I just read a few workplace wellness and health promotion research papers. I don’t know why I do this. It gives me a splitting headache. Some wellness vendors obnoxiously wave the papers in your face like they’re the 10 Commandments. “OK, OK, I’ll read the things.”
In my high school days (not too long ago), I made a smart-ass comment to the physical education teacher (a former pro football player). I don’t advise doing that for amateur smart asses by the way. Anyway, he made me stay after school and write a 1,000-word essay on “the social life of a ping-pong ball.” In the middle of the essay I wrote, “This is a bunch of (!%*#.” I gave him the paper, was heading to the door, and he said, “Connors, next time don’t bury the headline in the middle of the paper.”
That’s what a lot of these research papers do — they bury the “you know what” in the middle.
You’ve got to read the whole boring mass of junk carefully.
Here are my “Crazy 8s” − just a small example of what runs through my bio-fueled, C+ grade brain when I read these things.
1. A commercial vendor did the research: Come on, man! Are you kidding me? I don’t give any credibility to anything posing as objective research when the investigator has a direct economic bias. Even if the conclusions are correct, you’d have to corroborate those findings with more objective research to trust it. I am all for case studies and white papers, etc. That information doesn’t pose as hard science, and can often be helpful. Vendor-produced scientific research on their own programs is “contaminated.” As in useless. And scientific journal editors would be well advised not to publish that nonsense. I’ve still got that paper on the social life of a ping-pong ball if they’re hard up for some good content.
2. Extrapolates national health statistics: For example, xx% of the U.S. population is overweight, thus we did this study on XYZ population. But XYZ population may only have 2,000 people in it. I am not able to make the connection. It’s like someone coming to your front door and saying, “30% of the U.S. population is overweight, but we can get your family to ideal weight.” In other words, the claim is the vendors can create a competitive advantage by making your population healthier (and more productive) than the average, and probably the competition. If someone could actually do this, it would eventually be scaled up, and the vendor would rival Google in growth. The workplace wellness industry is tiny because we haven’t done anything in 30 years that is scalable.
3. Conclude consistency with national health statistics: After spending thousands of dollars studying the health status of a workplace population, the researchers say the populations’ collective health status mirrored national health statistics for this demographic. Ya think? You can ballpark the health status of almost any workplace population by just knowing the general age, gender mix, and type of industry. It ain’t science, but I’ll bet you can come within a few percent of their actual, collective health risk, in about 10 minutes. I grew up around insurance actuaries and underwriters (also athletes, entrepreneurs, revolutionaries, transients, dogs, comedians, and dreamers), and I can assure you they’re not using these wellness research papers to evaluate their risk in insuring a population. They’re using demographics, national-health statistics, and health-claims experience (which they know wellness programs have no material effect upon).
4. Lack of long-range outcomes: We never know what happens to the people who allegedly improved their health status. The researchers talk about those who improved over a short time period, but I wonder how they’re doing now? Guess what I think? The population reverts back to the average national-health statistic for their group. The bio-medical, health-screening model of wellness is forever going to be stuck “reverting back to the norm.” It’s a business model that has us all swimming upstream. It’s the wrong paradigm, and it’s not sustainable. So all we ever read about is the group of people who improved something for a short time. Nobody has broken out into the open fields of sustainability.
5. Health risk as a measurable factor: I do think the brighter bulbs in our business are getting away from claiming healthcare savings from wellness programs. But we’re still reading a lot about lowering a group’s health risks. Even if that is happening, it’s short term. And really, so what? We know wellness does not lower healthcare costs. If it did, it would be a $20-billion-per-year business instead of the $2-billion-per-year business it is. So what does reducing health risk in a working population actually do? Nothing significant enough to support the effort.
6. BMI and weight loss: When these measures are mentioned as a component in a wellness research paper a little red alarm should go off in your head. Take 15 minutes and dive into the history of the BMI metric. It’s not a valid tool for determining population risk based on weight. And workplace weight-loss programs don’t work over the long term. There is not a single valid example of one sustaining ideal weight of participants in a working population. Weight is a symptom. An individual is much better trying to experience improved health on a holistic level. A person can be heavy and still be healthy, and even physically fit. I acknowledge the weight problems, on the extremes, are vexing. However, diseases like anorexia and morbid obesity are better addressed as mental-health issues than biometric issues. The idea of focusing on weight loss as a workplace-program goal is a non-sequitur to improving a population’s health.
7. Use of extrinsic incentives: Some research is about using incentives; some include a mention of it as a program component; and others bury the fact incentives were used to drive participation. But if rewards or punishments were used to enhance participation in wellness programs, the research is invalid in my mind. Once extrinsic incentives are removed the population reverts to the norm. There is not one example of extrinsic incentives improving long-term health outcomes. And there is not one bit of scientific evidence that extrinsic incentives can somehow be morphed into an intrinsic-incentive approach. I don’t think there is ever going to be either. Extrinsic incentives actually harm intrinsic motivation, and are destroying the credibility of workplace wellness.
8. Unintended consequences: The road to hell is paved with good intentions. Stuff happens. One thing missing in the research on wellness is how much we have increased cost, inconvenience, and even suffering by exposing people to misdiagnosis, over diagnosis, medical errors, and unnecessary treatments. As we screen millions of people for disease we expose them to all the inherent risk of the healthcare system. It’s impossible that they have all completely avoided experiencing these negative consequences. But find me one calculation or estimate of this cost. It’s never calculated. It’s possible that if this cost were figured into wellness programs’ biomedical screening ROI analysis, it would be a deal killer for the whole biometric screening model.
The kind of research I’d enjoy reading and learning from would get at these 8 questions:
1. How do we prepare great leaders to drive high-performance organizations?
2. What is the role of autonomy in job satisfaction and risk taking at the employee level?
3. How do we define and achieve great visions, which transcend self?
4. How do we build and maintain joy in our work?
5. How do we attract, develop, and grow with people we want and need to work with?
6. How do we master the art of storytelling to develop brand, culture, and expectations?
7. How do we build meaningful relationships with all stakeholders including employees (and their families), the community, investors, suppliers, the media, and customers?
8. How can we achieve a meaningful balance between work life and home life?
Before people can be healthy, they’ve got to find their work enjoyable and rewarding. And the workplace itself needs to be healthful before that can happen. I suspect much of helping people improve their individual health would fall under 7 and 8 above. First, by tying employees into the activities of the surrounding community and by inviting the community activities into the workplace. Second, by improving our balance of work life and home life, which is probably the ultimate form of sustainability for a healthy soul.
That’s enough for now. If you haven’t taken much vacation time yet, please plan to ASAP. The world really needs you at your best and brightest. Just do me one favor: Promise not to read workplace-wellness research papers on your time off.
Shawn is the President and Founder of Hope Health. For over 30 years, his work has focused on bringing clear, easy-to-read and watch health messages to the public via workplaces. He bills himself as the “Best C+ Student in the Wellness Biz” because, as he says, “I like to challenge the notion that there is no such thing as a stupid question.” Shawn is on a mission to tie workplaces into their surrounding communities to share resources and ideas in an effort to improve the health of all Americans.
You may reach Shawn at sconnors@HopeHealth.com or 800-334-4094.