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Alberto Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries
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Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

May 17, 2018

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Page 1: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Alberto Ogata -BRAZIL

The Workplace: a Key Setting to Fight Chronic

Disease in Emerging Countries

Page 2: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

BRAZIL   WORLD  

Own  a  cell  phone   100%   77%  Live  in  urban  area   84%   51%  Are  between  15-­‐64  years  69%   66%  

Are  part  of  labour  force   54%   46%  

Use  the  internet   43%   32%  

BRAZIL A developing country

Page 3: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

But  with  many  challenges..  

§  Education  

§  Infrastructure  

§  Inequalities  

§ Health  –  double  burden  

Page 4: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Brazilian Health System ü 1988 - social right to health with universal access to healthcare and the establishment of a Unified Health System (SUS) ü Some of the factors that have been big success stories for Brazil include improved tobacco control, reach universal coverage of vaccination and prenatal care and the world's largest free HIV/AIDS drug distribution system ü private plans are offered by commercial insurers and companies with self insured plans regulated by the National Regulatory Agency for Private Health Insurance and Plans (ANS) - 48.7 mi of private health plan users. ü overlaps between the public and private sectors linked to the insurers for rendering health services.

Page 5: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Brazil – Occupational Health and Safety

ü Complex legal framework for occupational health regulation. Professional staff requirements are defined by law ü Workers' compensation function was fully integrated into the nation's larger social welfare system which required all employers to insure their employees ü The employer continues to pay full wages for the first 15 days of lost time, at which point the public system takes over with continued full wage replacement.

Page 6: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

ü population-based, national cohort study with more than 39 mi employees.

ü There were 3.5 times more non-work-related than work related claims. ü  The main diagnoses were injuries, musculoskeletal disorders, and mental disorders. ü Rates increased with age up to 59 years. The incidence of sickness benefits is higher among female workers

Page 7: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries
Page 8: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Source, WHO,2012

BRAZIL

Page 9: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries
Page 10: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Metabolic risk factors trends - Brazil

Source: WHO,2012

Page 11: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Mortality trend by NCD in Brazil, 1996-2007

Page 12: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Effect of physical inactivity on NCD worldwide: an analysis of burden of

disease and life expectancy

Lancet, 380(9836),219-229,2012

Page 13: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Obesity trends – 2006-2011 (Vigitel)

Man Woman Total

28%

Page 14: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

ü A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face ü  Around 30% of respondents reported a 12-month disorder ü  Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders ü Only one-third of serious cases had received treatment in the previous year.

(Andrade et al,2012)

Page 15: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Working Well: A Global Survey of Health Promotion Strategies Brazilian Employers 2012

Page 16: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Issues Driving Health Promotion

 Brazil  

Africa/  Mid  East  

 Asia  

 Australia  

 Canada  

 Europe  

United  States  

Stress   1   1 1 1 1 1 6   Workplace  safety   2   3 1 2 9   2   11   Physical  activity   3   2   2   6   3   3   1 High  blood  pressure   4   6 6   13 5   12   5   Nutrition/healthy  eating   5   4 4   9   6   7   2   Depression/anxiety   6   13   11   3   2   5   9   Psychosocial  environment   7   12   10   5   10   6   14   Chronic  disease   8   8   9   11   4   10   3   High  cholesterol   9   11   8   14   8   13   7   Work-­‐life  issues   10   10 12   12   11 9   11   Tobacco  use/smoking   11   15   14   8   14   14   4   Sleep/fatigue   12   15   13   6   12   10   12   Personal  safety   13   8   5   4   13   8   13   Obesity   14   17   14   9   14   14   4   Substance  abuse   15   13   17   15   15   15   16   Infectious  diseases  (HIV)   16   6 16 17   17   17   17   Maternity/newborn  health   17   16   15 16 16   16   13  

Source: Buck Consultants, 2012

Page 17: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Employer Objectives Driving Health Promotion Strategy

 Brazil  

Africa/  Mid  East  

 Asia  

 Australia  

 Canada  

 Europe  

United  States  

Absenteeism   1   2   3   2   2   2   3  

Presenteeism/productivity   2   1   5   3   3   3   2  

Workplace  safety   3   5   1   1   7   5   7  

Morale/engagement   4   3   2   4   1   1   7  

Org.  values/mission   5   6   7   6   6   6   5  

Attract  and  retain   6   7   8   7   5   7   8  

Maintaing  work  ability   7   4   4   4   8   4   6  Social  Responsibility   8   9   9   9   10   9   10  

Health  Care  costs   9   8   10   10   4   10   1  

Promote  image/brand   10   10   6   8   9   8   9  

Source: Buck Consultants, 2012

Page 18: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries
Page 19: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

• The Laboratory has been launched to produce and disseminate knowledge from health innovations developed in the health systems. • The Innovation Laboratories are spaces for the product ion of evidence and knowledge management, from practices, processes, tools, innovative programs and policies in the healthcare area. It is based on the idea that health system of Brazil is a huge 'laboratory' in which many innovations are produced from good ideas and initiatives of local managers. •  Innovation Laboratories seek to provide visibility to innovations and the process of production, incorporation and sustainability, to develop a network of innovators and promoting a culture of innovation in health. • www.apsredes.org

Page 20: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Nutrition Physical Activity Stress Management Relationships

Preventive Behavior

Lifestyle

Physical environment Social environment Personal fulfillment Wages and benefits Social relevance of work

Work Conditions

A comprehensive approach At workplace

Quality of Life Index

Nahas, 2010

Page 21: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

§  Brazilian Quality of Life Associa t ion (ABQV) is a national non-profit organization founded in 1995.

§  Joins more than 400 members that represent a universe of 2,100,000 employees.

•  Connection with IAWHP •  I Latin American IAWHP Summit

•  Sept,29th – São Paulo, Brazil

Page 22: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

v  No country in the world can be competitive in the world economy with unhealthy workers v The workplace setting can play a major role in encouraging people to adopt healthier lifestyle There is still a great deal to be done......

Joana Godinho, WORLD BANK

Page 23: Alberto Ogata -BRAZIL - Cigna Ogata -BRAZIL The Workplace: a Key Setting to Fight Chronic Disease in Emerging Countries

Thank you “Obrigado”

ALBERTO OGATA [email protected]