Abstract
BackgroundThe global increase in the prevalence of NCD’s is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits. The main aims of this research study were to determine the extent to which insufficient physical activity (PA) clustered with other risk factors for non-communicable disease (NCD) in employed persons undergoing health risk assessment, and whether these risk factors were associated with higher healthcare costs.MethodsEmployees from 68 companies voluntarily participated in worksite wellness days, that included an assessment of self-reported health behaviors and clinical measures, such as: blood pressure (BP), Body Mass Index (BMI), as well as total cholesterol concentrations from capillary blood samples. A risk-related age, ‘Vitality Risk Age’ was calculated for each participant using an algorithm that incorporated multiplicative pooled relative risks for all cause mortality associated with smoking, PA, fruit and vegetable intake, BMI, BP and cholesterol concentration. Healthcare cost data were obtained for employees (n = 2 789).ResultsParticipants were 36 ± 10 years old and the most prevalent risk factors were insufficient PA (67%) and BMI ≥ 25 (62%). Employees who were insufficiently active also had a greater number of other NCD risk factors, compared to those meeting PA recommendations (chi2 = 43.55; p < 0.0001). Moreover, employees meeting PA guidelines had significantly fewer visits to their family doctor (GP) (2.5 versus 3.11; p < 0.001) than those who were insufficiently PA, which was associated with an average cost saving of ZAR100 per year (p < 0.01). Furthermore, for every additional year that the ‘Vitality Risk Age’ was greater than chronological age, there was a 3% increased likelihood of at least one additional visit to the doctor (OR = 1.03; 95% CI = 1.01 – 1.05).ConclusionPhysical inactivity was associated with clustering of risk factors for NCD in SA employees. Employees with lower BMI, better self-reported health status and readiness to change were more likely to meet the PA guidelines. These employees might therefore benefit from physical activity intervention programs that could result in improved risk profile and reduced healthcare expenditure.
Highlights
The global increase in the prevalence of non-communicable disease (NCD)’s is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits
The total healthcare expenditure was significantly higher amongst the nonparticipants than the wellness day participants (Table 1)
This finding is supported by other studies that have reported that employees attending wellness days or completing Health Risk Assessment (HRA)’s have lower healthcare expenditure [24], are usually older, report fewer days of sick leave and have better self-reported health status, than those who do not [13]
Summary
The global increase in the prevalence of NCD’s is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits. The results of a study based on data from the United States National Health and Nutrition Examination Survey, shows that individuals who are inactive are more likely to have additional risk factors for cardio metabolic disease [8]. These findings are corroborated by a study conducted in Swedish men and women where those who had higher levels of physical activity had significantly lower triglycerides and less atherogenic lipid profiles compared to those who were inactive [9]. The Swedes who had higher fitness levels were 50% less likely to have additional three or more risk factors for NCD [9]
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