Targeted strategies needed to stem global tsunami of lifestyle diseases

• Stats SA report indicates lifestyle diseases as the fastest-growing cause of death among South Africans
• Discovery says targeted and coordinated strategy needed among all stakeholders to change population behaviour and stem global tsunami of lifestyle diseases
• Interventions include lifestyle and behaviour modification, workplace wellness programmes and public policy shifts

A new report released this week by Stats SA on mortality and causes of death in South Africa, indicates that 55.5 % of deaths can be attributed to non-communicable diseases, also known as lifestyle diseases. The findings of this report are in line with the increasing importance of wellness and lifestyle choices in society today, and a global understanding that lifestyle choices have a dramatic effect on mortality, morbidity, healthcare costs and economic development. Research from the Oxford Health Alliance indicates that four human behaviours – poor nutrition, lack of physical exercise, smoking and excessive alcohol consumption – lead to the four diseases (cancer, diabetes, lung and heart diseases) resulting in over 60% of deaths globally. 

Dr. Craig Nossel, Head of Vitality Wellness, commented, “The findings of the Mortality and Causes of Death report validate our view that lifestyle disease is one of the biggest societal challenges facing South Africa. The impact of health behaviour and risks on individuals’ quality of life, their ability to fully participate in the workplace, and the resultant negative effect on our economic development, require a coordinated and targeted approach from all stakeholders. Any effort to curb the rise in lifestyle diseases must address both individual behaviour modification, as well as workplace health issues, within a policy environment geared towards health promotion.”

Positive impact of lifestyle behaviour modification

Behavioural economics has long been regarded as a critical element in tackling the burden of lifestyle disease. It aims to understand what drives individual behaviour and why people often make decisions that are inconsistent with their long-term welfare. Individuals are unaware of their health risks, over-optimistic about their health status and generally discount the value of a healthy lifestyle. Given the unique behavioural dynamics of lifestyle choice, encouragement and the use of incentives are increasingly being seen as an effective response.

Nossel highlighted the experience of Vitality, Discovery’s world-leading wellness programme; “Our experience with Vitality as a way to address modifiable health risk factors, has been extremely encouraging. Over the past 20 years, our clients have responded positively to the programme and incentives, with increasing levels of engagement and most importantly, substantially improved health outcomes over the long term.”

Vitality, with its simple focus on encouraging regular exercise, healthier nutrition, and regular screening has had a dramatic effect on the Group’s insurance and healthcare businesses. Externally verified research indicates that patients with chronic conditions, who are highly engaged in Vitality, have between 10% and 30% lower healthcare costs, shorter stays in hospital and fewer hospital admissions.

Nossel continued, “The success of Vitality in changing health behaviour lies in the clinical science behind the programme design. We continuously analyse credible clinical research on the link between health behaviour and disease, and adapt the programme to ensure it remains clinically relevant.”

One of the programme’s most successful benefits, Vitality Active Rewards - now with over 300 000 members, was precisely designed to encourage regular physical activity as a response to the mounting evidence for the importance of physical activity in reducing mortality and morbidity rates. Results from South Africa shows that clients taking part in Active Rewards have increased their physical activity levels by 25%.

Workplace wellness programmes as an entry point to change behaviour on a large scale

Nossel also highlighted the importance and potential of the workplace as an entry point to encourage behaviour change on a large scale. “Business leaders have a major responsibility to ensure the health and safety of their employees. More than that, there is a strong and proven business case for workplace wellness programmes and health as a key measure for future profitability.”

The critical importance of health to business is underlined in the results of a recent survey of over 5 500 private and public sector leaders by the United Nations Global Compact initiative. The survey identified health and wellbeing as a significant business and sustainable development opportunity. According to a 2010 Harvard Business Review article, the return on investment (ROI) of comprehensive, well-run employee health and wellbeing programmes can be as high as six times their cost to implement.

According to Nossel, the greatest potential of workplace wellness programmes lies in their ability to trigger improvements in other health promoting behaviours and overall health status. “Earlier this year, Vitality published the results from a three-year study of 100 000 US Vitality members taking part in workplace wellness programmes. The study showed incremental physical activity also led to changes in other health behaviours, resulting in increasing health engagement at the workplace.”

Supportive policy environments

A third critical element in an effective approach to combat lifestyle disease involves a policy environment focused on health promotion. The proposed sugar tax implementation is an example of a policy shift to support behaviour change on a population level. “South Africans are notoriously high consumers of sugary drinks and we now count among the top 10 consumers globally. Clinical research shows that excess sugar consumption is directly linked to obesity, which is the number one risk factor for lifestyle diseases. From a health point of view, believe that it is a positive step to implement a tax structure that encourages product reformulation and the availability of drinks with a lower sugar content.