The Essence of Wellness – Unspoken Truths

1. The Essence of Wellness – Unspoken Truths Donald Schopflocher, PhD Centre for Health Promotion Studies, School of Public Health, University of Alberta

2. Why Wellness? Why Health Promotion? • What’s work got to do with it? • Broadening the concept of Wellness

3. Even as income continues to rise…

4. and life expectancy also continues to rise…

5. the cost of health care is also rising. Health Quality Council of Alberta, Measuring and Monitoring 2009

6. Costs are rising partly because older people have higher health costs… Health Quality Council of Alberta, Measuring and Monitoring 2009

7. and our population is aging.

8. Costs rise mostly because disease types and disease rates have shifted…. Source: http://www.pitt.edu/~super1/

9. and chronic diseases are difficult to eliminate…

10. because the factors creating risk occur early and latency is long. Natural History of Disease Incubation / Latency Period of Susceptibility Period of Clinical Disease At Risk Exposure / Trigger Disease Onset Symptom Onset Diagnosis Treatment / Management Resolution Timeline

13. Causes of Death in Alberta

15. Of course, diseases don’t have to kill to cost…

16. Of every 10,000 Albertans, each year : Reported Attempting Suicide this year Thought about Suicide this year Completed Suicide Hospitalized for Attempted Suicide Report that they ever thought about Suicide ED for Attempted Suicide Source: Statistics Canada, CCHS, 2001 Alberta Health and Wellness

17. Mental Disorder Proportion of Total Economic Burden of Disease, Canada, 1998 Source: Health Canada, Economic Burden of Disease in Canada, 1998

18. Further, mental disorders may also be on the rise… Source: Statistics Canada, Canadian Community Health Survey, 1998, 2002

19. And mental disorders have their own risk factors… There cannot be a stressful crisis next week. My schedule is already full. Henry Kissinger The I in illness is isolation, and the crucial letters in wellness are we.  Author unknown Source: Statistics Canada, Canadian Community Health Survey, 2004

20. The challenges are in the risk factors… Source: Ohinmaa, Schopflocher, Jacobs et al Chronic Diseases in Canada, 2006

21. Risk factor rates are high…. Source: Schopflocher, The Healthy Alberta Trends Index (HATi), 2008

22. and not improving very fast. Source: Schopflocher, The Healthy Alberta Trends Index (HATi), 2008

23. What can be done? Types of Prevention

24. Ottawa Charter for Health Promotion 25 years young! Health Promotion Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive conceptemphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being.

25. Wellness and Health Promotion: Hand in hand

27. Estimated Annual Cost of Chronic Disease Estimated Annual Expenditure on Health Promotion Source: Jacobs, Klarenbach, Ohinmaa, Golmohammadi, Demeter, Schopflocher, 2004: Chronic Diseases in Alberta : Cost of treatment and investment in prevention

28. Critical Success Factors for Wellness Programs • Sustained over a long period of time • Comprehensiveincluding multiple approaches in multiple settings • Innovative • Individual responsibility within the context of changes to the environment Sources: Making the Case for Primary Prevention: An Economic Analysis of Risk Factors in Manitoba. Krueger H., Williams D., Kaminsky B., McLean D. (2007) The Health Impact of Smoking and Obesity and What To Do About It

29. Why Wellness? Why Health Promotion? • What’s work got to do with it? • Broadening the concept of Wellness

30. Work is a big part of life -

31. Critical Success Factors for Workplace Wellness Programs • Does it pay? What is the ROI? • Easy access to programs to insure high participation rates • Sufficient Duration • Incentives to employees • A culture of health Source: Goetzel,RZ & Ozminkowski, RJ (2009) The Health and Cost Benefits of Work-Site Health-Promotion Programs, Ann. Rev. Public Health,

32. Source: Alberta Wellness Survey (2007)

33. Stress Recipe for Stress • Novelty • Unpredictability • T hreat to the ego • Sense of loss of control Stress – don’t go NUTS Source: Sonia Lupien. Stress can make you Thick, 3rd Annual Exploring Health and Healing Conference, Banff, 10/2006

34. Some sources of Work Stress • Work-Life Balance • Job Structure

36. Lowe, GS (2007) 21st Century Job Quality Trends, Canadian Policy Research Network

37. Source: Brisbois, R. (2003) How Canada Stacks up: The Quality of Work, Canadian Policy Research Networks

39. Source: Canadian Index of Well-Being (2011) Caught in the Time Crunch

40. Lowe, GS (2007) 21st Century Job Quality Trends, Canadian Policy Research Network

41. Source: Alberta Wellness Survey (2007)

42. Source: Human Resources and Skills Development Canada, 2011

43. Job Structure

44. Source: Alberta Wellness Survey (2007)

47. Adding to Workplace Wellness Programs • Stress Management Programs • Child Care and Elder Care Support • Job Redesign

48. Why Wellness? Why Health Promotion? • What’s work got to do with it? • Broadening the concept of Wellness

49. Well-Being Wellness Happiness Health

50. ‘Wellness’ (as Primary Prevention) still focuses upon Disease Prevention • Psychologists (and Economists) have relatively recently started to examine ‘Wellness’ as a positive quality to life, ie happiness