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How Your Job Can Wreck Your Health

Article by Ronesh Sinha | Found on Politico

During my medical training, I learned that a typical heart attack patient is a white male older than 50 who smokes cigarettes and eats red meat. So I was surprised when patients in my Silicon Valley office succumbing to uncontrolled diabetes and heart disease turned out to be 30-year-old vegetarian, non-smoking engineers from countries like India and China.

The typical risky behaviors I had learned about didn’t seem to apply to many of my tech patients. Silicon Valley employees don’t have the typical socioeconomic risks linked to diabetes and obesity that we see in less-privileged parts of the country. They are highly educated, earn great incomes and enjoy abundant employer-sponsored benefits. Instead of living in a food desert, they enjoy high-quality organic meals in their cafeterias, markets and restaurants. Techies also live in an area with year-round pristine weather and endless outdoor activities as well as onsite gyms and recreation facilities.

What was going on? That’s when I realized the habits and behaviors intrinsic to the modern work environment pose a risk for my patients.

These diseases are some of the biggest drivers of poor health and high health care costs in America. And if this younger, more advantaged cohort is struggling, it means the solutions may be even more difficult than many people assume. Employees need to be motivated to take care of themselves, and employers need to find the right strategy to help them.Providing state-of-the-art fitness facilities, healthy food options and abundant wellness resources aren’t silver bullets that help all employees achieve their health goals.

What habits and behaviors contribute to heart disease and diabetes in my patients?

First, sedentary behavior reaches epic proportions in a workplace where productivity is defined by the hours spent in front of a screen. In my clinic, I consider walking steps to be a vital sign as important as blood pressure and pulse, and my patients on average walk about 3,000 steps daily, far less than the goal of 10,000 steps a day. Twenty to 30 minutes on an elliptical machine are better than nothing, but can hardly counter the adverse metabolic effects of marathon sitting sessions. Onsite fitness facilities and classes are usually utilized by already motivated employees, but the most at-risk employees need more creative solutions to get them out of their chairs and moving.

Second, food habits are still a major challenge. Company-offered meals and snacks have definitely evolved from the early days and now include more natural plant-based options, but employers still waver between offering foods that keep employees healthy and foods that keep employees happy. Unfortunately, the two are not often interchangeable and an employee under high stress will often pass by the salad bar and head straight for high-carb comfort foods and sugary desserts. Chronically stressed workers tend to overeat or, in many cases, undereat. Either extreme can trigger conditions like diabetes, heart disease and obesity from caloric abundance or nutrient deficiencies that slow metabolism and trigger autoimmune health conditions.

Third, they don’t see the doctor often enough. Despite having access to world-class medical centers minutes away, many employees still are not accessing preventive health care. On a work campus with onsite restaurants, haircuts, car washes and dry cleaning, a 10-minute drive to a doctor’s office seems like an unacceptably long journey to many. To overcome this barrier, some tech companies have invested in onsite medical clinics. The company I work for, Palo Alto Medical Foundation, operates a mobile medical clinic called Care-A-Van that brings preventative health care to tech employees’ workplaces.

Last, there is too much stress. The Silicon Valley dream is the American dream on steroids. Most people who arrive here want to join or start the next billion-dollar company. Their self worth is equated to their net worth, and their plan is that “once they hit it big,” they’ll have time to focus on their health by hiring an entourage of personal trainers, chefs and support staff. They push ahead, glued to their devices, working late into the night, putting health on the back burner.

In the years that I have worked with employees in this high-stress environment, I have found a few strategies that work well, particularly when resources from the health care system, company and community merge to create integrated, team-based care.

Personalizing solutions for individual health problems is key. Many companies and health care groups have developed robust tools to evaluate the risks of large populations – and that can be very useful. However, the most effective approach is to apply the most personalized solutions to solving the health issues of highest-risk individuals. One patient’s diabetes risk may be primarily linked to sleep problems while another’s is tied to a poor diet and inactivity.

A successful example can be found in how we treat our large Asian Indian population, which unfortunately leads the world in early onset diabetes and heart disease. These patients often see me for a culturally tailored medical and lifestyle consult, and then get referred to the South Asian Heart Center, a not-for-profit community resource where they get further counseling and monthly support from volunteer health coaches.

Employers also have an important role to play. Empowering employees to take care of their health needs means a culture of health must pervade every square inch of a company, from the cafeteria to the break room, to the person in charge of catering meetings. A culture that is motivating means making sure managers are buying into that message and not just focusing on extreme levels of productivity. What if employee evaluations included the question, “Does your manager encourage a balanced lifestyle?”

Employees who have overcome health challenges should be celebrated as energetically as high producers. Some companies have designated employee health champions to help motivate peers. Often an employee can motivate a peer far more effectively than a doctor or a dietitian can. Every company has a legion of potential health champions who can inspire the rest of the troops.

Improving human health is far more complex than any other challenge Silicon Valley has taken on and no single company or provider can do it alone.

Highly talented Silicon Valley employees, — ironically, many of them working for health care start-ups, are skating a thin line between productivity, innovation and burnout. To become healthier, they need to be fully supported by their employers, their health care system and the community.

It’s time for all companies to weave health into their corporate culture and identity, rather than offering it as a “benefit.”


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