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October 8, 2009 Volume VI, No. 21

HIN Communications Editor Jessica Papay

Dear Healthcare Intelligence Network Client,

In this week's issue, learn how obesity can affect women during pregnancy and how being overweight can increase their chances of developing more health problems later in life. However, the good news is that workplace wellness programs can help to prevent obesity and lower healthcare costs.

Your colleague in the business of healthcare,
Jessica Papay
Editor, Disease Management Update

This week's DM news:

Table of Contents

  1. Obese Women and Survival
  2. Obesity and Pregnancy
  3. Desktop Videos Dispense Dose of Wellness
  4. Coaching in Weight Management
  5. Healthcare Trends & Studies
  6. Worksite Wellness and Risk Prevention
  7. Healthcare Trends in 2010

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Please send comments, questions and replies to jpapay@hin.com.

Melanie Matthews, mmatthews@hin.com

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Obesity in Mid-Life Reduces the Chance of Healthy Survival in Women

A new study by Harvard School of Public Health (HSPH) and Brigham and Women's Hospital (BWH) researchers has found that being overweight in mid-life was associated with having more health problems later in life, including multiple chronic diseases, and impaired cognitive function, physical function and mental health. In a large study population of women who lived until at least age 70, women who were lean at age 18 and maintained a healthy weight through mid-life had the best odds of achieving optimal health later in life. It is the first study to show the role adiposity may play in the overall health of women who survive to older ages.

The researchers analyzed data from the BWH-based Nurses' Health Study, which began in 1976. The study population included 17,065 female participants who had survived until at least age 70. Body mass index (BMI) and weight gain were measured over time, beginning at mid-life (age 50). Factors such as socioeconomic status, lifestyle, smoking and diet were controlled for in the study.

Women who had increased BMI in 1976 at the beginning of the study (when the women's mean age was 50 years) had reduced odds of healthy survival. Obese women (BMI greater than or equal to 30) had 79 percent lower odds of healthy survival compared with lean women (BMI = 18.5-22.9). The researchers also found that women who were overweight (BMI greater than or equal to 25) at age 18 and gained more than 22 pounds between age 18 and 50 had the worst odds of healthy survival and, for all three BMI categories at age 18, those who gained weight had lower odds of healthy survival compared with women who maintained a stable weight.

To learn more about this research, please visit:

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Obese, Overweight Women Have Higher Risk of Giving Birth to Baby with Heart Defects

The largest study of obesity during pregnancy and babies with heart defects in the United States finds that women who were overweight or obese before they became pregnant had an approximately 18 percent increased risk of having a baby with certain heart defects compared with women who were of normal BMI before they became pregnant. Severely obese women had approximately a 30 percent increased risk, according to a study by the CDC.

The study, published in the American Journal of Obstetrics and Gynecology, found a significant increase in several types of heart defects in babies born to overweight and obese women, compared to babies born to normal weight women. These included obstructive defects on the right side of the heart and defects in the tissue that separates the two upper chambers of the heart.

The study looked at 25 types of heart defects and found associations with obesity for 10 of them. Five of these 10 types were also associated with being overweight before pregnancy. Women who were overweight but not obese had approximately a 15 percent increased risk of delivering a baby with certain heart defects.

To learn more about this research, please visit:

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Wachovia Desktop Videos Dispense Weekly Dose of Wellness

As part of Wachovia's Healthy Connections program, employees with PCs receive a 55-second dose of health and wellness-related information each week that is delivered with the company's daily desktop video news program. The desktop videos launch automatically when users turn on their computers, and are replayed in the company's break rooms, common areas and financial centers throughout the day. These offerings are a core part of Wachovia's wellness culture, says Donna Shenoha, the company's vice president and senior consultant of health and welfare.

To listen to this complimentary HIN podcast, please visit:

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Health Coaching, Web Use and Participation in a Weight Management Program

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Philip Smeltzer, strategy leader for wellness and health promotion at Humana.

Question: Do participants prefer receiving helpful information on their weight loss from a health coach as opposed to from the Web? Have you had any problems in getting participation in your weight management program?

Response: When given the option, two out of three people will choose a health coach as opposed to receiving electronic information. In some cases, the health coach will use the electronic information as a supplement to their telephone, e-mail or in-person coaching, referring the individual back to the Web portal and giving them information and other action steps from it. On average, a health coach will make about five calls to their clients over five or six months to their clients. This method has proven to be very successful; nearly half of those who indicated they wanted to make a lifestyle change have done so. More importantly, close to 25 percent are still successful in their efforts at the six- and 12-month interventions, keeping most, if not all, of their weight off. Another 25 percent are still exhibiting a net weight loss, but are coming back up.

Program participation is slowly increasing. This could be attributed to the challenge Humana faced in getting individuals to register for health coaching without a strong promotional effort from the employer groups. The health plan alone is not successful in recruiting members; the employers who talk about obesity and weight management programs, promote them and offer some incentive typically yield a utilization as high as 20 percent. Employers simply “going through the motions” or offering little incentive and no promotions yield a participation rate of about 2 percent. If they do offer a small incentive, once the promotion wears off, these organizations rarely see any new registrants.

For more information on obesity and weight management program benchmarks, please visit:

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Obesity & Weight Management — Weighing in on the Growing Epidemic

Increasingly, healthcare organizations are creating initiatives aimed at the 67 million obese and 85 million overweight Americans. In this HIN white paper, learn how nearly 300 healthcare professionals are managing and working to prevent this growing problem.

To download this complimentary white paper, please visit:

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Worksite Wellness Programs Lower Healthcare Costs, Make Employees Healthier

Worksite wellness programs are a proven strategy to prevent the major risk factors for cardiovascular disease — smoking, overweight, obesity, high blood pressure, high cholesterol and diabetes — according to a policy statement published in Circulation: Journal of the American Heart Association.

According to Mercedes Carnethon, Ph.D., an assistant professor in the department of preventive medicine at Northwestern University Feinberg School of Medicine and lead author of the paper, “research shows that companies can save anywhere from $3 to $15 for every $1 spent on health and wellness within 12 to 18 months of implementing a program. Beyond cost savings and increased productivity, visionary employers are realizing the value of an employee’s total health. An effective worksite wellness program can attract exceptional employees, enhance morale and reduce organizational conflict.”

The statement recommends incremental changes to get employees on track, recognizing there is no one-size-fits-all approach to wellness. The paper also outlines keys to a successful worksite wellness program. These include tobacco cessation and prevention, regular physical activity, stress management/reduction, early detection/screening, nutrition education and promotion, and weight management. They also include disease management, cardiovascular disease education including cardiopulmonary resuscitation (CPR) and Automated External Defibrillator (AED) training, and changes in the work environment to encourage healthy behaviors and promote occupational safety and health.

The policy paper was published at the same time that the American Heart Association (AHA) revealed its 2009 list of Start! Fit-Friendly Companies, a program that recognizes employers who create a culture of physical activity and health in the workplace, and provides free walking path kits and online tracking tools for companies that want to get involved. The AHA also champions worksite wellness programs in its healthcare reform efforts.

To learn more about this research, please visit:

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Healthcare Trends in 2010

Healthcare reform, a fragile economy, high numbers of uninsured, the lingering threat of H1N1 and emerging care models are just a few factors that promise to drive changes in the healthcare industry in the coming year. To learn how other healthcare organizations are preparing for 2010, complete HIN's fifth annual survey on Healthcare Trends in 2010 by October 30 and receive a free executive summary of the compiled results. Your responses will be kept strictly confidential.

To participate in this survey and receive its results, please visit:

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