Health care reform should benefit shift workers: Circadian Age

Nov 10 2009

Circadian Age, Inc. – ‘Working Nights’ – a company dedicated to helping shift workers and their families adjust to their unique lifestyles, is concerned with making sure that any health care reform will benefit the 25 million Americans working shifts. These workers represent 10% of the insured population, but incur 17% of the health care costs.

“Shift workers are impacted by chronic, costly health conditions, and these folks need additional help to address the challenges they face,” reports Betsy Connolly, President of Circadian Age, Inc. “Sleep disorders, cardiovascular disease, gastrointestinal ailments, musculoskeletal complaints, and mental health issues are all more prevalent among people working shifts than those working during the daytime.” As an example, when surveyed, workers on shifts cited moderate or severe fatigue problems at nearly 70% of facilities with shift work operations. Fatigue leads to accidents and injuries and chronic health issues resulting in increased health care and workers compensation costs.

In a June 2009 survey of 1,100 human resources and benefits managers by Aon Consulting, the majority (67%) indicated believed that continuing “the employer-based healthcare system with greater focus on wellness, chronic condition management, evidence-based medicine, and other innovative approaches,” was the best approach to expanding health care coverage. This was as opposed to expanding government administered health plans.

How can employers ensure that the wellness oriented, innovative approaches they design with their health benefit suppliers will reach their shift workers – one of the neediest components of their workforce? Scientific research has recommended periodic health assessments of employees working shifts. When assessing the health of shift workers, Working Nights recommends that part of the effort be focused on detecting early signs of difficulties adjusting to work schedules. Health evaluations should focus on sleep (duration, quality, and difficulties), cardiovascular diseases, digestive problems, musculoskeletal issues, mental health, and use of medication and other substances such as alcohol and stimulants. Experts recommend an assessment one year after the start of night shift or rotating shift work, followed by health checks every three to five years and two to three years for those under age 45 and over 45, respectively.

A recent study by researchers at Harvard University and Harvard School of Public Health reported that after completing a health assessment people visited the doctor and filled prescriptions just slightly more often. And, the only specific care screening where the participation rate improved after taking a health assessment was testing for cervical cancer. Women, healthier people, and those enrolled in consumer-driven health plans were most likely to complete an assessment.

In short, it’s tough to get the less healthy employees to complete health assessments. Employers could use the Star Perks Program to more directly target shift workers’ participation in health and safety programs. Underlying incentives would be given to shift workers who complete health evaluations and use workplace tools like Working Nights calendars, health and safety guides, and managing a shift work lifestyle training programs. Training helps employees understand shift work adaptation, learn to manage work/life balance amidst scheduling changes, and identify and address specific higher risk, potentially shift work related, health concerns.

When employers provide specific education about the unique challenges of working shifts and offer ideas to confront the difficulties, shift workers feel more cared about. And as a result, they are more interested in their own health and safety.