Imagine, in the 21st century - with all of the medical, scientific and technological advances and accomplishments our country has seen - a generation of children that is at risk of not outliving their parents. Not because of a national plague or famine. Quite the contrary, the current generation is at risk of dying prematurely because so many of them are overweight or obese.
By the numbers, 15% of children and adolescents are overweight, and 16% are obese, which amounts to 24 million children - a number that's nearly tripled in the last 30 years, according to the Centers for Disease Control and Prevention. As if that statistic isn't startling enough, these children also have an 80% chance of still being obese at 25 with implications of more raised health costs. In addition, hospitalization and physician visit rates are 3.7% and 1.7% higher, respectively, for obese children, according to Thomson Medstat.
In short, whether employers are taking steps to address it or not, childhood obesity is an employer problem in addition to a parental and societal one, accounting for an extra $14 billion in increased health care costs.
So, why aren't more employers specifically targeting employees' children with wellness programming?
"They do not know," says LuAnn Heinen, vice president of the National Business Group on Health. Many employers have employees take health risk assessments, but not their kids. Although such workplace wellness initiatives can identify and intervene with overweight or obese parents - and statistics show a child has an 80% chance of being obese if they have an obese parent - overweight/obese children remain invisible to employers.
Still, the costs are not. Average per-capita insurance claims costs were as high as $2,907 for an obese child and $10,789 for a child with Type II diabetes. So far, though, employers are targeting these costs through a trickle-down strategy of improving children's health by improving the health of their parents.
"Parents' decisions and habits affect their children. The major difference between a parent and a child is that in a lot of cases it's not the child making an informed decision - they may not be thinking about their decisions," says Joe Miller, managing director at CHC Wellness, an onsite corporate and community provider of health and wellness programs. "It starts on a higher level. What is causing the struggle? I don't think it's an issue of what they're eating, it's more of a decision that's being made by parents."
Not that employer wellness program messaging should put parents on the defensive, says Elisa Mendel, vice president at HealthWorks by Kaiser Permanente, their workforce wellness program that's geared to employer groups. Employers can take a more tactful approach in addressing the issue, "You're not saying, 'Your kids are fat and you better do something about it,' but 'You're busy, and you need help.'" In framing the solution as involving the entire family in eating right and spending more time together, it becomes less obtrusive.
Sesame Street combined with screenings
Not many wellness programs specifically target children, which is exactly why brand-new firm, Eat, Move, Play, America! entered the market. As of presstime, the program was just six weeks old and looking to land its first client.
However, CEO Saul Nirenberg thinks there's a gap for the company to fill. "Yes, [employers] do offer the programs, but at a point, they're not very effective. We're trying to change the playing field," Nirenberg says. EMPA! is a 13-week program that starts - like most wellness initiatives - with a health screening for each child. But rather than nurse lines and health coaches, the program uses a cast of characters loosely based on Sesame Street to keep young participants engaged and motivated.
To keep parents on board, the program provides a parent's guide to help reinforce healthy habits and a playbook that includes recipes and games.
Keeping the program childlike is EMPA!'s strategy for turning around the current childhood obesity statistics. "When you have a situation with this generation that will have shorter and less healthy lives than their parents, it's outrageous," says co-owner Julie Lewit-Nirenberg. "It's not that we don't have the wherewithal to change it, but the better mousetrap has yet to be invented."
Another program working on a new "mousetrap" is WellNet Interactive, which targets children and families through more traditional methods, including phone calls from registered nurses after initial health screenings.
"One of the questions we ask is: 'What kind of support do you have at home?' When we're talking about the whole family, we advise them on emptying their cabinets of junk food, the sweetened beverages, and we ask what kind of exercise they get on a regular basis," says Ellen Lewandowski, director of clinical services for WellNet Interactive.
At Alere Health, the Healthy Kids program offers an online tool to engage adults and their children, and also offers a health risk assessment.
"The biggest challenge is having them first take the time to take the health risk assessment and help them to get them over the hump to look at the internally motivating factors," says Heather S. Zeitz, vice president of health programming and content at Alere Health. "We work on our communication once we've targeted them. One of the most powerful messages is, 'If your family gets healthier, you'll get healthier.' Once you become a parent, you've naturally put your children's welfare ahead of your own. It's a teachable moment if [parents are] told that their child is obese."
Alere's program has demonstrated a 15% increase in physical activity among participating families, a 13% reduction in screen time (TV watching, video game playing and computer use) and an 18% increase in fruit and vegetable intake.
Such programs may not turn the ship around, but at least it slows its forward momentum somewhat. There still are environmental factors to contend with, says Leah Holzwarth, wellness corporate director for Wellness Advantage, the wellness component at Baptist Health South Florida. "It's not as easy to go out and play as it used to be, and with all the time crunches, it's easier to run through a McDonald's than to prepare a meal."
BHSF's "Families Step Up" program, launched in 2006, aims to educate families away from the path of least resistance when it comes to health and fitness. Featuring cooking demonstrations, and exercise and parenting seminars, the no-cost, eight-week program takes five to eight families a session for a two-hour class every week.
"We see results with the parents first; the kids come second. We help them not to gain weight anymore with the hope they'll grow into the weight they already have," says Holzwarth.
Whether it's through trickle-down approaches or directly targeting children, "employers play a huge role, and I'm not sure how tapped in they are," Mendel says of companies' importance in combating childhood obesity. "Employers have a lot [more] influence in the communities they're in than they acknowledge. That's what is going to drive their medical costs ... Kids are the new frontier."
