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Global Health is Global Wealth. Michael Taylor, MD, FACP Medical Director for Health Promotion, Caterpillar Inc Linda Gzehoviak, Corporate Global Resources, ACS. Projected Deaths for Selected Causes. In 2010, cancer will become the world’s leading cause of death. Tobacco: 1 billion Lives.

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global health is global wealth

Global Health is Global Wealth

Michael Taylor, MD, FACP

Medical Director for Health Promotion, Caterpillar Inc

Linda Gzehoviak, Corporate Global Resources, ACS

projected deaths for selected causes
Projected Deaths for Selected Causes

In 2010, cancer will become the world’s leading cause of death

  • Overweight and obesity: 1 billion (increasing)
  • Obesity is quickly replacing malnutrition as the critical nutrition-related health challenge in many emerging economies like China
  • Mexico has second highest obesity rates in the world (first is U.S.)
tobacco quitlines
Tobacco Quitlines

Publicly financed quitlines exist in the following countries:



New Zealand

South Africa

Europe: at least 27 countries

Asia: Hong Kong, Taiwan, Thailand, Malaysia, Singapore




Quitlines vary in scale and sophistication.

costs to employers direct versus indirect
Costs to Employers - Direct versus Indirect

Most countries have government sponsored health care

In some of those countries, individual co-pays remain so high that companies provide additional coverage

Access to care is “the issue” in most of the developing world

Myth plays a huge role in early detection

the role of myth
The Role of Myth

Belief in survivorship – must be fostered

Education that cancer is preventable through- nutrition, physical activity, and tobacco

No one deserves cancer-but many believe they have caused their own cancer

Financial concerns – would rather not know

myths around the world
Myths - Around the World

In Malaysia, many men abandon or abuse a wife with breast cancer.

Quote from African patient: “A short man with an arrow shoots you and you get cancer. Sometimes his wife can stop him and then you don’t”

Quote from Indian Cancer Expert: “Even my mother didn’t want me to share my breast cancer experience. Her fear was that I would not find a husband”

why is cancer so devastating in the developing world
Why is Cancer So Devastating in the Developing World

Access to care

Guidelines must match the resources to follow them

No global cancer “wiki”

Lack of translated materials to educate around cancer

Lack of government policy

employer challenges
Employer Challenges

Traditional viewof global health

Health benefits as a direct cost

Federal funding “covers” the issue


Poor health= productivity loss

Indirect cost is a concern

Global employees need to be:


Well trained


impact on employers
Impact on Employers

Issue is productivity loss

Absence due to illness


Training cost of replacement employees


Global competitiveness

caterpillar principles of global health promotion
Caterpillar- Principles of Global Health Promotion

Healthy employee is a competitive business advantage

Corporate Medical Department

Set overall direction

Help identify the needs

Broker local resources

Solution is local

caterpillar principles of global health promotion14
Caterpillar- Principles of Global Health Promotion

Local needs vary





caterpillar principles of global health promotion15
Caterpillar- Principles of Global Health Promotion


Aligning diabetes data in India

Some traction around smoking policies in China


50 year history of worksite wellness

Onsite MDs, dentists

Physical therapy

Highest engagement scores at Caterpillar

examples of workplace wellness programs
Examples of Workplace Wellness Programs


Quit lines

In-person Counseling: individual & group (e.g., Freshstart)

Smokefree worksite polices

“No Tobacco” days

examples of workplace wellness programs17
Examples of Workplace Wellness Programs


Physical activity programs offered in the workplace, e.g., RFL

Onsite exercise facilities or sponsored gym memberships

Encourage active commuting and discourage motorized transport, using price and other incentives

Encourage use of stairs

Healthy onsite food options: cafeterias, vending machines

Key Findings from the 2009 ACS Global Workplace Wellness Program Feasibility Study: Survey of Employers

Demand for programs is broad based: corporate management, employees

There is need for employers and employees to understand the value of wellness programs - better documentation of ROI is needed

There is demand for ACS EI programs, and companies are willing to work with ACS directly and/or collaborate with partners selected by ACS. Many companies have partnered in the past

Most either have existing programs or plan to implement a wide range of programs in the near future

Key Findings from the 2009 ACS Global Workplace Wellness Program Feasibility Study: Survey of Employers

The majority of companies either have or are working on a global program

Most companies have long-term objectives but are approaching them using sort-term programs based on local demand and resources

Challenges include global consistency, privacy laws, resource allocation, local management buy-in, translation, cultural appropriateness, funding

The global economic recession has served to emphasize the importance of maintaining health and most companies surveyed report pressing ahead with plans

Key Findings from the 2009 ACS Global Workplace Wellness Program Feasibility Study: Survey of Academic Community

Awareness would need to be created to facilitate buy-in and ensure program success

Lack of existing infrastructure is a challenge, for tobacco cessation, cancer screening and treatment, and NCD management

Cultural issues can present challenges. They include fatalism, cultural acceptance of tobacco use, KABs on physical activity, diet and weight

Key Findings from the 2009 ACS Global Workplace Wellness Program Feasibility Study: Survey of Academic Community

Programs should focus on: tobacco, cancer, diet, physical activity, and obesity

Main recommendations for ACS involvement are corporate level policy (e.g., smokefree worksites) & program design and planning

Program delivery should involve partnering with local organizations and entities

It is important to consider local laws and policies

acsu for global employers
ACSU for Global Employers

More than 30 participants from across the globe came to Boston in August

Topic - global engagement around chronic disease prevention.

Confirmed large gaps in global employee services

acsu global employer program evaluation
.. it is a beginning to a long journey. Thank you and good luck!

Increase participation from Latin America, Asia, and Africa. Because that where the issues are burning and need focus. Thank you!!! This has been a great effort!!!

I enjoyed this opportunity and hope to implement some of the great information I learned. This was perfect timing since my company is in the process of building our global wellness strategy.

This was an excellent opportunity and extremely valuable. It was great to meet lots of new companies and contacts. I liked it. Was a good mix of MDs and other allied health and benefits people.

Need to run ACSU 2-3 times per year to allow companies to get others involved. This presents a great opportunity for networking. Need more participation from employers outside the U.S.

GEHC: I would like to do this for all of my medical officers worldwide


ACSU Global Employer Program: Evaluation
employers need
Employers Need…

Wellness services/programs that are global in scope but adaptable to local conditions; 80-20 Ikea rule

Public-private partnerships: effective coordination of efforts among stakeholders in the for-profit, non-profit and public sectors

Assets: NCD and tobacco cessation resources, including vendors and NGOs, by country

Translated materials on chronic disease prevention

Better data to make the case


World Economic Forum

World Health Organization

UICC-World Heart-IDF

Universities: Emory, Harvard School of Public Health

Mercer and other HR consultancies

global agenda council of world economic forum working towards wellness
Global Agenda Council of World Economic Forum: Working Towards Wellness

Areas of Focus

  • Economic impact on health systems
  • Importance of corporate role and supporting behavioral changes amongst business leaders
  • A “marketplace” of new ideas
  • Acting as an advocacy group
  • Bridging of the science gaps
  • Tackling the non-inclusion of chronic diseases in the Millennium Development Goals
  • Developing partnerships and finding out what we know and what we don’t know


  • Regional Forums
  • Davos
  • Corporate Partners
country partners
Country Partners

Public Health Foundation of India


Brazil – Chronic Disease Prevention Groups and NCI



Building Platforms for Survivor Voices - International Relay For Life Now available for NCTP Companiesat, JBS, Tata

McMurdo, Antarctica

corporate outreach beijing olympics
Corporate Outreach: Beijing Olympics

Reach out to companies around smokefree worksites in China

Media event August 9 and platform for engagement with Chinese operations of multinational companies

greater china
Greater China

Capacity Building: breast cancer programs, patient services, government

Tobacco control: cessation and smokefree worksites project

Work in Mainland China, Hong Kong and Taiwan


North Africa Tobacco Control program, including smokefree worksites

Africa Tobacco Control Research Initiative

ORACLE Five County Cancer Information and Capacity Project, including worksite engagement


With one in nine Americans of Mexico descent, this is a priority country!

Infocancer is modeled after ACS Patient Navigation

Support from Midwest Division, Pfizer Mexico, GEHC, and partnership with Mexican NCI