Proactive management of health conditions will build a productive workforce.

I believe the future of healthcare will see continued agility and innovation by all role players –providers, members, local government and the Department of Health.

The pandemic has disrupted people’s lives in so many ways but one positive is the increased focus on health and the importance of having access to healthcare when you need it.  There has also been an increased emphasis on a holistic view to wellness, both physically and mentally.

Employer buy-in is essential to support the workforce to stay healthy, not only in terms of preventing lifestyle diseases but managing them in a corporate environment.

Non-communicable diseases

Three years ago, the Human Sciences Research Council (HSRC) and the Medical Research Council in South Africa cautioned that chronic diseases such as diabetes and heart disease are becoming the biggest threat to South Africans’ health. The Council described the problem of these non-communicable diseases (NCDs) as an ‘emerging epidemic’ which can now be considered as a full-blown epidemic. Cardiovascular diseases, diabetes, cancer and chronic respiratory diseases are the most common causes of premature death and disability, with 80% of the deaths occurring in low- and middle-income countries.

Clearly, the future of and changes to healthcare need to revolve around preventative care and sustaining well-being as opposed to simply responding to illness. Healthcare must be heavily biased towards the management of these NCDs.

Urbanisation and lifestyle diseases

The Bonitas clinical team’s research shows that South Africa is urbanising rapidly: 63% of South Africans are already living in urban areas. Stats indicate this will rise to 71% by 2030 and, by 2050, eight of every 10 people will be living in urban areas. Living in cities does have a negative effect on people’s health. 80% of these health issues are the result of lifestyle risk factors.

Which lifestyle diseases are most prevalent?

Analysis indicates that hypertension is the most prevalent, followed by high cholesterol and Diabetes Type 2. Research shows that the main problems associated with changes in lifestyle and behaviour, due to urbanisation, are: increased alcohol and tobacco use, lack of exercise and poor nutrition – more processed and refined food, an increase in high-fat and high-sugar diets, fewer fruit and vegetables, complex carbohydrates and fibre.

Socio-economic factors also play a role in that the poorest people live in under-serviced inner-city areas or informal settlements and are the most exposed to unhealthy urban environments.

Air pollution is responsible for a range of lung and respiratory diseases, heart conditions and cancers. Chronic Obstructive Pulmonary Disease (COPD) and Asthma are two of the most prevalent respiratory diseases.

We have the expertise to respond to these risks and lifestyle diseases by providing comprehensive, integrated care, every step of the way. However, more needs to be done and again we advocate collaboration with public health authorities and a strong employer buy-in so that we can educate and encourage South Africans to look after their health.

Covid-19 and NCDs

It is common knowledge that Covid-19 and NCDs interact to create a perfect storm. The pandemic has made people more aware of having to take responsibility for their health.

Covid-19 and mental health

The pandemic has seen relentless waves of challenges affecting people globally – isolation, work stress, frustration at rules and regulations, fear for close friends and family and finally a loss of control over your life.  It is no surprise that mental health issues are creating their own pandemic of depression and anxiety.

Studies show that around 20-25% of patients with pre-existing mental health issues feel they are coping badly or deteriorating during the pandemic. We predict that depression and post-traumatic stress, which have historically been on an upward slope, will increase further in time.

This has a massive effect on our workforce. Employers are trying to keep their businesses going, prevent job losses and a maintain a healthy workforce – which is often remote – which is under severe pressure and stress. These levels of stress can also affect productivity.

To help members and enable corporates partnering with Bonitas to assist their employees, we have built a resource hub to better understand the condition and steps they can take to remain mentally healthy. The App includes a screening tool to identify warning signals of mental distress and ensure quality care.

Managed Care

Corporate wellness is extending to be more than just about screenings. It’s designed to help members identify and manage chronic conditions by using the best clinical and treatment protocols. This is achieved by analytics and continuous research, alignment to the latest technology, market trends and member needs and leveraging this data for enhanced treatment.

Managed Care is a critical component and improves quality of care. We know that proactive intervention and working with members to prevent or control lifestyle diseases is the only way forward. Because when ‘I’ becomes ‘we,’ illness can become wellness.

It is imperative that employers play a significant role in providing employees with the opportunity to identify and manage chronic conditions. It is important not only for the well-being of the employees but for the survival of the business and the economy. An unhealthy workforce translates into absenteeism, loss of productivity and higher employee benefit costs.

The best way to minimise disruption in the workplace, due to health issues, is to partner with a medical aid scheme which is proactive in corporate wellness and offers a comprehensive service. This should not just include general elements like wellness screening (for blood sugar, cholesterol and blood pressure) but also play a role in educating and creating awareness about healthy lifestyle choices and chronic conditions.

Back and Neck Programme

Over and above that ergonomics is an issue regarding back and neck pain, it is also a key health issue for those who have office jobs and high stress positions. Research indicates that the most common diagnosis for sickness absenteeism is musculoskeletal diseases.

Bonitas teamed up with DBC – a back and neck rehabilitation programme which has shown a 93% success rate. In 2022, we are introducing the eDBC app. This technology-driven channel offers digital coaching solutions and home-based care to help improve pain and mobility. It includes a self-assessment, baseline progress checks and outcomes’ evaluation.

The future

Making quality healthcare more accessible and affordable, while ensuring financial sustainability and longevity of the scheme, is our mandate. Our focus on Care, Capability and Reliability encompasses not only providing our members with the tools and preventative measures to guard against chronic conditions but help us redefine healthcare for a new world.

Lee Callakoppen is the Principal Officer of Bonitas Medical Fund.