A program to promote health in the workplace conducted in several worksites across India resulted in significant declines in heart disease risk factors.
A four-year heart disease prevention program implemented in six industrial worksites throughout India resulted in significant reductions in cholesterol, blood sugar, blood pressure, tobacco use and sedentary behavior and improved dietary habits at the workplace. The health intervention program was described in a study published in 2009 in the Journal of the American College of Cardiology.
The study suggested that an effectively designed health intervention program and a comprehensive heart disease prevention program are successful in decreasing cardiovascular disease risk factors at the population level.
Economic Benefit of Workplace Health Programs
The worksite intervention cost approximately $7.30 per person per year, and the researchers of the study predicted costs could be even lower if carried out as a larger program. The human capital in India’s workforce is almost 30 million, and implementing the intervention on a larger scale has the potential to make a national impact.
“Given the fact that India is expected to lose 237 billion international dollars from 2005 to 2015, an economic loss attributable to CVD [cardiovascular disease]…such a low-cost program would be extremely useful,” the researchers said.
Description of the Workplace Heart Disease Prevention Program
More than 5800 employees and their families aged 10-69 years participated in the worksite intervention, which was a multi-pronged strategy of health promotion, high-risk primary prevention, and policy level and environmental changes. The intervention was implemented by trained, locally stationed, project health care personnel.
The program’s primary objectives were to:
- Increase consumption of locally available fruits and vegetables;
- Promote a healthier diet, including higher fiber consumption and decreased intake of salt and oils;
- Promote physical activity;
- Reduce tobacco use;
- Maintain a healthy weight; and
- Raise awareness of prevention and treatment of high blood pressure and diabetes.
- The intervention sought to influence behaviors at the individual level, interpersonal level (family, workplace-related peers) and environmental/macro level (social norms at worksite and home).
Methods of intervention included:
One-to-one interactions between trained health project personnel and employees and families
Population-based strategies using posters, banners, handouts, booklets and videos for individual and mass awareness
Group interactions, health melas (fairs) and motivational sessions conducted by investigators and locally stationed project personnel
Posters, banners, handouts, booklets and videos were translated into several languages and distributed. These materials are available from the World Health Organization country office for India.
The program empowered and motivated management, employees and families who initiated policy and environmental changes. Dietary improvements at worksites included: adding salads to cafeteria menus; reducing frequency of fried foods served per week; voluntary withdrawing or restricting food that are high in salt; and periodically providing fruits as an alternative to Indian desserts. In addition, employers banned tobacco use onsite.
Individuals with risk factors were referred to health care facilities for treatment and further support. Onsite physicians received risk reduction targets and treatment guidelines for hypertension and diabetes. Individuals with risk factors participated in group counseling sessions on diet, tobacco use and physical activity and had the opportunity to arrange for individual counseling sessions.
Intervention Decreased Heart Disease Risk Factors
Positive lifestyle changes initiated by the workplace wellness program succeeded in decreasing heart disease risk factors, potentially saving a significant number of individuals from life-threatening cardiovascular events:
- Blood sugar decreased by almost 10 percent
- Systolic blood pressure reduced by 2.8 percent
- Tobacco use reduced from 39 percent to 29 percent
- Addition of salt to cooked meals was reduced by more than half
- Daily fruit consumption almost doubled
- Daily physical activity increased
- Significant declines in mean body weight, waist circumference, blood pressure, cholesterol and blood sugar
Workplace Programs May Have Positive Impact Around the World
The study suggested that a worksite approach in health promotion programs on cardiovascular risk factors can be implemented and can have a positive impact on health outcomes throughout India and other developing countries.
In populations at risk for CVD, even small reductions in the population risk factor profiles should result in larger reductions of morbidity and mortality caused by CVD, thereby saving millions from disability and expenditure on curative measures,” the study concluded.