Wednesday, July 29, 2015

Using Bans and Taxation to Fight Obesity

Several proposals that aim  to change people's behavior to reduce obesity have been suggested or enacted. These proposals include placing bans or limits on the amount of sugar sweetened beverages (SSBs) a person can purchase, and using taxation to make purchasing SSBs more costly.

In 2012, New York Mayor, Michael Bloomberg, proposed placing a "ban on sweetened drinks in containers larger than 16 ounces at any establishment that receives a grade from the health department." The limit on the size of the beverages was very unpopular. Sixty percent of the respondents to a New York Times survey were opposed to the limit. And in March of 2013, the SSB limit was struck down by Milton A. Tingling,  a State Supreme Court judge in Manhattan, N.Y.

Two other approaches to changing the behavior of persons using SSBs involve taxation. One approach would place a tax on SSBs, making it more costly to consume the beverages. And the other approach would remove the tax deduction companies receive as an ordinary advertising expense.

Making it more expensive to drink SSBs may indeed cause a decline in the use of the beverages. One study suggests that a "tax that raises the cost of SSBs by 20 percent could lead to an average reduction of 38 pounds per year for adults." Further, these types of "taxes would ... generate considerable revenue." Another study indicated that an SSB tax "could substantially reduce BMI and healthcare expenditures and increase healthy life expectancy." It should be noted that in 2014, Berkeley, California passed a measure that puts a one-cent tax on each ounce of sugar-sweetened drinks. Time will tell if this taxation has a positive effect -- on usage, for example.

As part of business tax deductions, companies are allowed to deduct a percentage of the cost of advertising. One study indicated that eliminating advertising deduction for foods that have little nutritional value could lower childhood obesity. And eliminating these deductions could also be a way for government to save money.

No doubt, more policy makers who want to address obesity will propose SSB taxation and SSB related bans. As demonstrated in New York and other places, proposals that place limits on people's choices face opposition. But it may be in all our best interests if we implement reasonable measures, including some  limits, that make us all think more about what we eat and drink.

Saturday, July 18, 2015

Improving Employee Wellness Programs

Many corporations are interested in on-site wellness programs to reduce obesity or improve the general health of their employees. Keeping employees healthy can increase productivity by reducing absenteeism and presenteeism, which exists when, because of poor health, a person produces less than normal. However, understanding why wellness programs don't always help employees is difficult, because there are workplace barriers that can hinder employees' involvement in the programs. Further, measurements used to evaluate key workplace elements, related to wellness programs, are often inadequate.

Concerning barriers to employee involvement in wellness programs, according to one study, the barriers include "irregular schedules, shiftwork, short breaks, physical job demands, and [inadequate] food options." Further, employees ... are confronted with issues of "motivation, time, money, and conflicting responsibilities." These conditions can limit employee participation in wellness programs.

Another problem associated with wellness programs is the lack of tools that can accurately assess the worksite programs' effectiveness. If good tools were in place, researchers could improve actual environmental elements that might benefit those employees who participate in the wellness programs.

Further, the selection of items being measured doesn't cover some important items. One study looked at the typical items measured. These items include exercise facilities, lockers, showers and healthy eating options such as vending machines. But the investigators found that workplace items that should be included such as the "role models and champions" of the programs were not considered. And these type of exclusions represent important gaps in the measured elements.

Therefore, as the above studies show, barriers to employee participation in workplace programs do exist. And a more accurate assessment of what's happening at the employee's worksite environment should be addressed.

So by removing  barriers to employee participation, and by improving the measurements related to wellness program elements, corporations can better meet the main objective of the programs: keeping employees healthy. Healthcare providers, including obesity medicine experts, can help improve employee health by helping employers improve employee participation in wellness programs.

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