A toxic place to work?

Talk about ironic: A new survey suggests that many hospital employees don’t practice what they preach when it comes to staying healthy.

The survey, conducted by the Thomson Reuters consulting group and released this week, found that health care spending for hospital workers was 10 percent greater than for the U.S. workforce as a whole. Hospital employees also were more likely to have chronic medical conditions such as asthma, diabetes, high blood pressure and congestive heart failure.

The report is based on an analysis of health care costs and utilization by 1.1 million hospital employees and their dependents who had employer-based coverage.

I’m not sure what to think of these findings. Are people who work in hospitals really less healthy than everyone else? Or is the real issue that hospitals often are stressful, unhealthy places for people to work?

I once spent a day shadowing a registered nurse. She was on her feet almost all day and barely even had time for lunch.

Multiple studies have documented the occupational stress nurses face every day and the toll it takes on them. Many observers believe the stress is only increasing as the work load intensifies, putting nurses at greater risk of burnout and chronic disease.

But it’s not just nurses who work in stressful conditions. It would be hard to find a hospital employee anywhere these days, from the kitchen to the intensive care unit, who isn’t feeling the pressure to do more with less, to be more efficient and deliver safe, quality services while reimbursement continues to be ratcheted down.

Despite a mounting body of evidence that 12-hour and rotating shifts are associated with fatigue, decreased physical and mental functioning and even lower life expectancy, these schedules are still commonplace at many U.S. hospitals.

Fast meals, often grabbed on the go from a vending machine, can become the norm during a busy day. Even eating in a hospital cafeteria isn’t necessarily the better option, especially when menus are designed to appeal to visitors rather than the workers who eat there every day.

Put it all together and it should no longer be surprising that hospital employees statistically comprise one of the least healthy occupational groups.

When the University of Michigan tackled an initiative in 2002 to develop a wellness program at Allegiance Health in Jackson, Mich., the researchers’ baseline assessment found some of the unhealthiest workers they’d ever seen. Only half of the employees who underwent the assessment were considered low risk; 19 percent were classified high risk.

All of this is to say that it’s usually not enough to tell people they should shape up. The environment must support this as well.

I had the opportunity recently to visit with a couple of local employers about some of the changes they’ve adopted to encourage better food choices and more physical activity among their workforce during the work day. They haven’t been draconian about it; employees can still get a candy bar from the vending machine if they’re really craving a Milky Way. But both these organizations – Affiliated Community Medical Centers and West Central Industries – have become more intentional in their policies and practices: smaller portions for catered meals, more low-fat entrees and fresh fruit and vegetables in the cafeteria, fewer high-calorie snacks in the vending machines, walking programs that encourage employees to log some exercise time each day.

Studies to date have shown mixed results on the benefits of employee health initiatives. The payoff – healthier workers and lower health care costs – generally isn’t immediate; in fact, costs can rise in the short term as issues such as high blood pressure are identified and treated. Corporate wellness initiatives seem to work best when they target the workforce as a whole, not just those who are deemed at risk. They can also be counterproductive if workplace hazards and other environmental barriers aren’t dealt with first.

The lesson here, it seems, is that wellness doesn’t begin and end at home. If we want hospital workers to be healthier, part of the solution will have to come from their employers.

Photo: Wikimedia Commons

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