Want to Cut Health Care Costs?

The statistics are sobering.

Approximately 18 million Americans live with diabetes. In Washington state, some 444,000 people have been diagnosed with the disease; an estimated 162,000 have undiagnosed diabetes. In King County, the percentage of residents with diabetes more than doubled to 5.8 percent in 2006 from 2.8 percent in 1996.

Experts project that the cost to our nations health care system from diabetes could reach $100 billion a year. Its estimated that the Puget Sound region alone annually spends $1.3 billion on health care costs for diabetes.

No longer can diabetes be viewed as only a chronic medical ailmentit has become a public health policy issue. The battle against this epidemic must be waged on multiple fronts, and one of the most important is workplace wellness programs.

There are two types of diabetes. Type 1 is primarily a genetic disease requiring life-long insulin injections. But it represents only 5 percent of the cases. The remaining 95 percent of cases are Type 2 diabetes, the byproduct of other causes, including poverty, ethnicity and advancing age.

The principal culprit, however, is obesity. More than 80 percent of those afflicted with Type 2 diabetes are obese, and obesity often is the trigger for diabetes. In King County, 25 percent of the population was obese in 2009, compared with 7.3 percent in 1990.

Avoiding obesity isnt easy. As Eric Schlosser points out in Fast Food Nation, Americans now spend more money on fast food than on higher education, personal computers, computer software or new cars. They spend more on fast food than on movies, books, newspapers, videos and recorded music combined.

Fortunately, Type 2 diabetes can usually be controlled. Multiple studies confirm that weight loss through dietary changes and increased physical activity can prevent or delay the onset of Type 2 diabetes.

One strategy to promote these changes is taxing candy and sugar-sweetened beverages. Its unfortunate that state residents voted to repeal a tax on those goods, a tax that would have discouraged consumption of such unhealthy products, which now account for as much as 20 percent of young peoples daily caloric intake. David Fleming, director and health officer of Public Health-Seattle & King County, in a recent newspaper column argued that because of such habits, this generation has a shorter life expectancy than its parents.

In July 2010, Public Health, using one-time federal stimulus money, offered $8.9 million in grants, many of them to support programs by school districts, cities and other organizations that promote exercise and good nutrition.

Perhaps the most effective weapon in the battle against diabetes is wellness programs. A good example is the program run by King County for its employees. Since its 2005 launch, the regimen has cut the countys projected health care costs by $18 million. Enrolled employees as well as their spouses or domestic partners have made statistically significant improvements in 12 of 14 health indicators, including body weight. One reason workplace wellness programs are so effective is the large chunk of time the average working person spends in the workplace environment, about 66 percent of his or her waking hours. Most people also eat one and sometimes two meals per day there. In addition, employees in a workplace wellness program become part of a support group, and studies confirm that people are more likely to change their habits when part of such a group.

As a registered dietitian, Ive observed firsthand the positive impact of a well-designed workplace wellness program. I taught weight reduction and behavior modification in diabetic classes at Virginia Mason Hospital, in which participants lost weight and gained more control over their blood sugar.

We may never find a cure for diabetes. And future demographics will make the battle against the disease more difficult. By 2030, older workers, who are more likely to develop the disease, will represent 23 percent of Washingtons workforce.

The public and private sectors must develop and support effective strategies such as wellness programs to fight diabetes and obesity. Now is the time to act.

Holly Wright is the CEO of Lean West Consulting, a firm focused on corporate wellness. She is a registered dietitian and Certified Corporate Wellness Trainer.