You cost us too much

However, small incremental changes by individuals and companies can reverse the tide, said Dr Craig Nossel, head of Clinical Vitality at Discovery at a GIBS forum on Healthcare Strategies.

Currently 8,6% of SAs GDP is spent on healthcare, compared to 7,7% in the UK and 14,6% in the US*. 

The payout for chronic drugs has increased by 27,5% pa between 1999 and 2003.

Non-communical diseases are the leading cause of death in South Africa . Cardiovascular diseases (CVDs) are a particular villain, according to the South African Health Review, 2003-2004. Fourteen percent of men die of CVDs and 19% of women.

CVDs comprise Ischaemic heart disease, diabetes mellitus, and hypertensive heart disease. The Medical Research Council estimates that 318 083 years of life are lost because of strokes and 284 438 because of Ischaemic heart disease.

According to WHO Mortality Statistics, SA ranks first in CVD deaths ahead of Brazil, China, India, the US and Portugal.

Twenty-three percent of men and 57% of women are overweight in SA, due to physical inactivity and unhealthy eating, says Health Minister Manto Tshabala-Msimang.

Absenteeism costs the economy R12bn a year, in the US 106m hours are lost a week to it, says Dr Nossel. A company with an annual wage bill of R140m and an absenteeism range of between 4,5% to 10% is losing between R6m to R14m a year in wages. 

Yet relatively small lifestyle changes can have a significant impact on health and the associated cost of healthcare, as many of the causes of disease are avoidable, says Dr Nossel. 

The main contributors to avoidable morbidity are smoking, inactivity and being overweight, with all these characteristics your chance of suffering from coronary artery diseases, stroke or diabetes is 44%, according to a report entitled the Effect of Lifestyles on Death and Disease. 

Quit smoking and your chance of suffering from one of those diseases falls to 29% quit smoking and become active it falls to 19% quit smoking, become active and lose weight it falls to 14%. 

On average, a man with a normal body mass index (BMI 18,5-24,9) misses three working days and women three and a half days a year. Obese men with a BMI of more than 40 miss five working days and women eight days a year, according to National Health interview surveys.

One death per year may be prevented for every 61 people with diabetes who walk for at least two hours a week, says Dr Nossel. 

For every one point increase over 23 in your BMI the risk of stroke for men increases by 6%. Men who weight-trained for one half hour or more each week had a 23% lower risk of heart disease then men who do not.

According to Dr Nossel, Discoverys bronze, silver, and gold engaged Vitality members pay less in claims than non-engaged. 

To ensure that individuals become healthy both the individual and the workplace needs to be made responsible for their health, says Dr Nossel. The workplace as: a large proportion of the population is employed and spends more than a third of their waking hours at work. If the workplace enables and supports health, employees are more likely to make healthier choices, according to a government white paper from the UK. 

When employees are healthier, productivity, recruitment potential and morale increase, absenteeism, health costs, group risk costs and staff turnover decrease, says Dr Nossel. 

A company that gets involved in the health of its employees can reduce absenteeism and increase productivity. For example, after Blackmores in Australia introduced a gym, absenteeism fell by 40%, said a study entitled the Economic Impact of Sport. Productivity went up 80% at Union Pacific Railroad after it introduced an exercise programme, according to a report by Ernst & Young.

But just over 10% of companies take an interest in their employees health, according to the 2004 PruHealth Index Findings. (Source: The Citizen, 10 November, 2005).