I would like to welcome you to my new blog “The Global Update on Health Promotion” (or short the Global Update). As I have been following global developments in the field of health promotion and wellness, especially with regard to the workplace, and sharing my insights for many years through presentations, articles and newsletters, I would like to make this available to a broader audience and generate more interest and discussion that way.
My first entry reflects on the status of health promotion worldwide. I have crafted ten statements about global health promotion and wellness. This is part 1 of 2.
10 Key Statements About Global Health Promotion and Wellness
1. Country disease profiles and health risks are becoming more similar
Chronic disease is on the rise globally. Cardiovascular disease, cancer and depression are the major causes for mortality and morbidity worldwide. Even in developing countries, where infectious disease still prevails in a major way, chronic diseases are rapidly increasing, thus creating a double burden. The urban area disease profile in developing and emerging countries, e.g., Mumbai or Manila, resembles the profiles in industrialized countries. The Global Burden of Disease Project initiated by the World Health Organization (WHO) projects the share of non-communicable diseases in developing and newly industrialized countries to increase from 27% in 1990 to 43% in 2020. An obesity epidemic is sweeping the world. In China the number of overweight urban dwellers is already 30-60% with figures expected to double within the next decade. India does not fare any better: 55% of women between 20-69 years of age and 40% of men above 35 years of age are overweight. Every fifth diabetic in the world is Indian. Smoking rates amongst Asian and Russian males are often above 60%. Another key global risk factor to be aware of is mental disease and stress. Depression will climb to the number 2 in the global disability ranking by 2030 and the high work-related suicide rates in Japan, Korea and China are alarming.
2. Health care costs are on the rise globally
US employers are struggling to cope with the ongoing increases in health care costs. Although health care systems in other countries are constructed differently and employers abroad typically do not have to pay directly for health care, cost increases still affect employers and employees. The rise in costs will continue to affect the corporate environment everywhere, i.e., costs are being shifted to employers and employees as well as public health services are being scaled back in many countries forcing employers to step in and bolster their programs.
3. Investments in prevention and health promotion are minimal worldwide compared to the scope of the problem.
In spite of the abovementioned trends and increased media attention to the scope of the chronic disease problem, investments in prevention and health promotion are minimal compared to money spent on medical services. The OECD (Organization for Economic Cooperation and Development) average for expenditures on health promotion and public health is 3% of all health expenditures.
4. Employee health is becoming more significant as a competitive factor.
Competition is fierce in the global marketplace and companies are looking for a competitive advantage in every possible way. This includes enhancing the productivity of human capital. More and more, health is regarded as a key factor in human capital management, in particular with the growing number of white collar workers and the aging trend in industrialized countries. Employers are now projecting future disease and cost trends with a larger portion of aging workers. In countries with abundant and cheap labor, especially in Asia, employees are often regarded as expendable and therefore the health of employees as negligible. However, the demand for skilled knowledge workers is rapidly increasing in these countries and replacing workers is now more expensive and more challenging. For example, the Indian call center industry is struggling to find new hires due to the extremely high turnover, which is largely linked to employee health problems.
5. Numerous countries are shifting from traditional occupational health to workplace health promotion.
As physical workplace hazards, like asbestos and polluted air, are progressively better monitored and controlled, health services at the workplace are moving from a traditional occupational health (OH) model to more preventative and lifestyle-related services. This development is occurring at a slow pace in countries where the OH field has a long tradition and is resistant to the changes, e.g., in Europe, and in countries where the working environment still provides major hazards and enforcement of existing OH legislation is weak, e.g., in China. The World Health Organization (WHO) is pushing enterprises globally to look beyond the physical work environment via its Healthy Workplace Initiative (see http://www.who.int/occupational_health/healthy_workplaces/en/index.html).