President Obama clearly has been educated about U.S. health care prevention deficits. That’s why he’s seeking $684 billion over the next ten years for health care reform. And, he’s said that a good percentage of this should go to preventative care.
So, what does this mean for shift workers and shift work employers? A report by Circadian Technologies, Financial Opportunities in Extended Hours Operations: Managing Costs, Risks, and Liabilities, concluded that shift workers represent 10 percent of the working population, but they account for 17 percent of the health care costs. Following along with the chronic disease storyline, there are certain diseases that are more prevalent amongst shift workers than the rest of the population. Zeroing in on this group of workers will provide an employer more bang for their buck, meaning greater cost reduction return from prevention investment.
While spending on doctors and hospitals makes up over 56 percent of our health care spending, and prescription drugs account for only one-tenth of total health-care expenditures, what the drugs are prescribed to treat is easier to capture than what the doctors are spending their time on. And since spending in the U.S. for prescription drugs was $201 billion in 2005, almost five times more than the $40 billion spent in 1990, it can provide a good window into recent healthcare trends.[1] From 1997 to 2007, the number of prescriptions purchased increased 72 percent (from 2.2 billion to 3.8 billion), compared to a U.S. population growth of 11 percent.[2] Looking at spending on drugs gives an interesting window into what diseases doctors are treating.
Reviewing data from Drugs.com, approximately $156 billion was spent on prescription based pharmaceutical products in the U.S. in 2007. This is what was spent on the top fifty grossing drugs (representing $80 billion or roughly half of the total spent) by focus of the treatment:
Mental health – $21 billion
Heart – $20 billion
Gastrointestinal – $11 billion
Lung – $9 billion
Diabetes – $6 billion
Pain – $4 billion
Bone density – $2 billion
Sleep – $2 billion
Other (under $2b each) – $5 billion
Total – $80
Correlating this list to the most health risks of shift workers provides amazing results. All shift work data below by Circadian Technologies, unless otherwise noted.
Obesity – 71 percent of male and 53 percent of female shift workers are overweight, compared to 59 percent of males and 51 percent of females overall. 26 percent of male shift workers are considered obese versus 19 percent overall.
Cardiovascular health – Shift workers are 1.4 times more likely to have cardiovascular problems than daytime workers.
Gastrointestinal disease – Shift workers are 2.3 times more likely to suffer from gastrointestinal disease (especially heartburn and indigestion) than daytime workers. Stomach disorders are 4-5 times more common with an eight-fold increase in gastric ulcers.[4]
Excessive sleepiness – Sixty percent of shift workers report feeling fatigued, drowsy, or sluggish at work at least several times a month and almost half report fighting sleep or nodding off at least several times a month while at work. 60-80 percent of shift workers complain of chronic sleep disturbances.[5]
Musculoskeletal complaints – More than 30 percent of shift workers report chronic or frequent back problems and nearly 30 percent report chronic leg problems.
Depression – While the data is not complete, a number of studies have found an increased prevalence of depression among shift workers, particularly those working rotating shifts or permanent nights.
What can employees and employers do to tackle these costly health care challenges? Don’t forget to check out part III in tomorrow’s Health and Fitness section.