding the elements which make them

most beneficial and the blockades to their wider adoption

could help smooth the path for future investments in this

very promising avenue for improving health and

productivity.

4.3. Limitations

Selecting the study sample is a limitation, which is biased.

The study also cannot address the challenge of how pro-

grams should be designed to attain optimal results for the

Please cite this article in press as: Rameswarapu R, et al., Trends(2014), http://dx.doi.org/10.1016/j.apme.2014.07.010

employer and employee, since each organization has

unique characteristic workforce. Organizational values, in-

centives, participation rates are all likely to affect return

on investment. Further study is also needed to estimate

the cost benefit and effectiveness of the wellness

programs.

Conflicts of interest

All authors have none to declare.

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shaping corporate health in the workplace, Apollo Medicine

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