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The California commute and its adverse implications for health status

Lancaster is also hoping to make its communities more pedestrian-friendly. Last month, the City Council revised its residential zoning ordinance to provide incentives for infill development and to require developers to include pedestrian and bicycle connections to nearby amenities.

Lancaster Mayor R. Rex Parris said residents’ long commutes concern him, adding that he knows hundreds of families who endure debilitating treks to the office.

“The mother and father spend most of their productive hours on the freeway,” Parris said. “It’s just not a good way to live.”

via After a long fall, Antelope Valley is back on upswing – latimes.com.

Parris is right.  It’s not only not a good way to live, research indicates the daily commute has adverse health implications.  The Antelope Valley is located in California, an automobile-driven state noted for having some of the longest and most congested commutes in the United States, with the San Francisco Bay Area and Silicon Valley leading the nation in so-called “super commutes.”

The state recently formed a Let’s Get Healthy California task force made up of the Golden State’s top health experts.  Inexplicably given that commuting is such a big part of Californians’ daily lives, the role of commuting and its adverse affect on health is not discussed anywhere in the task force’s final report.  As Mayor Parris implies, if residents are spending all their daily hours working and commuting, once they get home they aren’t going to have time or energy to get the exercise they need for maintaining good health on the pedestrian and bike trails that his city envisions.

Ironically, while Silicon Valley companies produce some of the longest and worst commutes, they have also innovated much of today’s modern information and communications technology that allows those who perform knowledge and information work to get their work done from their communities.  It’s absurd Californians would jeopardize their health to drive hours each day to use a computer and telephone in some distant centralized office.  And it’s a major oversight this was not addressed by the Let’s Get Healthy California task force.

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California coalition’s report calls for overhaul to rein in health care costs – Health and Medicine – The Sacramento Bee

February 26, 2013 Leave a comment

Simply put, participants said Californians should “collectively” create a health culture.

A critical part of this involves creating environments where people are eating healthier foods in smaller portions and getting exercise, especially walking.

“We need to reduce the burden of illness on the health care system,” said Shortell. “It’s important that we design communities and schools to increase and encourage physical activity.

via California coalition’s report calls for overhaul to rein in health care costs – Health and Medicine – The Sacramento Bee.

I would add that how people work should not be overlooked as it was in the Berkeley Forum report.  We should rethink how knowledge work is done in the 21st Century and develop more modern ways of performing it rather than adhering to the outmoded 20th Century paradigm of sitting in a commute to go sit another 8 hours in a centralized office.

Is the sedendary commuter/cubicle treadmill that also wastes time that could be spent engaged in sustained exercise really worth the price to our health?  I say it is not, especially when most information and knowledge work can be accomplished outside of a central office location.   If Californians are properly to be expected to take more responsibility for their health status and prevention, they must also be afforded the fullest possible degree of freedom and time to exercise — literally– that responsibility.

California state building boondoggle squanders millions, presents workshifting opportunity

January 23, 2013 Leave a comment

The Sacramento Bee today has an item on the California State Board of Equalization’s longstanding problems with its high rise building in downtown Sacramento.  The state continues to throw good money after bad trying to remedy the problems that according to the Bee story include leaking windows, burst water pipes, toxic mold and faulty elevators.  Another $4 million will be allocated for the latest remediation project on top of $65 million spent over the building’s 22-year lifespan.

It’s time to make lemonade from this big lemon.  How?  By putting the workers assigned to the building into a workshifting program that allows them to work from their homes or other locations in their communities (such as distributed workplaces) where they can be productive.  That would save the taxpayers yet more wasted millions while at the same time getting workers out of a less than healthy environment and freeing them up from wasted, stressful commuting time each day.  That additional free time can also benefit the state’s finances by giving those workers more time to engage in health promoting behaviors that can lead to better health outcomes and reduced heath care costs.

Creating an organizational wellness culture for the 21st Century

January 16, 2013 Leave a comment

BenefitsPro.com has posted an item forecasting four employer wellness trends for 2013 featuring Stephanie Pronk of Aon Hewitt.  Pronk emphasizes a point for every employer interested a healthier workforce and lower healthcare costs: that employee wellness cannot be seen simply in the context of the work site, but must create a lifestyle change.  “When you think about why safety programs are so successful in organizations, it’s because they’re engrained in the culture,” Pronk is quoted as saying. “It’s part of the way they do their work every day, so we need to work at health and wellness in the same way. We need culture changes to support healthy behaviors in the long term.”

A major health safety hazard of the information and Internet economy of the 21st Century is holding onto outdated 20th Century practices that assume knowledge work can only be performed in a central office location between 8:30 and 5, Monday through Friday.  That forces knowledge workers into a sedentary existence that can lead to and aggravate chronic conditions associated with lack of exercise.  Riding the commute-to-cubicle treadmill (in a seated position) also sucks valuable time out of their lives, leading many to justifiably claim they lack the time for meaningful, regular exercise and even sufficient sleep.  And that’s not even counting the adverse impact on employee engagement and retention.  The commute-to-cubicle treadmill isn’t merely a job – it’s a default lifestyle – and an unhealthy one.

Employers that are truly committed to helping their staff members adopt healthier lifestyles must give them the freedom and responsibility to do so by giving them control over their daily schedules.  As this blog has noted previously, recently released research has shown the potential of schedule control to support health promoting behaviors – and by extension, healthier lifestyles.  Schedule control enables knowledge workers to function whenever and wherever they are productive with the proviso that they stay in communication with their team and management and fulfill their job functions and tasks. It’s an elegant, low cost wellness program that leverages the power of today’s Information and Telecommunications Technology (ICT) and truly represents the kind of organizational cultural change for the 21st Century that Pronk correctly observes is necessary to achieve a healthier workforce.

Time for sustained exercise to bend the healthcare cost curve — and promote better thinking

January 1, 2013 2 comments

Knowledge workers earn their livings analyzing, abstracting and communicating.  In today’s Information/Internet economy, all too many knowledge workers needlessly do so working under legacy Industrial Age 8-5 office schedules, spending even more time each day relatively immobile than sleeping.  Add to that another 1-3 hours spent sitting in a daily commute to a central office location.  Month after month, year after year of this occupational lifestyle sets the stage for the development of preventable chronic conditions such as diabetes, hypertension and obesity that drive the health cost curve and the health insurance crisis.

But that’s not all.  Lack of physical movement can also dull the knowledge worker’s most important tool: their brain.  This Sacramento Bee article cites research linking physical activity to the brain’s ability to perform learning and memory tasks.

The clear conclusion to be drawn is sustained exercise could produce dividends for organizations by not only lowering their healthcare and insurance costs, but also the added bonus of better and more creative thinking.  For knowledge organizations, affording workers control over their schedules and time for sustained exercise probably is likely the most cost effective “workplace wellness” program going.  A key program component is ditching outmoded Industrial Age commuting and office hours and becoming a more virtual organization and maximizing the use of Information and Communications Technology (ICT).  Knowledge work can be done anywhere, and some of the most creative thinking happens during and after sustained exercise.  That requires freeing up time for it every work day by getting people out of their cars and cubicles.

Schedule control necessary if contingent wellness programs are to achieve meaningful results

December 23, 2012 Leave a comment

In November, the U.S. Department of Health and Human Services (HHS) issued a proposed rule governing wellness programs offered as part of employer-sponsored health plans for plan years beginning January 1, 2014.  The proposed rule is aimed at boosting incentive for large employers to increase the health status of their employees since large employers will be continue to be regarded as discrete risk pools under the Patient Protection and Affordable Care Act, whereas small employers will be collectively treated as a single risk pool.

In addition to the traditional participatory wellness programs such as discounts on fitness club memberships, health assessments and seminars, the proposed rules create an enhanced incentive for employers to offer health contingent wellness programs.  The contingency?  Employees must adopt a lifestyle changes and health improvement plans designed to help them reach target biometric goals such reducing weight, body mass index (BMI), blood pressure, or cholesterol levels.  If they hit the prescribed targets, the proposed rule would allow employers to reward the employee with a payout of up to 30 percent of the cost of the employee’s health coverage for the plan year, an increase over the current 20 percent permitted under rules adopted in 2006.

The rulemaking’s preamble suggests HHS believes the increase in the maximum reward is necessary to boost participation in contingent wellness programs. It cites a 2010 survey by NBGH and TowersWatson in which just four percent of responding employers reported offering financial incentives for maintaining a BMI within target levels.  Only three percent did so for maintaining targets for blood pressure and cholesterol levels.  Based on these numbers, increasing the maximum award level alone isn’t likely to produce a significant increase in the number of employers and employees participating in contingent wellness programs.

However, if such programs were joined with affording employees greater control over when and where they work, participation could increase substantially and employers would see a potentially large payoff in improved employee health status and reduced medical utilization.  Schedule control eliminates the “I don’t have time” excuse for not engaging in health promoting behaviors such as regular exercise and getting sufficient amounts of sleep.  If employers want employees to take responsibility for their health, they must give them the means to adopt healthy lifestyles and avoid the daily sedentary (and hardly health promoting) routine of commuting to and from and sitting in a centralized office.  Plus they would likely enjoy the added bonus of crisper and more creative thinking and better ideas from employees getting plenty of sleep and exercise thanks to having more control over their work schedules.

More study needed of schedule control as promising “worksite wellness” strategy

December 8, 2012 1 comment

As organizations increasingly seek ways to improve the health status of their workforces and reduce burgeoning waistlines and health care utilization costs, they must look to new approaches that hold potential for achieving meaningful results.  A strategy previously discussed on this blog is affording workers more control over when and where they work – known as schedule control – in which work is seen as an activity and not a destination.

In a 2011 study, schedule control showed promise among knowledge workers who thanks to today’s information and communications technology (ICT) are able to be productive independent of time and place.  The study of 659 knowledge workers found that affording them schedule control can promote employee wellness, particularly in terms of prevention behaviors.  Another study published in 2007 found a positive association among workers who perceived greater control over their work schedules with hours of sleep and the frequency of physical activity.  It concluded schedule control may play an important role in effective worksite health promotion programs.

Health professionals would agree that health promoting behaviors take dedication and time – sufficient time for meaningful exercise and adequate sleep.  In recent decades, however, time has become a restricted commodity for full time workers, taking a toll on their health status.  Indeed, a 1996 study correlated too insufficient time for both work and family obligations to poor health outcomes.  Another study sponsored by Health Canada in 2004 found workers with high levels of work time conflict were in poorer physical and mental health and made greater use of Canada’s health care system.

Schedule control provides a means to take back wasted time and thus offers a potential win-win wellness solution for organizations.  Providing it costs organizations virtually nothing and even offers the possible bonus of saving on office space costs.  For knowledge workers, it frees up time devoted to a no longer necessary daily commute to the office. (Commuting has been shown in a European study to interfere with patterns of everyday life by restricting free time and reducing sleeping time.)  While more study is needed, existing research suggests that perhaps the most promising “worksite wellness” intervention may be to drop the “site” and instead focus on the work and the worker.

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