Fit for Duty podcast: Episode 2.

[00.00] Hello and welcome to Fit for Duty — a new podcast from Aetna International.

Because we know that organisations — large and small — recognise that their future growth and success depend on their people, Fit for Duty brings you insights on some of the biggest health and well-being challenges and forces shaping the corporate health landscape today. We’re here to help you build a healthy, happy, productive workforce.

I’m Lorien Norden, global content marketing lead for Aetna International. I’ve spent years having conversations with some of the most fascinating and well-informed clinical, well-being and health care experts out there. And now, in this new podcast, we’re bringing the latest thought leading market insights directly to you, along with strategies you can put into place today to help your employees flourish. Because when your people thrive, your business does too. 

We hope you find our discussions not only interesting but valuable. Make sure you subscribe to the podcast. And don’t forget you can follow Aetna International on LinkedIn for all the latest news and articles.

[01.14] Hi and welcome back to Fit for Duty. Today, I’m discussing employee health inertia with Simon Miller, Senior Director for Customer Proposition here at Aetna. Our recent survey revealed that people know what they need to do to stay healthy, but most of us are just not doing anything about it. We discuss what organisations can do to tackle this. And I ask Simon how employers can help their employees increase their awareness, engagement and levels of action when it comes to looking after their physical and mental well-being. If you have any questions or comments on today’s topic, you can get in touch with us by messaging Aetna International through LinkedIn. We’re always keen to hear your feedback and we hope to answer your questions in future podcasts. Hope you enjoy the episode.

[01.51:] Hi Simon. Thanks so much for being with us here today. Would you mind just giving our audience a bit of an intro to yourself, please?

[2.08:] Yeah, Hi Lorien. I’m pleased to be here. So I’m Simon Miller, and I’m responsible for our global product and proposition development at Aetna International. And an increasingly important part of that in recent years has been not just around how we insure and protect our customers but also how we support our customers in their broader health and well-being. So that’s an integral part to my and my team’s role in developing our proposition for our customers.

[2.36:] So we’re here to talk about health and well-being. It’s increasingly shaping the landscape for organisations and it’s not only being viewed as something that is important from a talent attraction and retention perspective, it’s viewed as integral to corporate culture and really to help shape and guide the health and happiness and well-being and productivity of employees. So with that in mind, I really wanted to ask you, why is it that you feel that organisations should be focusing on health and well-being, and what do they have to gain?

Okay, well, I think it’s a number of the things that you’ve already answered yourself there, Lorien, in terms of productivity, absenteeism, retention and all of those hard metrics. But I think one of the shifts that we’ve sort of seen significantly recently — Let’s not forget, health and well-being in organisations is not a new thing, right? Occupational health and risk management has been here for a long, long time. I’d say what the shift has been in the workplace is perhaps more of a shift from that duty of care and risk management perspective and, dare I say, even in some organisations and cultures almost a tick the box process, to now really a recognition of the need to support people in their holistic health and well-being and that there isn’t this divide that there used to be necessarily in people’s minds between work and out of work. You know, it’s life and to support individuals and get the best from individuals — and when we say ‘get the best’ that’s happiness, success, satisfaction and those harder metrics, retention, absenteeism, productivity. That’s about supporting people in their overall well-being in and out of the workplace. And that’s the shift that we’ve seen. And that’s down to a number of reasons. I think recognition that it’s the right thing to do but also the demand. The demand that’s coming from employees — either directly or indirectly. And when I say indirectly, I mean people are prepared to move an awful lot more now, do place more value on well-being support and to attract and retain that talent and to get the most out of that talent in a productive and sustainable way is just what employers need to do. So, thankfully we are seeing a shift.

[4.42:] So, in terms of ensuring that employees are engaged with their health, that they take advantage of the health and well-being programs that are being put forward by the organisations whilst they are obviously catering to the demand of employees. How can they make sure that employees do take advantage of these programs and do get involved for their own, their own health benefits?

Okay, yes, well in our recent research ourselves, we’ve seen a massive disconnect between what employers think that they provide to employees already and what employees think that they have available to them. As much as a sort of 50% disconnect and even greater in some regions and in some cultures. And I think that’s down to a few things. I think use a good question, are they employers providing the right things for individuals? Recognising that one solution certainly doesn’t fit all. But even beyond that, are they effectively communicating those and delivering those in a way that employees can really understand the support and tools that are available for them, how they’re relevant for them, how to access them, when to use them, what they should expect from them. So, that promotion of those information, that education, is a big challenge. But also delivering those in the right channels at the right time for individuals and making it easy for them to access. And even when that is done, I think there’s a real challenge around what the adoption and engagement levels are from employees. So, you know, even some of the best solutions we’ve seen on say mental health solutions, for example, that employers are providing. You know, at best, you may get 10, 20, 25 percent uptake rate and that’s not a bad thing. It’s just merely a reflection that there is a significant world of need here for individuals, a lot of different solutions. You know, if we look at something like mindfulness for example, you know there are more than 400 mindfulness apps in the app store and for a very good reason. Because a lot of different approaches suit a lot of different needs and requirements. So it’s very hard for an employer to deliver against all those different needs and all those different requirements. And that means coming back to a really strong analysis, gap analysis, knowing your employees, and really investing in the things with the biggest impact for the most people. And that’s as much around positive well-being and for example positive mental health as it is about necessarily addressing mental health illness and treatment.

[7.32:] And that’s without really taking into consideration the unique needs across different cultures in different parts of the world. So, if you have organisations with internationally based or globally mobile employees, the needs and the set up for these programs is going to be considerably different to those of a smaller, more domestic employer. So how do you think that international employers can really start to tackle these issues, in terms of providing that menu of options, those personalised options, in terms of health and wellness, Simon?

Yeah, I think you highlight a really good point there, Lorien. I think this is a real challenge at the moment. You know, if we look, if we talk to the HR industry in general, for global organisations, there are attempts to harmonise benefits, harmonise processes. And that’s a real challenge when it comes to well-being when there are very different regional and cultural needs, but also to your point, different scale of organisations within region. So you may be a global, large corporate organisation but your office in a particular region might be effectively an SME or, even you know, a micro SME and therefore your benefits solutions that you very successfully deploy on scale back at home are unlikely to be feasible or practical or necessarily relevant or applicable to a smaller workforce in a different culture. The other challenge for a lot of our international clients as well is within that overseas office, you’ve got a mix between expats and local nationals. So two very different sort of cultural requirements and expectations, shall we say, around workplace behaviour and around their expectations and engagement within well-being. So it is a real challenge and I think what employers need to do is in answer to your question is, first of all, recognise that and therefore be adaptable in their approach and ensure it isn’t a one-size-fits-all approach and strategy but something that can cater for regionalisation and those nuances even within those regions.

[9.46:] Yeah, absolutely, you know and as you say you’ve highlighted that there is a significant difference potentially between the expat needs and the needs of the local nationals as well, the local population. So in terms of health status — you know, people having knowledge of metrics of health, their cholesterol, their BMI, their blood pressure, going for a health check up on a regular basis whether that’s annually or when they have concerns, and generally looking at developing healthy habits, what are some of the strategies that organisations can implement to really raise awareness of the importance of that day-to-day health maintenance and healthy behaviours?

Okay, yeah, so, I think know your numbers as it’s often referred to is obviously a key foundation to understanding your health status and your health risk. And you know, any annual MOT, any check up with a GP will start with some very basic measures around weight, around waist circumference, around cholesterol, around blood pressure. You know, your typical base biometrics, and that’s a great starting point. But that obviously is a very small part of the picture and predominantly focused around physical health. So I think health assessments are great tools but I think you have to look at health assessments and perhaps take a more holistic approach and that is as much based around a conversation. And I think health assessments that incorporate aspects of coaching or soft counselling, should I say, that enable people to have a conversation with somebody who’s trained in understanding the broader holistic health needs forms a much better picture of your overall health both in terms of perhaps causes behind symptoms and existing conditions but also future risks. And then the impact of that is, can potentially prescribe as such a much more personalised program and route forward, so health assessments are valuable but I think they need to be health assessments that take a more holistic view of health beyond just biometrics. And that can then lead in to personalised and tailored action plans moving forwards with navigation into the resources to help those individuals to actually do something. So I think traditionally some of those health assessments have ended up perhaps in initial wake-up calls and then ended up in PDF reports that have sat on the desktop or hard copy reports that have perhaps sat on the shelf for another 12 months until the annual routine comes around. And those clearly haven’t necessarily worked for the masses in the past and so health assessments are great but need to be moved on — personalised, progressive and actionable.

[12.44:] Yeah, absolutely and in terms of understanding, as you say, how you can use the insights and the data and knowledge about your own health to develop healthier habits and healthy lifestyle choices, specifically when it comes to healthy eating there are a number of other strategies that organisations can employ. You’ve mentioned personalisation, so could you talk to us a little bit about healthy eating specifically and nutrition and personalisation of those results to help employees again to set off on a better path?

Yeah, I think the important thing here is recognising how everything is so interconnected. Right, you know, so healthy eating isn’t just about a healthy diet, it’s about understanding the psychological impact of why we eat what we do when we do, and the behavioural impacts of changing a behaviour in a lasting and sustainable way. And then looking at the impacts of like obviously activity on what we eat, looking at sleep which has a huge impact on how we eat and what we eat, and on our weight management. And again, I’m unashamed to use this, overuse this word, as I have done already, of referring to that holistic picture. So nutrition is an incredibly important part of that picture but it’s not an isolated part. And I think the value of having coaching support and solutions that look at the whole you, the whole self, is really where this needs to go and nutrition is an incredibly important part of that. And it’s also recognising things such as for example genetics as a cause as to what the right diet is, and what diets will have an impact on us. And this is something we’ve been piloting recently with health and wellness genetic profiles that help understand people’s propensity to certain risks and outcomes. So for example, I might be more likely or less likely to be carbohydrate intolerant. Now it’s not the complete answer, but it’s an important part of the jigsaw for a much more informed discussion with a health care professional to understand why people do the things they do, and what might be the most applicable and sustainable action plan moving forward.

[15.14:] Absolutely, so that really ties together your nutrition, your response to stress, the optimum way of exercising and obviously you mentioned sleep there as well. So those are very much part and parcel of holistic health and taking a really proactive approach to keeping yourself healthy and well. What about when it comes to how employers can help to really drive those behaviours and motivations throughout the working day? It’s all very well providing some hand holding and guidance in terms of what you should do to set yourself off on that better path. But how can organisations really help employers, employees to build that into their everyday so that it becomes a habit in and around the workplace?

Yeah, so I think this comes back to not necessarily making the distinction between workplace and out of work. Well-being isn’t Monday to Friday, 9 to 5, and neither is it just a weekend thing — smashing it in the park run at the weekend and then settling back into old routine Monday to Friday. So I think the first thing I’d sort of say is this is about developing a life plan to well-being. But in a way that can be manageable and sustainable Monday through Sunday. And so therefore work is certainly part of it but I think it’s about workplace providing solutions that enable people to look at the bigger picture beyond just the workplace and implement a plan for them that is personalised and, as I say, sustainable and achievable as well. I think that comes through a lot of the coaching and conversational support. There’s some great digital health tools out there that enable people to keep them on track and that might be right for them, but I think combining both those tools and access to professionals to speak to, to really understand what might work for you. And what’s important to you. You know, not everybody is out there looking to lose weight or looking to smash personal bests in terms of activity and performance, and not everybody is aspiring to the same financial and wealth goals. And therefore, it really does need to be a personalised approach. And that starts with listening. Having those conversations, and asking the right questions and devising a sort of stepped, staged achievable and sustainable plan.

[17.58:] Yeah, I completely hear you about, excuse me, the blurring of the lines between home and work life. And as you say, you don’t draw a line between the two in terms of maintaining healthy practises. But very specifically perhaps, looking at workplace policies, or encouraging employees to have chair breaks and regular screen breaks, during the working day. Is that something you feel that works if it’s mandated from the top down?

Yeah, it’s a really interesting question, Lorien. I mean, look, there’s been some incredible research analysis. There’s a World Health Organization report and I’d encourage people to look at that as a framework for health practises within the workplace. And it looks into what is measurable and validated as having a positive effect, and the outcome is clearly it’s different things for different workplaces in different regions and different people. And whilst there is some clinical evidence behind certain practises, a lot of it is incredibly hard to measure within the workplace. There’s always a skew as to people that participate in these programs. And also something called the Hawthorne Effect, which is a little bit like the placebo effect, in as much as if you have attention paid to you in the workplace, then you’ll feel like you’re in a better place. So this can skew results hugely so I think it’s hard to say, Lorien, in answer to your question, that one thing is definitely the right thing and you should do this, and you should do that. I think it starts with all good analysis, talking to employees, understanding root causes, and then really planning out — as you would with any insight-driven product or proposition development — really planning out what’s going to have the best fit for the most people for the best outcome. And that will be different for different people in different situations. You know, even looking at generational differences, the challenges that are coming through, for example in the millennials and Gen Z generations around loneliness and social connectedness might be vastly different to a workforce of a different age and maybe in a different region. So it certainly isn’t one-size-fits-all whether that’s in terms of physical environment, whether that’s in terms of emotional health, whether that’s in terms of physical health. So it really starts with good analysis and assessment, and then measurement, monitoring and tracking thereafter.

[20.32:] Yes, yeah, no I completely understand and in terms of maturity of workforce, there’s other things to consider as well. In terms of we now understand that are a number of dimensions that impact our well-being and that there are root causes that you alluded to earlier in terms of stress and mental health. And we know that financial well-being is high on the agenda for many organisations this year and into the future. So what is it that organisations can really do to support the mental and emotional health of employees — in terms of understanding the stressors, and then catering to and obviously providing solutions for those symptoms?

Yeah, okay, so I think the first thing I’d sort of say in terms of that subject matter – in terms of mental and emotional health specifically, I think there’s been a real shift in the last few years in the focus on this. Which is a fantastic thing. And with that, now some great resources, some great tools and some great frameworks for employers to look at use. In the UK specifically, I think the Farmer Stevenson Review that was commissioned by the Prime Minister back in 2017 has driven a really, really solid framework on really key steps that employers should look to take in terms of the workplace on building the right culture, the right conversation, the right dialogue, the right support and importantly they’ve looked at that both from smaller organisations as well as large organisations as well. So there are frameworks. A number of those are available, a number of steps. I think we’ve done a great job in terms of raising awareness in industries. There’s still more to do. I think we’ve made a good start in terms of breaking down the stigma from the top down in organisations although there’s still an awful lot more to do. And particularly in some regions and cultures. I think we’re not starting to get executive-level recognition, signing up to charters, people being on the executive board responsible for mental health and well-being and reporting back quarterly on that. An organisation that we’ve been working with — and a gentleman we’ve been working with, Rob Stevenson, and the Inside-Out organisation, they have a charter visible on their website and I would encourage all employers to have a look at that and ask themselves, you know, is this something that their CEOs could sign up to? And then there’s, you know, the cultural big next step around that sort of analysis, that gap analysis, around understanding the root causes of what’s actually driving the stressors, some of the mental health risks within their workplace. Whether it be management approach, skills, policies, you allude to, Lorien, and even just the demands of the workplace. And that can lead to then really sort of solid action planning and investment for impact in training, leadership, return to work policy development, that type of thing. So there’s some clear steps there and then beyond that, what are the more holistic tools available, because as you quite rightly say, Lorien, we’ve recognised in our research that this isn’t just about solving for the physical or mental health issues. It’s about recognising that things such as your sense of purpose, your connectedness, your values, your character strengths, all things that a solid well-being strategy from an employer can look to have an impact upon. So, long answer to a short question but I think the tools are out there. The frameworks are out there. The charters are out there. And we’re in a good place. What we now need to do is sort of move beyond the raising the awareness and talking about it, and really start actioning some of this in a meaningful, measured and accountable way.

[24.24:] What is it that you think that Aetna International does particularly well in terms of offering support for organisations to then help their employees in turn?

Well, by the very nature of what we provide, our core product is cover for an indemnification for access to health professional support whether that’s primary care or secondary care. So you know by providing access to doctors, you know whether that’s a doctor you choose to go and see or a telehealth resource through our vHealth partnership, the ability to speak to our doctors any time, what you are reassured about is that you are covered for the onward recommendation that might arise from that and that might be into therapy, it might be into medication. Whatever that might be, so I think that’s the first thing is that we provide access to those resources and the support. But before that, we also provide access to specific programs, so for example, for our members we have recently partnered with a leading smoking cessation app, Smoke Free, which provides a digital health tool based on behavioural health techniques based to support people in making that first step around self-help, knowing that they can then come into our further resources if they need professional support thereafter. And even before that layer, is probably more the more holistic well-being assessments that enable people to understand, well what are the things that are having a risk on my health, understanding my alcohol consumption, understanding my weight impact or cholesterol risk due to my diet, for example, so there’s many layers to this. I guess really, what we’re trying to do is meet people on their journey, wherever they are in that journey. Whether they’re well, worried-well, at risk with an existing condition, at future risk based on a hereditary condition. If we can meet you on that journey in the right place and navigate you to the right support, knowing that you have access and cover for that, then I think that’s a value we can bring.

[26.54:] Super, and then in terms of signing off, what would be your top three considerations for organisations in terms of their health and wellness strategy for employees?

Yeah, I think the first thing that I’d probably say is to not see it as a health and well-being strategy. See this as business strategy. See this part of our core mission and our core values. You know, this is about your people. This is about the engagement of your people. It’s about the output and productivity of your people and importantly the happiness of your people. And I think there’s a number of reports out there that will show the correlation between all of those things and you know, GWP and performance from an organisation and employee value of course. So I think that’s the first thing I’d say is not look at it as a health and well-being strategy, look at it as your business and people strategy. The second thing I’d then say is not look at it as an HR initiative or look at is as a set of tools or look at it as an insurer-driven initiative, but to look at it as a cultural initiative. And to make sure that that is something that is really, really accountable from the top all the way through the organisation. So, fantastic if we’re saying the right things at the executive level, but is that what happens in line manager conversations, and line manager support everyday within the organisation. So really making sure that’s something that’s in people’s roles and objectives. That they’ve been given the support, the training, the skills that they need to do. So I’d say that those are the first couple of things. And then the third thing is I’d say is really appraising, first of all, the value of the resources you already have at your disposal — either within the organisation, from your partners like your health insurer, if that’s Aetna or others, and then also through the community. Whether that be through state-sponsored resources or in the local community as well. And not all of these necessarily need to require a big investment budget to undertake. There are fantastic free resources available in the countries, in the community, for people take advantage of. And people simply don’t know they are there. And an employer can help flag and navigate people to that, and of course there are fantastic resources available from your partners. You know, EAPs — Employee Assistance Programs — have come on in leaps and bounds in terms of what they offer but are significantly misunderstood and underutilised and I think insurers and employers can work together a lot more to extract value from those, for example. And that’s something at Aetna that we’re doing now and are keen to partner with companies in getting more value out of. So lots of resources there, and also a lot of changes that can be made which have the biggest impact are sometimes around policy as well. You know, this isn’t necessarily about investing in the latest digital health tools or wearables to support — valuable as those may be —but perhaps the biggest issue for some of your employees are small things in your environment, within the work practises. You know, can I have flexitime one day a week to pick up my children, which might be the biggest stressor for me when my husband’s away or my wife’s away? You know, can I resolve a parking issue which causes a significant stress to a certain proportion of my population each day? Or is it, do I have the access to the tools that I need to do my job efficiently? You know, these are internal issues that might be root causes of what might seemingly be small stress drivers, but when you add those up and put those on top of life’s stress drivers can have a significant impact. But fortunately, it is something that most employers are able and empowered to do something about themselves if they understand the issue. And that understanding comes through talking to their employees, surveying them, engaging with them and importantly, listening.

[31.10:] And Simon, yes, you’ve mentioned some of the challenges for employers there, but what about some of the challenges for international employees?

Yeah, that’s a really good point, Lorien. Because if we look at international employees, yes, there are those cultural challenges. And some are more adept and adjusted to that, perhaps based on previous experience than others, but also there’s a varying need between somebody who’s being sent on a short-term assignment with or without their partner or their family, versus somebody who’s taking on a role longer term role, perhaps even fully emigrating and even taking on different citizenship as part of that shift. So there are some really different needs to consider here. So from a well-being point of view, for example, I stereotype slightly but you can imagine somebody being sent over to Hong Kong, perhaps Southeast Asia, in the Financial Services Sector, on a 3 to 6 month contract, for a particular project. You know the demands of that might be very different to somebody being sent over to effectively take on a new role and a new career in a different environment and that person on that shorter term assignment may not be prioritising holistic well-being in that 3 to 6 months. They’re going to be working hard and possibly playing hard as well, and what they’re looking for is probably the essential support around their health to make sure that you know, they don’t fall off their track during that period and neglect themselves as opposed to finding themselves and their holistic health in that period. So those needs differ differently. One of the things that we did do recently, Lorien, is some really interesting research into this and I think that one of the things that came out hugely was around the challenges around connectedness and community. Finding communities, finding new friends when overseas. In addition to the obvious challenges around language, settling work and family, settling children in new schools for example. But that bit around connectedness and community really came through strongly and for singles, dating in particular. This was a real concern and a real challenge for those in overseas environments, in a meaningful way, that they might aspire to back home. So that’s an interesting one around, what is the role of someone like Aetna to support employers in overcoming those issues. What’s the role of the employer in terms of addressing some of those? But really interesting finding and probably represents a manifestation of issues within broader well-being that we can probably connect that to.

[34.04:] Fantastic, Simon, thank you ever so much. And I’m really looking forward to speaking to you again in a couple of weeks’ time as we look more at the corporate health and wellness trends that are really set to shape the landscape for the rest of 2020 and beyond in fact. So I shall talk to you again very soon but thank you very much for your time today.

It’s been a pleasure, Lorien.

For those who don’t know us, Aetna International is a global health and wellness benefits provider. But, we’re more than just an insurance safety net; our skill lies in delivering the tools, services and resources that help drive health care costs down and people’s physical and mental health and well-being up. This is something that’s important to our corporate clients and self-funded members alike. That’s why we currently serve almost 900,000 members around the world — from Shanghai to Seattle. Ultimately, we believe that when people thrive, their work and personal endeavours thrive too. For more information about us, you can visit AetnaInternational.com.

Thanks for listening. We hope you found the episode insightful and valuable. If you enjoyed this podcast, join us for the third episode where we discuss the rising stars and trends in corporate well-being that we’ll see emerging as we move through the year and into 2021. Make sure you get the latest updates by following us on LinkedIn. We hope you’ll join us again for the next edition of the Fit for Duty podcast.