How UAE employers can support their chronically ill staff

Has your company got a grip on rising healthcare costs?

Chances are, the answer is no. But it’s not all doom and gloom. Because while watching any cost spiral out of control is extremely worrying, what’s most surprising is that there are ways to reverse this negative trend, and these approaches are not only readily available but are relatively easy to implement.

The first and biggest step is something that applies to all of us whether we’re individuals, corporations or healthcare providers. It is understanding this simple fact: Healthcare costs can be perfectly manageable if we simply take care of our health in the first place.

Okay, let’s think about that for a moment. It’s not exactly a revolutionary idea but given that one in five of us here in the UAE is thought to suffer from a potentially fatal non-communicable disease (NCD) it is a vital starting point. And just to recap, an NCD might include type 2 diabetes, cardiovascular disease, obesity, chronic respiratory illness – all of which are preventable according to the World Health Organisation (WHO).

No more ‘sickcare’ – it’s time for real healthcare

Treating the sick is of course paramount, but treating the healthy, to keep them healthy, leads to prevention of disease.

What we’re seeing right now is a kind of ‘sickcare’ model – when what we need is true healthcare. Because even when we consider other factors at play with regard to rising healthcare costs such as fraud and abuse, it is prevention and effective management that have the most potential to bring down medical expenses and alleviate strain on our struggling healthcare system.
And collectively we have the power to make this happen.

We need to start by unambiguously linking up lifestyle choices with overall health. This is not only important in preventing illness but absolutely key to managing long-term chronic medical conditions as well. All-too-common diseases and ailments such as heart disease (the biggest killer in Dubai, responsible for 30 per cent of all deaths) and with diabetes (affecting 19 per cent of our population) can be managed and perhaps even reversed.

We’ll look at this in more detail in a moment, but what’s important to remember is whether it’s the diseases mentioned above, or other problems such as chronic back pain or obesity, or even mental health issues, there is a way to create better health outcomes for us all.

But before we get to that, let’s ask the big questions: Whose responsibility is all of this? And how much falls to the employer?

In my opinion – quite a lot. The fact is, the medical system in its current guise does a lot to treat symptoms and little to combat the root causes of illness. Therefore if employees are not receiving the right information from their physicians, it falls to the employer to pick up the slack.

So the next question is what would this model look like? What form would it take? To find out, let’s take a look at how employers can contribute to managing some of the most prevalent chronic illnesses in the UAE and beyond.

Employers and management of chronic illness: Overweight and obesity

We’ll start with a condition that is an impending disaster here in the UAE: Overweight and obesity. The WHO reported in 2014 that worldwide 39 per cent of adults (18 and over) were overweight and 13 per cent were obese. Think that’s shocking? Well, you better sit down. Because in the UAE, the obesity rate is twice the world average. Yes, you can go ahead and double that 13 per cent.

Keeping in mind that obesity is entirely preventable, it becomes clear that much more needs to be done to tackle this issue.

So what’s an employer’s first move? Well, helping staff manage obesity means you need to keep two key areas in mind. First, programs cannot be undertaken in isolation and should be managed in conjunction with physicians and other healthcare practitioners.

Secondly, education is paramount. Rather than simply suggesting weight management goals and offering up incentives, corporations must work with staff to educate them on diet and fitness – and to draw a clear correlation between what goes in our bodies and the impact it can have on our health.

Employers and management of chronic illness: Type 2 diabetes

According to the 2015 UAE National Diabetes and Lifestyle Survey, just under one-fifth (19 per cent) of the population of the UAE suffer from diabetes. That’s a figure that places the Emirates in the top 20 countries in the world for the occurrence of this disease. No one wants to be a member of that club. And just like obesity, type 2 diabetes is entirely preventable. In fact, according to Diabetes UK, up to 58 per cent of cases can even be reversed.

So the figures are bad, but there is a great deal of hope since we can make real changes for the better.

Now, as far as employers are concerned, there are some key things to get right when helping staff manage and potentially reverse diabetes. The first is finding it early by regularly screening for indicators of pre-diabetes. These can be present up to a decade before type 2 diabetes takes hold. Next, it is important to educate on diet and lifestyle, particularly when it comes to the possibility of reversing diabetes.

Finally, it’s ensuring that we’re really specific about these diet and lifestyle changes – many people for example are not aware that almost all nutrition experts recommend removing grains as well as sugar from the diet to turn back the clock on this disease.

It’s vital that as employers (filling the gaps where physicians are not educating sufferers) the information gets out there on the need to eat a diet high in oily fish and leafy, fibrous vegetables as a way to manage symptoms or potentially reverse the damage caused by the disease.

Employers and management of chronic illness: Depression

It isn’t just physical conditions that require continued management. There are plenty of mental health issues that need attention as well, with depression leading the way. According to figures discussed at the 2015 Global Expert Meeting on Brain Diseases held in Abu Dhabi, around 5 per cent of the UAE population suffers from depression. Many experts in the field believe that the majority of cases go unreported so that figure is potentially much higher.

As for how corporations can help support depressed employees, the UK mental health charity Mind recommends three easy steps. The first is to encourage an open conversation to remove any stigma around the condition; second is to work to reduce any workplace-related stresses that could potentially trigger

The first is to encourage an open conversation to remove any stigma around the condition; second is to work to reduce any workplace-related stresses that could potentially trigger depression; and finally to be flexible to help accommodate employees during different stages of the condition. There is little that can be done to ‘reverse’ mental health conditions but effective long-term management can certainly make a world of difference to both the sufferer and their employer.

Employers and management of chronic illness: Chronic back pain

While chronic back pain may not appear as serious as the other entries on this list, it is a condition that plagues the lives of many here in the UAE and affects people of all ages. A 2003 study published in the Bulletin of the WHO not only calls low back pain a “leading cause of disability” but it is the most common reason for a person visiting the doctor.

So again, we’re adding to the strain on physicians when there are things we can do. In fact, there is plenty that employers can do to help manage this condition. Many already provide backrests, standing desks, orthopaedic chairs and allow regular breaks – to manage, alleviate and prevent chronic back issues. A complete workstation assessment is vital for new employees.

For more serious conditions, corporations could follow the example of the UK’s Royal Mail postal service who provide regular access to occupational physiotherapists. Royal Mail saw a success rate of 67 per cent from their scheme which aimed to put long-term absent employees back into work after just 10 weeks of treatment.

UAE healthcare situation: We must act now

While this may seem dramatic, it is not: We are simply out of options. The time for change is now. The fact is, the majority of the chronic conditions that plague the UAE are on the increase and in many cases they are of our own making – brought on by stress, poor diet and sedentary lifestyles.

Let’s say it again: These factors are largely within our control.

What’s more, the conditions that may be somewhat out of our control, such as depression and long-term back pain, are simply not being managed effectively enough.

And that is the very crux of the issue. We have on the one hand a growing number of organisations offering health-based incentives and wellness packages aimed at delivering optimum health to their workforces. On the other hand, we have a healthcare system that focuses on treating symptoms of conditions rather than attempting to search for the root cause.

It is time to bring these two sides to together.

How do we do this? By developing chronic illness management and wellness programmes in conjunction with physicians and healthcare providers – to treat symptoms but also to manage the long-term impact of the condition. We must keep symptoms under control and where possible reverse the effects of common medical conditions through both medication and simple lifestyle changes.

Only then can we move away from the expensive sickcare “get ill and then treat” model that is not helping individuals or companies.

Prevention where possible needs to be the new mantra, where we start to see less dependence on expensive medications and hospital visits and witness a genuine and sustained improvement in employee health across the board and a reduction in those sky-high corporate medical costs.

Carole Khalife is head of Human Capital and Employee Benefits at Al Futtaim Willis