Are We People or Parts?: Chronic Illness and Employer Wellness Programs

It’s difficult for me to concentrate today. And it would have been impossible for me to work.

But my situation – and so many others – are at risk of being inhumanly shoved to the side by corporate trends in Human Resources.

The current arctic cold snap has graciously gifted me with the worst RLS (officially Willis-Ekbom Disease) pain I’ve had since August.

The variants of treatments that my doc and I have been working on have been helping. When I first got FMLA for this, I was missing work at least a day or three a month, every month. Since we’ve tweaked my medications, before this week I’d not missed due to the RLS for several months.

Unfortunately, I’d gotten conventionally sick earlier this month and missed several days. So I’ve been gone a lot in the last thirty-odd days.

Which brings us back to my point. Right now, I’ve been pretty much awake for three days, with a few hours of sleep sprinkled in there in one to two hour long sections. I was somewhat incoherent yesterday; today I don’t trust myself to drive. I’ve fallen asleep twice standing up while writing this blog post, and made SOOOOO many errors while writing, ranging from typos to leaving out words and sentences, or typing gibberish. Nobody would want me starting an IV, updating sensitive records, or handling radioactive materials today.

In these cases – whether from an upper respiratory infection or from a documented chronic illness – if I’d tried to force myself to work it would be a net loss for everyone. The person who is ill will recover more slowly, or even make themselves worse, like I did after I tried to force myself to work after my hypertensive crisis a few years back. (Warning – that post has some grody pics.) And if it’s an infectious illness, the workplace will suffer more, because other employees (and perhaps even customers) will get ill later. Even if it’s not infectious, the ill employee simply can’t be as productive and will have more errors due to pain, discomfort, or just plain fatigue.

If directly quizzed, most people will recognize that forcing people to come to work sick is a bad idea. The CDC, for example, estimates that the flu alone causes over $7 billion in lost productivity. Any method – such as letting sick people stay home and away from the rest of the office – that would reduce those costs seems reasonable.

Even if the sick worker doesn’t infect the rest of the office, more than half the estimated $576 billion of lost productivity from illness comes when sick employers turn up to work but are unable to perform at their best. And with liberal sick day policies – or even something like a four-day work week (seriously, read that article) – we could reduce illness while increasing overall productivity and quality of life.

Sadly, that doesn’t seem to be the focus of our current workplace culture as a while. Rather than recognizing that illness happens, and making greater accommodations for that fact, it seems that most articles about workplace illness in the last few years focus instead on how to force – I mean, encourage – employees to be healthy. This excerpt is pretty representative:

The biggest way you can make an impact on the health of your employees is to promote exercise. A lack of regular physical activity is one of the leading causes of preventable death worldwide ahead of poor sanitation and alcohol abuse. It doesn’t have to cost a fortune either. Many gyms offer a range of discounts for local businesses, allowing them to provide discounted, part or full payment of memberships to their employees, allowing businesses to choose how much input to have.

But financial incentives are not the only way to help staff lead healthy lifestyles – a healthy culture needs to be promoted too. That might include organising lunch time gym sessions, providing secure bike parking, and ensuring staff are offered healthy meal choices.

https://web.archive.org/web/20171212173301/https://hrcsuite.com/reduce-sick-leave/

This kind of attitude is awful in a few ways.

1. It treats people as widgets, or maybe as parts in a machine.
2. It further stigmatizes those with illnesses – chronic or otherwise – by framing “health” as a choice. Believe me, I’d much rather be at work – rested and pain free – than at home and in pain right now. It’s the kind of mindset that leads to discounting invisible illnesses, or even the toxic attitude I saw in the military toward trainees who went on sick call.
3. It puts the whole burden on the worker. Not only are you expected to devote the largest part of your life to your employer, but you’re supposed to spend additional time and resources in order to fulfill these wellness programs.
4. This attitude is horribly toxic and counterproductive. It frames illness (and needing sick leave) as something voluntary.

It’s like telling a religious child that their pet died because they didn’t pray hard enough for God to save them. This attitude – that if companies just make encourage workers to do enough “wellness” programs like eating better or going to the gym, then they won’t get sick. Clearly, if they do get sick… well, that’s the employee’s fault, isn’t it? There’s nothing wrong with encouraging healthy choices. I’d love it if, say, the healthy food choices cost less than the unhealthy ones at work. That’s where the proof is in the … ahem… pudding. Because to continue this example, I’ll bet that if your employer has a “wellness program” of this sort, it’s still cheaper to buy cheap junk food at your cafeteria than a healthy meal… and that’s if healthy food options exist for you at work at all. If that $576 billion or so of lost wages was so strongly effected by “wellness choices”, you’d think some of that money could be put into subsidizing (or providing) healthy food choices. Or maybe paying for part or all of gym memberships instead of relying on the gyms’ generosity …or even making it so that workers don’t have to choose between time at the gym or the time they need to work to pay the bills. Maybe the toxicity of this attitude is so blatant to me because my chronic medical condition has NOTHING to do with my wellness choices. I had the first symptoms as a child, and have had symptoms continually since, including when I was active duty military and in the best physical shape of my life [1]. Maybe this attitude toward illness will change as more and more of the people in charge of these areas get older and start having inevitable degenerative illnesses of their own. Or maybe they’ll just find themselves at the wrong end of some corporate wellness program. Featured Photo by Armin Lotfi on Unsplash [1] For those interested: I’ve had a few people suggest that my RLS is due to my obesity. While there’s one study showing a correlation between RLS and weight gain, there’s no causation shown. Reviews of the literature show either that there’s not enough real research, that the lack of sleep caused by RLS might contribute to weight gain, or that both obesity and RLS might be caused by the same lack of production of dopamine (not really something you can control with a “wellness program”), or:

A comprehensive analysis of RLS epidemiological studies finds the prevalence rate of RLS to be 5–15% in the general population with 2.5% of adults having symptoms severe enough to require medical intervention. Some of the risk factors for RLS include female gender, pregnancy, low iron levels, lower socioeconomic status, poor health, elderly age, comorbidity with Parkinson’s disease, positive family history of RLS, and comorbidity with psychiatric disorders.

https://link.springer.com/article/10.1007/s11325-011-0606-x?error=cookies_not_supported&code=d1a7e4fc-9f42-4db6-a6b5-81ad38f18eb3

Additionally, there’s a preponderance of evidence that dopamine agonists – the main treatment used in the West – can cause symptoms to become worse over time (augmentation) and are associated with new compulsive behaviors – including overeating – to the point where one paper concludes:

Physicians should be aware that compulsive eating resulting in significant weight gain may occur in [patients] as a side‐effect of dopamine agonist medications.

Whoops.