8 Health “Facts” That Really Aren’t

For many people the idea of “alternative facts” is extremely troubling, given that a fact is defined as: “a thing that is indisputably the case.” How then do we make sense of the relationship between a fact and an “alternative fact?”

Is it like flammable and inflammable – two terms that on first blush seem like they mean the exact opposite, but actually have the same meaning? Or is it more like the word pregnant which never means not pregnant or even kind of pregnant? Can an indisputable fact really be disputable? If you jump off the roof of your house can you say with 100% assuredness that you will fall down and not up?

It is with this as a context that we explore 8 assumptions, often presented as facts, that clearly are not facts. The following such assumptions are related to health, heath care and organizational and employee well being. They are in no particular order as each person gets to decide which is the most and least important for their circumstances.

1) The Body Mass Index is a reasonable, though not perfect proxy for health.

Even 8th graders, understand that the BMI is a very poor indicator of just about anything; more accurately – an invalid metric. Unfortunately, it is still the most widely used “determinant” of who has and does not have a “healthy” weight. Some have suggested we should just use it as a rough guide or perhaps combine it with other measures to make it “more valid.” Here is the problem. Valid and invalid do not have the same relationship as flammable and inflammable. A metric cannot be valid and invalid at the same time. And adding another metric to an invalid metric does not make it – “more valid.”

For example, the Copernican model of the solar system (planets revolve around the sun) is valid while the older, Ptolemaic model (sun and planets revolve around the earth) is not. You cannot make the Ptolemaic model “more valid” by combining it with the Copernican model and concluding that the earth travels only half way around the sun. The bottom line is that the BMI is an invalid metric and it is simply scientifically inappropriate to keep using it and pretending it is not.

2) Talking about “love” at the workplace is just new-age fluff.

Talking about love in relation to business has certainly never been a mainstream phenomenon. We are however, beginning to see more discussion of the potential power of love in the business world. Business professionals are talking and writing about it and there are conferences talking about it or even being named after it.

In the words of Tim Sanders, former Chief Solutions Officer of Yahoo from his book, Love Is the Killer App: How to Win Business and Influence Friends:

“I don’t think there is anything higher than love… Love is so expansive… the way I define love is the selfless promotion of the other.”  

And from Kevin Roberts, CEO of one of the world’s largest advertising agencies from his book, Lovemarks: The Future Beyond Brands.

“Human beings need love. Without it they die. Love is about responding, about delicate, intuitive sensing. Love is always two-way. When it is not it cannot live up to the name Love. Love cannot be commanded. It can only be given.”

Perhaps even more importantly, increasing numbers of highly respected and successful companies are realizing that “love” may be one of the most important concepts for organizations to embrace if they want to successfully navigate the demands of today’s rapidly changing business environment. Listen to how the authors of the book, Firms of Endearment: How World-Class Companies Profit from Passion and Purpose speak about the fundamental underpinnings of their organizations.

"A company that endears itself to stakeholders by bringing the interests of all stakeholder groups into strategic alignment. These companies meet the functional and psychological needs of their stakeholders in ways that delight them and engender affection for and loyalty to the company."  

There is no hesitation whatsoever when it comes to these leaders using the “L” word. As they describe in their introduction, their goal is to demonstrate how to:

Build a high-performance business on love (It can be done. We'll prove it.)

3) The health care system in the United States is broken.

Few would question the fact that our health care system is wreaking havoc throughout our society. For example, middle class income has been declining for 20 years, in spite of the fact that employers are spending far more on employees than ever before. The problem is that every dollar and more has gone to healthcare, primarily because employers have mismanaged the way they purchase health benefits.

People who understand the complexities involved are hesitant to say that the system is “broken.” The consensus of these experts is that the health care system is functioning exactly as it was designed to function. As Otis Brawley, Chief Medical Officer of The American Cancer Society puts it in his highly acclaimed 2012 book, How We Do Harm:

“The system is not failing. It’s functioning exactly as designed. It’s designed to run up health-care costs.”

And Dave Chase, in his powerful, new book, The CEO’s Guide to Restoring The American Dream: How To Deliver World Class Health Care at Half The Cost concurs:

“Wasteful health care spending consumes 79 per cent of household income growth, leaving just 21 per cent for everything else. This, more than nearly anything is destroying the American dream.”

The good, no really the great news, as Dave explores in detail in his book, is that the fix to the problem is fairly straightforward and numerous organizations of all sizes and in all industries, are already accomplishing it.

4) Obesity and diabetes have combined to stagnate life expectancy in the United States.

Contrary to popular belief and some widely circulated claims that were never supported by the research, there is no evidence to support this contention. The good news is that we can put to rest the fear mongering around the belief that our kids are not going to live as long as their parents because of obesity. The bad news is that life expectancy for Caucasians in the United States has stagnated and perhaps even decreased in recent years.

The fact is that the stagnation in life expectancy is directly related to drug overdoses, suicides and depression. In fact, the number one cause of death for people 50 and under in the United States is now drug overdoses.

Unfortunately, workplace wellness initiatives to deal with this epidemic have been almost non-existent. Until very recently there has been a complete lack of focus on what is potentially the most pressing issue for employee health. While sitting is certainly not the new smoking it is very possible that opioid addiction is!

5) Carrots work better than sticks! No, sticks Work Better than Carrots - to change employee behavior.

To improve the dismal participation in workplace wellness offerings, many companies first used carrots – rewarding employees for participating. With participation still less than stellar and the passage of the Affordable Care Act in 2010, more and more businesses moved to implementing sticks – punishing employees for not participating.

However, the evidence over the past 3 or 4 decades is conclusive and consistent. For anything other than simple, one-time behaviors (going to get a vaccine for example) extrinsic motivation (carrots or sticks) does not result in sustained change. And both carrots and sticks typically engender a wide range of potential negative consequences including decreased intrinsic motivation and creativity and increased cheating, lying and taking shortcuts.

The next time you are offered a white paper or a presentation claiming to review the ins and outs of using extrinsic motivators; whether you should use carrots or sticks or how you should manipulate their frequency, type, or choice; save your time and money by heeding the very simple words of Daniel Pink from his ground-breaking book, Drive:

“Any extrinsic reward should be unexpected and offered only once the task is complete.”

6) “You are what you eat” accurately portrays the importance of nutrition to health.

People are constantly making this statement as if it were indeed a fact. But, is it? Research on the determinants of population health, embraced by both the WHO and the CDC, demonstrates that the contribution of various factors to the health disparities in our country looks something like this:

Individual health behaviors account for about 25% of these disparities. And nutrition is only one of these behaviors along with exercise, cigarette smoking, etc. As is clear from the figure, by far biggest impact on health disparities comes from the Social and Societal Characteristics and Total Ecology, commonly referred to as The Social Determinants of Health (SDOH). As renowned physician Norton Hadler writes in The Last Well Person: How to Stay Well Despite the Health-Care system:

“At least 75% of the hazard to longevity can be captured with measures of socioeconomic status and job satisfaction. Socioeconomic status overwhelms and subsumes all the measured biological risk factors for all-cause mortality as well as most other mortal and illness end-points.”

Given these realities, a more accurate assessment of the contribution of the various factors to health disparities in this country might therefore be – “you are where you live.” 

Michael Marmot, perhaps the world’s leading expert on the SDOH, expresses the power of this reality when he writes for the CDC from his seminal work, The Status Syndrome:

 "If you catch the metro train in downtown Washington, D.C., to suburbs in Maryland, life expectancy is 57 years at beginning of the journey. At the end of the journey, it is 77 years.” (a distance of about 12 miles)

Although nutrition and other individual health behaviors have an impact, if we want to make the biggest difference in reducing health inequities in our country, the research is clear about where our efforts need to be directed.

7) Organizations without a hierarchy would lead to anarchy and poor business outcomes.

Given the history of top down hierarchical control that has dominated business organizations in the United States for more than a century, it is not surprising that people would believe that businesses without such structures would naturally lend themselves to chaos. Frederick Taylor, the father of scientific management was clear about this when he said in the early 20th century:

“Each man must give up his own particular way of doing things, adapt his methods to the many new standards and grow accustomed to receiving and obeying instructions, covering details large and small, which in the past had been left to individual judgment. The workmen are to do as they are told.”

Fortunately, forward thinking leaders who understand the realities of the rapidly changing business world and who have embraced the new scientific understandings of the human experience, are realizing that one of the main drivers of worker productivity is autonomy, the ability of workers to think and do for themselves. As a result, companies in a wide variety of industries are embracing the concept known as self-management.

In self-managed organizations, employees closest to the actual work being done make most of the decisions, oftentimes without the need to get authorization from anyone “above them” in the hierarchy, which is often non-existent. As Frederic Laloux describes in his fascinating book – Reinventing Organizations:

“These companies are highly profitable, despite the fact that they seem to be, compared to traditional corporations, quite careless about profits. They don’t make detailed budgets, they don’t compare budgets to actuals at the end of the month, they don’t set sales targets, and colleagues are free to spend any money they deem necessary without approval from above (as there is no one above to approve the spending). They focus on what needs to be done, not on profitability and perhaps precisely for that reason, their efforts are rewarded with stellar profits.” 

8) Workplace wellness saves money

This continues to be presented as fact, appearing commonly from wellness vendors and supporters. The problem is that there is simply no evidence, especially since the passage of the wellness provisions of the Affordable Care Act to support the claim. In fact, the only place you will see this claim made anymore is from these sources. Independent reviewers, those without a so called “dog in the fight” have made it clear that these programs don’t save money. Rand expert Dr. Soeren Mattke put it this way:

"Those programs are not particularly effective, and many are not voluntary. Often these purported savings are achieved through smoke and mirrors."

What is even more amazing is that some of the wellness industry elite have admitted that their programs don’t even pay for themselves.

Just because the typical approach to workplace wellness is flawed; health behaviors are not what’s driving healthcare costs and wellness programs are not effective in reducing healthcare costs, does not mean that organizations should ignore wellbeing all together. In fact, research supports that, when it comes to organizational effectiveness and performance, wellbeing matters profoundly; the key is how companies are viewing and supporting it.

Take Home

Examining the realities of the status quo is the first step towards moving forward and improving what we do. If the idea of doing that with our understanding and approaches to health care, safety, organizational effectiveness and employee well being excites you, we invite you to consider a unique, multi-disciplinary conference to be held in Minneapolis in November of 2018 - FUSION 2.0 – A Purposeful Gathering of Humanity – check us out – we’d love to see you there!