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Behavioural change a key component to managing chronic disease
Cassandra Williamson-Hopp | June 21, 2019
More than 50 per cent of working-age Canadians are living with one or more chronic disease, up from just 37 per cent in 2007, according to Jonathan Tafler, senior director of Employer Health Solutions at Shoppers Drug Mart Inc.
Speaking at Benefits Canada's 2019 Chronic Disease at Work conference in Toronto on June 5, he said the majority of these conditions have significant lifestyle components, yet 80 per cent of people surveyed with chronic disease said they're struggling to adapt their lifestyle.
Read: What are the top chronic diseases in the workplace?
"How many of you always follow Canada's Food Guide, get 150 minutes of physical activity every week, consume according to safe drinking guidelines or sleep at least seven and a half hours each night?" asked Michael Vallis, health behaviour change consultant and associate professor at Dalhousie University, who also spoke during the session.
The first thing we have to do when we ask, "Why aren't people following our recommendations?" is to hold up a mirror and realize we don't follow them either, noted Vallis.
The human brain's dominant characteristic is to approach pleasure and stay away from pain, he said, noting unhealthy food is immediately accessible and opportunities to avoid physical activity abound. "We have to do more to educate and engage people so we can help them overcome these tendencies."
Also speaking during the session, Diana Sherifali, associate professor at McMaster University, said reconceptualizing healthy behaviour is important because it's considered abnormal. "Instead, we need to break down the complexity of behaviours into small simple habits people can adopt."
Read: Employers look to behavioural economics to drive health plan adherence: survey
One of the most important things about managing chronic disease is repetition, noted the panel, and what better place to have repetition than in the workplace where people spend much of their time? The average employee spends two hours a year with a health-care professional compared to the thousands of hours they spend at work and at home, said Tafler.
In the context of diabetes or obesity, there's still judgement that people have caused their own chronic conditions, said Sherifali, noting people don't choose to have these diseases and there's a myriad of factors involved. "It behooves us all to recognize their story, demonstrate there is an acceptance and move people beyond the stigma of having a chronic condition."
"We're all focused on behaviour, but we have to acknowledge emotion," added Vallis. Employees with chronic conditions will feel their employers are biased against them if the emotional component isn't recognized, he said. "We need affected employees to be functionally disabled because their condition is not going to go away."
Read: Focus on preventative measures in fight against chronic disease
The health-care system has been built around laboratory results rather than being driven by patients, said Sherifali. She referred to a randomized, controlled trial where she and other researchers provided diabetes patients with access to a health coach for one year. At the end of the trial, their glycated hemoglobin levels were reduced to levels on par with those taking medication.
"Would you rather take a pill or talk to a health coach for 15 minutes a week who helps you improve your life quality?" she asked the audience. In addition, she noted these patients obtained more education relevant to their diabetes than they did in years of accessing publicly-funded diabetes education.
"I'd encourage employers to sit down with these individuals and listen, then flexibly co-create a program," said Vallis. "Chronic disease is something we're all vulnerable to. Individuals with chronic disease don't have psychopathology. There's nothing wrong with them. They're normal people in an abnormal world."
Read more stories from the 2019 Chronic Disease at Work conference.
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