T ic struggle may get a bit easier but it w ill never

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T: 'iC struggle may get a bit easier but it w ill never be elimi :>a l eb. Vigorous exe rcise does not require such di ff icult choices but does involve a h igh degree of continuing motivation. It imposes strong demands for time in an already crowded schedule. The pro cess of exercise is boring for many, at least at first. Exercising can also l ea d to orthopedic inju ries that can complicate developing a co ntinuing exercise habit. The many satisfac ti ons of improved fitne ss , reduced stress and the exerciser's "high" take some time to develop. In the cases of exercise and reduced-calorie consu l7 ,p- tion, the rewards can be seen an d felt in the matt er of weeks. S ome s moker s. but not all. may find cessation leads to reduced cough and improved respiration. But much of the pay of f for smokers, virtually all of it for hypert ensives and some for exercisers comes from reduction of longer- te rm ri sks - for heart a tt acks. lu ng cancer, emphy sema. strokes and o th er morbid eve nt s whose chances of appea r- ance can only be described as probabilities, n ot certainties. Reducing the variables that co nfer risk has not in every case been shown to lower risk. Whi le smoking cessation and hypert ension control do lower risk, phy s ic al exercise ha s not yet prospectively been demo nstrated to reduce cardio- vascular incidents. With respect to cardiovascular ri s k, elimination of obesity will reduce ri'k if it cause, a lowering of high blood pre ssure, m ay reduce it if weight lo ss medi· ates a reduction in c holester o l, a nd prob ably will n ot s ub · stantially af fect risk in a person with low cholesterol level, and blood pressure unless he/,he is 25% more overweight. For only a few risk reducti on efforts ca n benefit' be accurately assigned and any att e mpt to equate costs and benefits be justified. In these instances, such as smoking cessation and hypert ension control , the variation in costs and effectiveness of reduction eff or t' and th e question ab le assumptions needed to complete the equations make any conclusions tentativ e. very sen si tive to changes in assump- tions and therefore eminently assailable. A possibly better way to approach the is sue of return on in vestme nt in these programs is to co mp are c ost wi th effects. Wh at is it worth 914 Employee Health Programs/Fielding .. ; . ... ~,) 'r, '(.: ~ .-l k\ ' ... ·;${::!t"tJ· .',".;;" '" , . -V :.r.lt 'li2ll fa U [JI , W~ m1. mJ :j?'ffJ !!~U'jtf;: tm , I11~ !tJ1 - gn ,~!,, 9 ~ ~trt JN"jJ.;;tt r{"t';!If.~f- :niJ-'lJi¢ UU", 't,; :l!lh,: ' r ,u.i ... t';.,"i '!:~ ,-; ,"I" "' N )~ I'· · i, ' ':',
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for a company to reduce the number of heart attacks per 1,000 male employees per year from 10 to six? What is it worth to reduce the chanc e of an employee getting lung cancer from 1/200 per year to 1/2,000 per year? In most cases employers will feel that their interest in the health of their employees justifies a significant investme nt to achieve this type of reduction, regardless of whether their return will be higher than their average annual return on other inve sted funds.
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  • Spring '12
  • fwsf
  • th e average, th ese programs, th ese program, al th prohssionals, th e work

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