Expert: Just stop getting fatter

In anticipation of Gov. Rick Snyder’s special message on health and wellness in September, Bridge Magazine spoke with Dee Edington, one of the nation’s top experts on designing workplace wellness plans.

Edington, director of the University of Michigan’s Health Management Research Center, said he has not advised Snyder on how to improve the health of Michigan citizens. But as this edited conversation with Rick Haglund shows, Edington has plenty of suggestions for the governor.

Explain the title of your latest book, “Zero Trends: Health as a Serious Economic Development Strategy.”

The trend in health care costs has been 6 percent-to-8 percent growth for many years. To get that trend down to the overall rate of inflation, that’s the zero trend I’m talking about. It not only goes for health care, it goes for disability and workers' compensation. We have to get everything down.

We all focus on cost, but the real issues are people’s quality of life and the quality of the work force. I gave up on this being a health argument in the 1980s. Companies are more focused on economics than health, so I tried to switch this to an economic issue. Economics are driving the health issue. Cities are getting hit just as hard as companies, even more so.

You say in the book that we need to switch from a “wait-for-sickness” health-care system to one that also incorporates a wellness strategy. What’s the business case for that?

I think healthy, high-performing people are going to be the competitive advantage in the 21^st century. That will keep a company’s costs down. If you only focus on reducing sickness costs, wellness might get hurt. If you focus on all costs, you get a different picture. You have to look at the total value of health.

Wellness is such a small percentage of the health-care dollar. It’s about 2 percent. It should be more.

If you were advising Gov. Rick Snyder on developing a health promotion strategy, what would you tell him?

Just making a statement will be an important event. But he can’t just say, “We’re going to do this.” He has to get the senior leaders in the organization engaged -- and I mean engaged. All of the department heads and the people who report to them have to be on board with the governor.

He has to say, “This is why it’s important to do this. We need be the best place to live, the best place to work, the best to invest.” He needs to send a message to businesses that Michigan has healthy, high-performing people who are going to keep their costs down.

And he’s going to need to allocate some financial resources for this. It’s not a one-year deal. It has to become part of the culture of Michigan. It needs a champion. I’d like to see this effort led by the economic people, but Snyder will probably give it to his health people.

We should take advantage of our tourism and agriculture industries in Michigan. Recreation and nutrition are basic parts of peoples’ lives.

I would say to the governor, “You came in with some promises and you delivered on them. Now here’s another one that’s critically important for the health and well-being of citizens.”

We’ve had president’s councils on physical fitness under various names since 1956. Governors have enacted health-promotion programs. Yet obesity is on the rise and health-care costs keep escalating. Why have these programs failed?

The president’s councils usually put in an athlete as the spokesman for the council. They forgot that this is not about athletics -- this is about real people. These organizations generally have a single focus and they don’t work with the culture that is working against healthy habits.

You’ve been advising corporations and organizations for decades on implementing wellness programs. What are some of the things successful companies do?

The easiest thing I see companies do is focus on changing the vending machines in the cafeteria. Put the healthy snacks at eye level. Put the unhealthy snacks at the bottom so people at least have to bend over to see them. Some companies don’t have fried foods on Friday in their cafeterias.

Open up the stairwells. Give people a chance to walk at lunchtime. Give them flextime if possible. As an employer, you want to ask, “Is this a good place to work? Would your employees recommend people to work here?”

Managers must recognize the importance of this. At some companies, people don’t smile. The attitude is, just keep working. Celebrate people who walked two miles or five miles. Make it a place where people don’t leave worse at the end of the day than when they showed up.

Explain what you mean by implementing a “don’t get worse” strategy.

That’s my favorite strategy. The public health people hate that. They think it’s setting the bar too low. But you can’t get better until you don’t get worse. It takes the pressure off people. If you tell them to just don’t gain weight, they’ll say, “I can do that.”

Adults in this country gain an average of one pound a year. If there are 5 million adults in Michigan and they didn’t gain weight for a year, as a state we’d be 5 million pounds lighter. I think we get better by small wins. The first win is, don’t get worse.

Are you optimistic that Michigan citizens will become healthier?

I absolutely am. Some state has to step up and set an example for the rest of the country. The governor who does this will talk to other governors and other states will figure out they can do it, too. Why not be No. 1 instead of No. 48?

What did you eat for lunch today?

I had carrots, peanut butter and iced tea.

Did you exercise today?

I walked. I think walking is the exercise for Americans. I have a high desk so that I can stand up at my computer. Don’t ask me about sleep. I’m not very good about that.