Need to know:
- Encourage staff to adopt healthy behaviours to help reduce the risk factors associated with cardiovascular disease.
- Raise awareness of heart health and ensure staff feel able to engage with the health interventions available to them.
- Support for employees returning to work after a cardiac event should take into account both their physical and mental health.
Heart, blood pressure, and circulation problems accounted for 3.1 million of the 137.3 million working days lost due to sickness or injury in the UK in 2016, according to the latest Sickness absence in the labour market report, published by the Office for National Statistics in March 2017. With this in mind, what steps can employers take to support the heart and circulatory health of their workforce?
Reduce the risk factors
Organisations can take a proactive approach to supporting employees’ cardiovascular health by helping them to reduce risk factors such as smoking, obesity, and physical inactivity. Discounted gym membership and on-site exercise classes are among the benefits that employers can offer to encourage staff to stay active, but smaller changes to everyday behaviours can also make a difference.
Dr Steve Iley, medical director at Bupa UK, says: “We know that sedentary behaviour is one of the risk factors for cardiovascular disease and it is very easy in certain environments in an office to be very sedentary; driving to work and sitting down all day can mean that [employees] are not getting anywhere near what [their] recommended daily activity should be.”
Indeed, research by Axa PPP Healthcare, published in February 2017, found that 25% of respondents spend between seven and eight hours a day sitting down at work, while May 2016 research by the National Charity Partnership, a collaboration between the British Heart Foundation, Diabetes UK, and Tesco, found that more than half (52%) of employees never leave the office at lunchtime. To address this, employers could promote the use of the stairs rather than the lift, hold walking meetings or run campaigns that motivate staff to go outside or take part in an activity during their lunch break.
Team challenges can also inspire staff to include regular exercise in their daily routine, with the use of mobile apps and fitness trackers adding another level of engagement. While organisations could make wearable technology more accessible to staff via discount schemes and its provision through certain insurance products, it should be considered as part of a wider health and wellbeing strategy rather than a standalone solution. “Wearables are another tool to use, not a silver bullet,” says Iley.
Enabling staff to make healthy food choices and maintain a balanced diet can also play a role in reducing risk factors for cardiovascular disease, such as high cholesterol and being overweight. This could range from introducing healthy options into workplace vending machines and canteens, to publishing healthy recipe cards or running a cooking course for staff, says Mike Blake, compliance director at PMI Health Group, part of Willis Towers Watson. “Everything may not have to be a healthy option, but [employers] could at least signpost it so that [employees] have got a choice and they know what’s at the healthy end of the spectrum and they know what’s less healthy,” he adds.
Engage staff with their health
Raising awareness about cardiovascular disease and the changes individuals can make to their lifestyles to reduce the risk factors can encourage staff to engage with employer-facilitated health and wellbeing initiatives. Organisations could take advantage of calendar events such as February’s Healthy Heart Month and Valentine’s Day to run communication campaigns around heart health, says Vicki Leslie, client relationship manager at EC Insurance Services (ECIS). Ensuring that senior leaders highlight the campaign in their interactions with staff can add further weight to the topic, and increase buy-in across the business. “When senior management are engaged and practising what’s being preached, that does feed down [to other employees],” adds Leslie.
Developing a broad dialogue across an organisation about the benefits of adopting healthy behaviours and giving staff the confidence to engage with the health interventions available to them could also encourage at-risk employees to seek support, says Dr Chris Tomkins, head of proactive health at Axa PPP Healthcare. “People don’t want to be singled out, so what [organisations] need to do is go out there with positive messages that open up the opportunity for [employees] to step up and engage,” he says.
This could begin with know your numbers-style health screenings to monitor metrics such as blood pressure and body mass index (BMI), and then progress to more targeted interventions for those who require them.
The dedicated services offered through benefits such as private medical insurance (PMI) can also help employees with cardiovascular disease to manage the condition; telephone-based coaching programmes can provide individuals with personalised support from specialists such as dieticians, says Bupa’s Iley.
Provide appropriate rehabilitation support
An employee who has been absent from work following a cardiac event or treatment may need additional support upon their return to work. Seeking medical advice, such as through occupational health services, is key in assessing when it is appropriate for the affected individual to return to work and whether any adjustments are required. “Ensure that there is a joined-up approach between the proactive health and wellbeing piece, and the occupational health piece,” says Tomkins.
In some cases, a phased return to work may be appropriate. Leslie says: “Some people, depending on the issue they have, may be able to come back to work fairly quickly [but] others may require a more flexible return where they maybe start off doing part-time or morning hours.”
Making sure that the employee feels fully supported by the organisation, and that their line manager is trained to manage the situation effectively, can help to ease any concerns the employee may have about the impact of their health condition on their working life, adds Leslie.
Look beyond the physical
A cardiac event, diagnosis, or a long-term absence from work may have an adverse effect on an employee’s self-confidence and mental health. “It’s not just about supporting them from a physical perspective, it becomes important to support [the employee] from an emotional and mental health perspective as well, and not to lose track of that,” says Leslie. Employers can highlight services such as employee assistance programmes (EAP) to make staff aware of both the physical and mental health support systems available to them.
Helping staff to manage stress, by taking steps to support their work-life balance or offering mental health resilience training for example, may also reduce their risk of developing cardiovascular disease. Iley says: “Cardiovascular health is just one part of being a total person and there is evidence that how we manage our stress has a direct link to cardiovascular health, so concentrating on just the physical and not looking at how [employees] feel more generally and how [their] mental health and stress levels are being managed would be missing part of the piece.”
RSK supports employees’ heart health and wider wellbeing through pedometer challenges
In February 2015, environmental consultancy RSK launched an employee pedometer challenge to encourage staff to stay active as part of Healthy Heart Month. The challenge, which saw 50 teams of five employees achieve a total step count of 62,624,561 over the course of the month, ran alongside a range of activities to promote health and wellbeing. This included fundraising initiatives for the British Heart Foundation, and a quiz to increase awareness of heart health.
The organisation runs wellbeing initiatives on a quarterly basis to support the health of its 1,600-strong global workforce. In May 2015, it launched a Let’s Do Lunch healthy-eating campaign to encourage staff to take their lunch break away from their desks and to interact with colleagues.
This was followed by Give a Thought to Sport Day in October 2015, which looked to highlight the link between sedentary behaviour and health conditions, such as heart disease, as well as providing a fun way to promote physical activity and healthy lifestyles. In addition to spectators, around 150 employees took part in the sports day events, which featured old favourites such as the egg and spoon race.
In October 2016, RSK introduced its second pedometer challenge, which saw an increase in participation rates. Over four weeks, 63 teams globally took a total of 89,434,971 steps. Employees could choose to track their step count via pedometers given out by the organisation or through their own wearable devices. While the organisation did not publish individual or team step counts, it did promote the challenge leaders through its intranet each week, as well as sharing useful information, such as walking tips, via its Twitter page.
The aim was to encourage everyone to get involved, irrespective of their usual activity level. To do this, the organisation celebrated best improvers; the most-improved individual was recognised with a Fitbit Charge HR. There were also prizes for the most-improved team, the winning team, the most steps walked as an individual, as well as best team walking tip, best individual walking tip, best team name, and best team photo. The prizes had a health focus and looked to reinforce team spirit and social interaction, for example, healthy hampers, fruit baskets, walking books, and keepsakes such as mugs with the best team photo on and keyrings embossed with the best team name.
RSK also wanted to make sure that all global staff who were interested in taking part in the pedometer challenge could do so, including those who worked in smaller offices who may not have been able to form a full team locally. With this in mind, Zoe Brunswick, HR director, formulated teams from across the organisation, which also helped to create and strengthen connections across the business.
“The key for us is around having fun, raising awareness, and social interaction,” says Brunswick. “We are such a diverse business and we’ve got various teams, they could be sat in the same office and never interact with each other, so these sorts of [initiatives] are about bringing the business together and breaking down those barriers.”
Viewpoint: Empower staff to eat and work in a healthy way to support cardiovascular health
In a world where we are increasingly exposed to longer working hours, reduced time for exercise, an increased sugar intake and weight gain, focusing on health in the workplace could not be more important.
The Circulation Foundation, the charity affiliated to the Vascular Society of Great Britain and Ireland, is committed to promoting cardiovascular health in all aspects of modern day life.
Within the workplace, staff should be encouraged to adopt a healthy lifestyle by being empowered to both eat and work in a healthy way. Simple measures such as the availability of food and snacks to include healthy options and low-sugar drinks can encourage individuals away from the habit of craving sugar between meals. Allowing enough time for proper meal breaks is more conducive to eating a healthy meal than condoning snacking while continuing to work at a computer. It also encourages mobility and exercise by forcing staff to leave their desks.
Access to drinking water is also vital. While most commuters grab a coffee on the way to work, many do not keep well hydrated throughout the day. This is exacerbated by the dry air associated with air-conditioned offices and the diuretic effect of caffeine. Dehydration combined with immobility in some higher-risk groups can be an additional risk factor for the development of a deep vein thrombosis.
Thankfully, it is now impossible to smoke in most UK working environments, which has both reduced the risks associated with passive smoking and encouraged many to give up. However, smoking remains a way of life for some. Exposure to smoking cessation advice at work can capitalise on the added advantage of peer pressure to help this group stop where other methods have failed. Regular health check sessions can also help, whether run via a local GP practice nurse or an in-house occupational health department, which can encourage blood pressure, cholesterol and glucose checks to pick up problems and treat them at an early stage.
Finally, advertising health literature and appropriate screening programmes on staff noticeboards can be a way of targeting workers who do not often visit their GP.
Michael Jenkins is chairman of the Circulation Foundation Committee