Chronic disease is the leading cause of death and disability in the United States
The Centers for Disease Control and Prevention (CDC) defines chronic disease broadly as any condition lasting more than one year, that requires ongoing medical attention or limits daily activities (or both).
Heart disease, stroke, and other cardiovascular disease are responsible for 1 in 3 deaths in the U.S. each year. Managing these conditions, as well as diabetes, costs the U.S. healthcare system over $540 billion per year. That’s more than Sweden’s entire GDP.
While the human and financial toll of chronic disease is staggering, there is hope. Research repeatedly shows that certain lifestyle factors can be modified to significantly reduce an individual’s risk for heart disease, stroke, diabetes obesity and more. But as all benefits leaders know, changing habits is easier said than done! In this blog we unpack how chronic disease intervention has fared in recent decades and share our latest thinking on what employers can focus on when it comes to tackling this problem in employee populations.
Common interventions to address chronic disease have flatlined
Containing the astronomical cost of chronic diseases is now an urgent priority for employers across industries. Before charging ahead, it’s worth a look in the rearview mirror to understand what’s working – and what’s not.
In 1996, the CDC initiated a study to understand the impact of lifestyle changes on preventing or delaying the onset of diabetes. At that time, diabetes prevalence was 5.4% and rising. The study concluded that lifestyle changes reduced the incidence of diabetes by 58% for the at-risk population.
Over a decade later, in 2010, the CDC established the National Diabetes Prevention Program (DPP). The DPP is a nation-wide effort to scale the lifestyle interventions studied in the original clinical trial to communities everywhere. The DPP uses a standardized curriculum-based model that teaches participants about healthy diet, exercise and behavior change. Typically, the 16-week curriculum is delivered by case-managers in healthcare settings or in community settings including the YMCA.
Success has been lackluster. In a 2019 study published in the American Journal of Preventive Medicine, only 2.4% of the study population (consisting of 2,341 eligible adults) reported engaging in a DPP program. What’s more, only 4.2% reported being referred to the 12-month program in the first place. The results of this study suggest a massive gap in the ability of DPP to reach folks in need, and engage those it reaches. One possible reason for the dismal engagement levels is that it uses a one-size-fits-all curriculum, which lists the same set of goals for every participant.
So it’s hardly a surprise that some healthcare innovators had a different idea: deliver disease prevention help in a more convenient (digital) way – this time through employers. Digital DPP solutions for this massive problem are now ubiquitous and largely commoditized, ironically creating a new challenge for employers seeking to choose the right vendor. If you’re evaluating options, we’d love to talk.
Between the National DPP and efforts from innovative companies to ‘appify’ the DPP in order to reduce the burden of chronic disease, all signs pointed to the potential for great improvement in this area. But unfortunately — that’s not where the U.S. or your employee population is today. Chronic disease and associated risk factors are still rampant, and on the rise: 10.5% of Americans have diabetes today compared to 8% in 2002, and this number is projected to grow. Obesity has also increased in both adults and youth from 1999-2016. Further, 50% of your employees are likely pre-chronic with more than two out of range risk factors leading to both increased costs and an unacceptable risk of developing a chronic disease that will cost between $15,000-$20,000 per year to manage.
How can employers learn from the past, and successfully prevent chronic disease in the future?
Target more than just diabetes
Diabetes presents a huge potential for cost-saving among employers since it is a) easily identifiable in claims data, 2) possible to prevent, and 3) extremely expensive. Plus, by preventing diabetes (or so the logic goes), you’ll reduce risk factors like high blood pressure and obesity, which in turn contribute to other major chronic conditions like heart disease, stroke and cancer. With Newtopia, employers achieve all of this (and more) without limiting engagement to employees with diabetes. We’ll help you identify the segments of your population who stand to benefit the most from our habit change platform and get them the help they need – before they receive a diabetes diagnosis.
Motivate, not dictate
Perhaps the most glaring issue with the DPP approach is the way content is delivered. Habit change, behavior change, lifestyle change – whatever you call it – is hard. And most folks won’t be motivated (let alone stay motivated) by a one-size-fits-all curriculum designed to increase knowledge. Rather than educating your population on what a healthy lifestyle looks like, Newtopia helps them build one by acknowledging the human elements of habit change. Participants start with a quiz that provides their Inspirator with crucial information on their personality, motivation, social determinants, and readiness to change. Participants are also offered a genetic test (optional) for engagement to help understand if they have inherited any factors that may be having an impact on weight and lifestyle. The genetic test offers clues to the kind of lifestyle changes that may be most effective. These factors ensure each participant gets a hyper-personalized action plan and habit change design suited to their unique reality. Ultimately, we believe motivation lies somewhere between being heard and being challenged – and Newtopia helps find that sweet spot for every individual.
Sustained habit change = lasting outcomes
When employees feel motivated and have the tools to change, they stay on track with their goals. This is one reason why 50% of Newtopia participants remain engaged for 12 months, which persists over multiple years. Unlike traditional CDC DPP providers, the progress our participants achieve doesn’t stop after one year. In a randomized control trial (RCT), Newtopia participants achieved 10% average body weight reduction in Year 2.
At Newtopia, we’re not just focused on diabetes. We’re not just focused on the sick!
We are focused on individual change at individual levels, empowering employees to live their version of health and prevent chronic disease.