Picturing Tomorrow's Workers

Experts wonder whether the next generation of American workers will be healthy enough for the long haul. The latest diabetes estimates from CDC and new dietary guidelines from HHS and USDA are warning signs.

• By Jerry Laws
• Mar 01, 2011

About 220 million people worldwide have diabetes, according to the World Health Organization. More than 10 percent of them are Americans -- the American Diabetes Association says 25.8 million Americans are living with diabetes and an additional 79 million American adults are at risk for developing type 2 diabetes.

The association's Alert Day 2011 on March 22 is its "wake-up call" to inform the American public about the seriousness of diabetes. The association hopes they'll take the Diabetes Risk Test and find out if they, or their loved ones, are at risk for developing type 2 diabetes, which can be prevented or delayed by making simple lifestyle changes. ADA says early diagnosis "is critical to successful treatment and delaying or preventing some of its complications, such as heart disease, blindness, kidney disease, stroke, amputation, and death."

Unfortunately, the trend lines are decisively turned in the wrong direction. Combined with the latest data on Americans' obesity problem, the diabetes trend is cause for alarm for employers, both for today's workers and for the workforce of the next two decades.

"There's a lot of evidence to suggest that youths are relatively unhealthy, compared to their counterparts decades ago, which is having and is likely to have increasingly negative impacts in terms of worker health and safety down the road," said Dr. Joseph Castorina, MD, MPH, a Regional Medical Director with Concentra Urgent Care and a member of the company's Medical Expert Panel on wellness. Concentra is the leading operator of on-site occupational health clinics.

About 6 million U.S. children are overweight, and that will have an effect as they age into the workforce, with low levels of physical fitness and overweight contributing to diseases and to increased injury rates, Castorina said. Childhood obesity rates have basically doubled since the late 1980s, and 12 percent of U.S. high school-age young people today are obese, he said. "It's been increasing steadily since the late '70s."

He said 47 percent of 18- to 24- year-olds in the United States were overweight or obese in 2005. There are signs this proportion is leveling off somewhat, said Castorina. Rates are rising for all age groups, with younger people having lower rates than older ones -- but today's rates are far higher for young Americans than they were for the same age group 20 or 30 years ago.

"We're seeing the increasing rates of diabetes in the population. . . . Obesity and lack of physical activity are prime risk factors for the development of type 2 diabetes. We definitely have an epidemic of type 2 diabetes, rising and out of control," he said.

Hypertension, heart disease, and strokes are tied to overweight and lack of physical activity. "It's driving health care costs, it's driving morbidity and mortality. We know that young people are more at risk of injury because of unfamiliarity with the work, maybe lack of training for it, a desire to show they're young and strong -- we are seeing higher injury rates with them at this early point," he continued.

Castorina said he expects there will be a "second wave" of increased injury rates for today's younger workers when they're older. "As people come in the workforce now less fit and more overweight, I don't have any data to show this, but one would expect that those patterns will continue to be reinforced," he said.

New Dietary Guidelines Aim at Obesity 'Crisis'
The 2010 Dietary Guidelines for Americans released on Jan. 31 by U.S. Agriculture Secretary Tom Vilsack and HHS Secretary Kathleen Sebelius are another warning sign. The guidelines seek to reduce overweight and obesity through improved nutrition, physical activity, and simply eating less.

"The 2010 Dietary Guidelines are being released at a time when the majority of adults and one in three children is overweight or obese, and this is a crisis that we can no longer ignore," Vilsack said. "These new and improved dietary recommendations give individuals the information to make thoughtful choices of healthier foods in the right portions and to complement those choices with physical activity. The bottom line is that most Americans need to trim our waistlines to reduce the risk of developing diet-related chronic disease. Improving our eating habits is not only good for every individual and family, but also for our country."

The guidelines recommend eating more vegetables, fruits, whole grains, fat-free and low-fat dairy products, and seafood; and also consuming less sodium, saturated and trans fats, added sugars, and refined grains. They contain 23 recommendations.

Castorina mentioned the changes made last year by the U.S. Army -- a big employer -- in its physical training and in its focus on recruits' healthy diets because they are arriving less fit than recruits of years past. This article from DoD's Human Performance Resource Center explains how the Army's training changed.

Manufacturers of fall harnesses have been designing products for heavyweight workers for several years. Employers in general are aware of the problem and are embracing wellness programs, either strongly encouraging or requiring their employees to take steps to be healthier through exercise and better diet, Castorina said.

"This is a major trend across the country. We're a leader in providing workplace wellness programs, and we're seeing a strong trend with them," Castorina said. "It's a very fruitful strategy for employers to be using, focusing on wellness, and fitness, and more physical activity."

Promoting wellness lowers health and worker's comp costs, raises productivity, and will prevent injuries, he said. "There are certainly indications that the trend is positive," he said.