Monday, November 18, 2019

Business of health 2020: Tackling polarised perceptions in corporate health and wellness

Executive summary
We are working harder than ever before. Technological innovations, globalisation, hyper-connectivity and their influence on workplace culture, coupled with less distinction between work and home life, mean that people are putting in longer hours and facing ever more intense workplace demands. As a result, employee mental ill health and lifestyle-related health conditions are increasingly impacting their productivity and the performance of the organisations to which they belong. In response to this upswing and to rapidly changing market forces, consumer demands, investor expectations and new emerging technology, companies are implementing increasingly sophisticated risk-management strategies. So, health and wellness benefits and well-being agendas are now as commonplace as policies for annual holidays and sick leave, provision for company pensions and on-site health and safety.
Today, the concept of health and wellness is much broader in scope than just the treatment or management of disease. Well-being encompasses several dimensions including physical and emotional health, financial security, social connectedness, purpose and character strength. This view is reflected in the demands and expectations of well-informed employees, and they’re looking for health and wellness initiatives that keep pace. While a culture of well-being has become one of the top differentiators for many companies, others are struggling to keep up with talent values and market trends.
As a leading global benefits provider, we commissioned a survey and this subsequent report to examine the level of health and wellness support businesses are providing their employees, and the impact this is having. We surveyed more than 1,000 HR Directors and 4,000 employees in large and medium enterprises across the world, gaining insights from their regional and cultural perspectives. Our interviews took place in the UK, the US, Singapore and the UAE.
Through the survey data, we explain how the right approaches to corporate wellness can have a positive impact on the holistic health and well-being of employees. We also consider the strategies and resources that help employers develop and embed a successful corporate wellness plan while enriching the company’s culture: namely, those that help drive health care costs down and workforce health, happiness and productivity up. In this way, companies can help safeguard their future growth and success. Ultimately, when your workforce thrives, your business thrives.
“While many employers are currently struggling to keep pace with talent expectations and changing risk profiles, the good news is that there are a lot of excellent well-being solutions available in the market. The key is to work with payers and benefits providers that configure these into a single, affordable, flexible well-being proposition and to pair this with workforce analysis. In this way, employers can provide engaging, motivating and empowering well-being solutions that effectively address these concerns.” Simon Miller, Senior Director, Customer Proposition, Aetna International
Seven key findings
Our research finds that there is a considerable disconnect between employer-provided benefits and employee expectations, awareness, understanding and experiences. While employers think they’re doing a good job of supporting people’s physical and mental health, employees don’t agree.
This report looks at some of the greatest challenges faced by corporations in maintaining a healthy workforce and improving business performance. It also details the opportunities available to help organisations achieve their goals.
We have called out seven key insights below, along with one or two stats from the full data set, which are covered more fully in the subsequent chapters: 
1.   Health and wellness benefits are missing the mark
70% of employers believe they provide good access to health and wellness benefits and support, but only 23% of employees agree.
2.   Lack of mental health support is a pressing issue
82% of workers across the globe are concerned that mental health issues could one day impact their ability to work. However, only 25% of employees believe that their company provides good support for mental health conditions.
3.   Company health support affects employee job choice
75% of employees stated that they would not join a company that failed to provide good support for treating physical health concerns such as back pain.
4.   ‘Sick day’ stigma impacting health
72% of businesses don’t think employees at their company take enough sick days. And 18% of employers think that a culture where people do not feel they can take sick leave is the biggest cause of an unhealthy working environment.
5.   Poor sleep cycle caused by and impacting work
56% of employees don’t think they get enough sleep. Of these, 34% say job stress and problems at work are responsible for their sleepless nights.
6.   Stress: the threat to employee well-being
Across all four of the markets we surveyed, 47% of global employees feel stressed because of work and 80% of workers rated their company’s support for stress as adequate or poor.
7.   Having local insight is a must for international organisations
Workers in the UAE rate access to ongoing programmes to support wellness as the poorest globally, with only 20% ranking them as good. However, 76% of HR Directors in the UAE rate access to wellness programmes as good, the highest number internationally.
Finding 1: Health and wellness benefits are missing the mark
Our survey results show that employers are failing to meet employee needs for health support in the workplace, resulting in a significant risk to talent attraction, retention and productivity. In addition, they reveal a significant gap in the perception of mental and physical health benefits provision between employers and employees.
·         70% of employers believe they provide good access to health and wellness benefits and support, but only 23% of employees agree with them.
·         More than 88% of HR Directors based in the UK, the US, the UAE and Singapore state that their company could do more to reduce presenteeism and sickness rates by improving health and well-being support.
·         37% of employers are unsure about what employees want from their benefits package and 44% are concerned about the cost implications of employee health and wellness.
·         69% feel they are increasingly expected to do more with less time. The vast majority believe that compliance with new laws and regulations is an ongoing challenge.
·         82% of employees would feel undervalued if a company did not support their mental and physical health.
·         32% of employees rate the level of support for mental health in their workplace as poor compared to just 16% of HR Directors.
We also find significant experience perception gaps in the region:
Workers in the UAE rate access to ongoing programmes to support wellness as the poorest globally, only 20% ranking them as good. This contrasts with the opinions of HR Directors in the same country, of whom more than three quarters say that access to wellness programmes is good.
“Clearly, the first goal of a workplace wellness programme is to help employees become healthier, but it’s no longer just about medical cost, attraction, retention and productivity; people are recognising that these programmes are improving their stock performance. Ultimately, the goal of every wellness programme is to inspire individuals to change their wellness habits — and to give them the tools to be successful.” Cate Darroue, Senior Director, Product & Marketing, EMEA, Aetna International
“Many employers offer a one-size-fits-all well-being solution. It may be a very good package of benefits but only relevant to 25% of the population. Also, many employees are simply not aware of what’s available to them. As a result, employers’ considerable investments are missing the mark — not because they aren’t great solutions, but because they haven’t focused enough on fully understanding and addressing individual needs and company culture from the top. We find that the most effective well-being engagement initiatives are often driven by the CEO, improved line manager capability and support, and employee champions.” Simon Miller, Senior Director, Customer Proposition, Aetna International
We asked several Aetna International experts from across the business to comment on the research findings. These videos provide insights into the health and wellness benefits provision challenges faced by employers and the solutions available to them: 
Q 1.1. What are some of the challenges employers face in providing health and wellness benefits for their employees? And how can they tackle them?
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Q 1.2. What can employers do to overcome the gulf that exists between the health and wellness benefits employers are offering and what employees need?
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Q 1.3. How can Aetna International help employers bridge the gap between employee health and wellness benefits expectations and employer provision of benefits?
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Finding 2: Lack of mental health support is a pressing issue
Globally, mental health conditions contribute greatly to the burden of workplace disability, lost days and reduced productivity due to ill health at work. However, support for mental health conditions at work is perceived by employees as particularly lacking, which is at odds with the employers’ perspective. Wellness provision for mental health conditions is improving, but our survey shows a pressing need for organisations to step up their efforts:
·         According to our data, 43% say their organisations offer good support for mental health conditions such as anxiety and depression. However, only 25% of workers believe that their company provides good support for these conditions.
·         82% of workers across the globe are concerned that mental health issues could one day impact their ability to work. While 38% of workers view workplace support for stress as poor, only 11% of employers think their provision of benefits and support for stress is poor.
·         The gap is particularly noteworthy in the UAE, where only 20% of employers rate their support for mental health in the workplace as good (compared to the global average of 25%). Conversely, 38% of workers in the UAE rate their company’s support for stress in the workplace as poor (higher than the global average of 32%).
·         67% of workers stated that they would not join a business that did not have a clear policy on supporting those with mental health conditions such as anxiety and depression.
“Organisations are increasingly broadening their definition of wellness to include more than just physical health. Wellness is not just an absence of illness: effective wellness programmes focus on holistic well-being and redefine what it means to be healthy.” Cate Darroue, Senior Director, Product & Marketing, EMEA, Aetna International
Tackling stigma in the workplace
Our survey found that mental health still carries negative stigma to a degree. This is particularly true in countries such as the UAE and Singapore, where half our respondents found it hard to talk about mental health at work, compared to 40% of employees in the UK and the US.
“Organisations are seeing a rise in absenteeism and presenteeism being allocated to mental health conditions relating to stress, anxiety and clinical depression. This is partly because there’s much better awareness and a subsequent rise in diagnosis. Also, it’s becoming less taboo to cite mental health as a reason for absence or illness. That’s a good thing and while it’s probably always been a factor, we can now better measure and attribute impacts in order to take more assertive and positive action for the benefit of employee and employer alike. Companies are increasingly reporting to the market on their sense of purpose, societal contribution and employee engagement. I suspect and hope that employee well-being and mental health indicators specifically, will also soon become a familiar part of annual reporting and shareholder accountability.” Simon Miller, Senior Director, Customer Proposition, Aetna International
“A more collaborative management style seems to suit more people. People need to feel valued, heard and have some control of their working day too. It’s not just about putting in a gym in a building, it’s about having flexibility and some awareness of when people are starting to struggle with stress. If someone doesn’t self-report their stress, anxiety or depression, it can be challenging to detect.
“Tackling a culture of presenteeism is a big challenge. People are taking days as leave when they should be taking sick leave — known as ‘leavism’. We’re seeing an erosion of employee protection and less secure work and roles and this is without a doubt having an impact on stress. People are often left feeling ‘lucky’ to have a job, which can heighten stress levels as they fear for their job security. This results in a number of maladaptive behaviours such as working excessively long hours, checking emails continuously and using annual leave as a time to catch up on rest and recovery.
“Employers need to change their corporate culture. It’s important to ensure that if people are experiencing the ill effects of stress, they don’t blame themselves. Employers need to collaborate on strategies to deal with high levels of stress and support their employees’ mental and physical health.” Dr Meg Arroll, specialist health behaviour change psychologist at 10 Harley Street and author of The Shrinkology Solution (Quadrille).
Discover what Aetna International’s experts say on the provision of holistic health and well-being support in the workplace:
Q 2.1. How can employers go about helping to look after employees holistically — balancing their emotional and physical health?
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Q 2.2. What can employers do to help deliver and promote mental health support in the workplace?
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Finding 3: Company health and condition management support affects employee job choice
Data reveals that there are certain medical cost drivers that are common to employers across the globe. These cost drivers include lifestyle-related diseases such as diabetes, heart disease and musculoskeletal conditions, as well as seasonal illnesses such as the flu. Many employers recognise that prevention is better than cure, and many organisations have introduced prevention and early intervention strategies into their health and wellness benefits offerings as a means of controlling health care costs, while ensuring positive health outcomes for those affected.
Back pain
We found contrasting attitudes, costs and availability of local health care for the treatment of back pain across the different global markets.
·         39% of US employees said their companies provided good support for employees to deal with back pain, whereas in Singapore, the number of companies who did the same for their workers was only 23%.
·         However, our survey found that even in the UK, with universal, government-funded health care available, 19% of UK HR Directors said back pain posed a considerable challenge to businesses.
·         Globally, only 6% of large corporations with more than 5,000 employees said that dealing with time off sick and lost productivity from back pain was their greatest HR challenge, whereas for smaller enterprises the figure is 18%.
·         75% of employees stated that they would not join a company that failed to provide good support for treating physical health concerns such as back pain.
·         39% in Singapore and the UAE, and 30% of employees in the UK and the US, are concerned that lifestyle-related diseases such as back pain will affect their ability to work in the future.
Flu and viral illness
We find considerable need and demand for preventative health measures such as flu immunisations as part of corporate wellness provision.
·         23% of employers stated that flu and other common viral illnesses represented the greatest challenge to their business in terms of lost productivity and increased sickness rates.
·         40% of employees said that support for flu and common viral illnesses was good at their company.
·         Concerns were highest in Singapore and the UAE, with 25% and 28% of HR Directors stating that cold and flu viruses were their greatest challenge to employee health and wellness. 
“Flu vaccines represent a true win-win situation. Smart organisations make every effort to get their workers vaccinated because they realise how expensive the alternative is financially — due to lost productivity, and emotionally — due to low workforce spirit.” Dr Lori Stetz, Senior Medical Director, Aetna International
Learn more about the ways in which an organisation’s approach to health and wellness impacts talent acquisition and retention, as well as cost containment efforts.
Q 3.1. How can well-rounded health and wellness benefits plans help employers contain health care costs?
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Q 3.2. What does good look like when it comes to corporate health and wellness benefits for employees?
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Finding 4: ‘Sick day’ stigma impacting health
Sick leave
As career expectations change, the demand for flexible (and remote) working, clear policies around employee self-care and sick leave as part of an employer’s approach to employee well-being is strong, and a challenge that businesses must overcome if they wish to attract and retain the right talent.
·         72% of businesses don’t think employees at their company take enough sick days, and 18% of employers think that a culture where people do not feel they can take sick leave is the biggest cause of an unhealthy working environment. From an employee perspective, 40% of employees in businesses in the UK, the UAE, the US and Singapore take six or more sick days per year and 47% strongly agree that companies should actively encourage people to take time off when ill.
·         Only 12% of HR Directors believe that flexible working policies have a positive impact on employee retention. However, flexible working hours is the most popular workforce policy requested by employees to help them lead healthier lives.
·         A comprehensive health and wellness benefits package is seen as the second-biggest positive impact on the ability to attract and retain employees by businesses, second only to salary and job role specifics. This is followed in most markets by annual leave entitlement, flexible working policies and location. Flexible working hours and a positive work culture are seen as more important for retaining rather than attracting talent.
After ‘aggressive managers’ and ‘long hours’, a major factor cited in unhealthy working environments was a culture where people don’t take sick leave.
·         96% of HR Directors agreed that their companies should encourage workers to take proper sick leave during illness. But nearly nine out of 10 (88%) stated that their company could do more to ensure that this happens.
·         However, prevention is better than cure: more than eight out of 10 HR Directors agreed that, by offering better health and well-being support in the first place, they could reduce absence rates and presenteeism within their organisation for illnesses that are able to be prevented, thereby containing absence rate costs through early intervention.
In order to attract and retain the best talent, HR departments need to improve work flexibility, self-care and sick leave policies, and company culture to attract talent and keep it healthy. In many countries, more than half the workforce are millennials or younger, who are more likely to make self-care and holistic well-being a priority. When they are ill, they expect to be able to take sick leave until they are well or, in some cases, work from home. Globally, laws and policies around requests for flexible working hours vary greatly.
“Organisations can often struggle to strike the right balance between keeping employees healthy and driving productivity — but these concepts are delicately intertwined. Prevention of health issues is of course better than ‘cure’, but every organisation will draw a different line in the sand. For example: is it when people start to experience symptoms that employers take note, or is it taking a holistic, integrative and preventative approach to wellness? Prevention requires a significant investment when they’re looking at the bottom line. But there is evidence to say that prevention works as far as productivity is concerned. Companies will get more out of people if they feel valued, healthier and not overly stressed.” Dr Meg Arroll, specialist health behaviour change psychologist at 10 Harley Street and author of The Shrinkology Solution (Quadrille)
Discover how attitudes and workplace culture can shape employee health and well-being.
Q 4.1. How can employers create a culture that empowers employees to prioritise and look after their health and well-being? 
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Finding 5: Poor sleep cycle caused by and impacting work
Managers might be forgiven for not having considered the impact of sleep on an individual’s work life — after all, we don’t sleep at work. But from a prevention and early intervention perspective, companies have an opportunity to help improve their employees’ well-being by helping them get enough quality sleep.
Our sedentary lifestyles and unhealthy habits are reducing the amount of sleep that we get, which is one of the many reasons Aetna International takes a holistic approach to health and wellness benefits provision. People who are overweight or obese, smoke, regularly drink sugary drinks, sit at their desks all day and are physically inactive are most likely to suffer from poor sleep.
Sleep-impacted workers are more likely to make mistakes and be less productive than their well-rested colleagues. If poor sleep continues, they are also at increased risk of developing mental health disorders such as anxiety and depression. Additionally, not getting enough sleep can be a symptom of mental health conditions themselves.
·         56% of employees don’t think they get enough sleep.
·         On average employees sleep just over seven hours a night (7.3 hours), which is at the lower end of the recommended seven to nine hours a night. Much of that sleep is poor quality, as on average our respondents say they get only 5.3 hours of quality sleep a night.
·         Job stress lies behind our sleepless nights, with 34% staying awake due to problems at work.
·         Technology is also to blame for keeping us awake at night, with one in four saying that using laptops, phones or tablets in bed prevents them from getting a good night’s sleep.
Furthermore, through working non-traditional hours, commuting for longer than an hour per day, yielding to unrealistic time pressures and stress, and experiencing a lack of choice in daily work, our sleep is further affected.
“Expats may lose even more sleep due to workplace-related issues, especially when they’re working several time zones away from home. Emails from headquarters fill their inboxes while they sleep, they have to get up early or stay up late to participate in conference calls, and frequent travel throws off their circadian rhythms.” Dr Mitesh Patel, Medical Director, Aetna International
Expat workers are prime targets for sleep-related disorders. Our survey found that the UAE, with its large short- and long-term expatriate community and work-hard, play-hard culture, had a higher proportion of workers suffering from a lack of sleep.
·         Of the four markets we surveyed, workers in the UAE got the lowest number of hours of quality sleep a night (5.1 hours) and were most likely (58%) to feel that they didn’t get enough sleep.
Preventative health programmes can play a useful role in encouraging healthy sleep patterns. Smoking cessation programmes, on-site fitness facilities and wellness programmes that reward workers for maintaining a healthy weight and keeping fit can help staff to improve not only the quality of their sleep, but also their overall quality of life and health outcomes.
We asked one Aetna International expert about the ways organisations can promote self-care in the workplace.
Q 5.1. How people can make health and self-care habitual? What role can employers play, and how can we influence our friends and family to adopt healthy behaviours, and vice versa?
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Q 5.2. Why don’t people invest in their own health? And what can employers do to help overcome this?
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Finding 6: Stress: the threat to employee well-being
There’s nothing new about the issue of workplace stress. However, our report finds that both the relentless pace of business today, and the growth of technology, enabling an ‘always-on’ working culture, is making nearly half the global workforce feel stressed on a regular basis. Long hours, tight deadlines and unrealistic expectations all contribute to the pressure.
Stress is mainly known as a cause of mental ill health, but it can take a toll on our physical health, too, leading to headaches, fatigue, insomnia and muscle tension. In the long term, stress can contribute to health problems such as heart disease, high blood pressure and diabetes.
Stress and the challenge to businesses
·         After viral illness, our survey found that employee stress was the most challenging occupational health issue facing corporations worldwide. It is therefore a big concern for global business. 19% of HR Directors surveyed agreed that stress was their company’s greatest occupational health challenge.
This comes as no surprise: research such as the Willis Towers Watson’s Global Benefits Attitudes Survey reveals a direct link between stress and workplace disengagement. Highly stressed employees are more likely to feel resentful at work; they take more sick days and are less productive.
Despite these concerns, we found that the corporate wellness provision is bad at tackling stress and supporting those who suffer from it. Only 25% of the HR Directors we interviewed believe that they offer good support for those who are stressed at work.
·         Across all four of the markets we surveyed, 47% of global employees feel stressed because of work.
·         80% of workers rated their company’s benefits limits for stress as adequate or poor. 38% also rated direct access to support services for stress as poor compared to 11% of HR directors.
·         Despite their stress, employees often don’t visit a health care professional, perhaps because of lack of awareness, or because of shame or stigma attached to their condition.
Smart employers use all sorts of strategies to keep their workers healthy, safe and productive. These must include the right tools for stress management. Acknowledging the risks associated with stress, regularly surveying staff and helping their workers to manage it is the next logical step in improving health and well-being.
“It’s not usually a sense of laziness or lack of motivation that prevents people from doing what they know they ‘should’. Everyone has the ability to make changes, but you need the right support. Employers have the opportunity to create a culture that supports psychological change, which will lead to behavioural change.” Dr Meg Arroll, specialist health behaviour change psychologist at 10 Harley Street and author of The Shrinkology Solution (Quadrille)
“Regardless of whether workers download an app or attend real-world meditation classes, it’s clear that they need support in dealing with stress in the workplace. Workplace stress is an important contributor to issues ranging from health to productivity to employee turnover. Organisations that figure out how to reduce or, better yet, prevent debilitating stress benefit themselves and their employees in significant ways.” Dr Lori Stetz, Senior Medical Director, Aetna International
“Organisations that conduct stress audits will be able to uncover what the triggers of stress are. It’s important to collect and analyse the data in ways you can do something about. Often, anecdotal but anonymised feedback in one-to-one stress-audit conversations provides the most insight so organisations can take appropriate action. And often it’s the culmination of small triggers around one’s core role that cause disproportionate stress that these conversations can reveal, such as travel to and from work, environment, working hours and flexibility. And the great thing is, that these are things that may well be in an employer’s control and can potentially be addressed.” Simon Miller, Senior Director, Customer Proposition, Aetna International
·         Even if today’s employees aren’t feeling stressed out on a regular basis, nearly all respondents (87%) worried that stress could affect their ability to work in the future.
·         By failing to tackle stress at work, employers leave themselves vulnerable. 66% of the employees stated that they would not join an employer who did not have a clear policy of dealing with workplace stress.
·         89% said that good workplace provision for dealing with stress and other mental health issues would increase their commitment to their employer and make them stay with the firm for longer.
·         67% of workers stated that they would not join a business that did not have clear policy on supporting those with mental health conditions such as anxiety and depression.
Management styles and their impact on workplace stress
When we asked employers and HR Directors about their greatest challenges to workplace well-being, their answers were revealing.
·         According to HR Directors across the globe, leaders with an aggressive management style are the biggest cause of an unhealthy working environment.
·         While this problem was acknowledged across all four of the markets we surveyed, the problem was greatest in the UK, where 42% of HR Directors stated that aggressive managers are the greatest cause of an unhealthy working environment.
Leaders need help, support and training in recognising and combatting the signs of stress – not only in the staff they manage, but also in themselves. When managers micromanage, show disrespect, are rude or uncivil, or  — even worse — bully and harass their staff, corporate spend on wellness initiatives could be substituted for recruitment costs due to high attrition.
“If leaders are invested in health, it trickles down and filters through the organisation. Aggressive managers don’t have the skills or ability to manage. They are stressed, have performance anxiety themselves or are under pressure to hit targets and they pass that stress on to their teams. So, providing support specifically tailored to managers will help prevent this vicious cycle of stress.” Ker Tyler, Managing Director, Fit for Leadership
For expat workers, a clash of workplace cultures, personalities and language issues can sometimes be responsible for breakdown of communication. Management styles may vary from country to country, as well as between individuals. Employees who have moved abroad for work may need extra support to help them assimilate into their new workplace. Some workplace cultures are known for more formal and distant management styles. This is not the same as workplace bullying, which must be dealt with swiftly and nipped in the bud. 
Expat stress
The expatriate community is particularly vulnerable to stress in the workplace. Combine work expectations, culture clashes, communication issues and isolation from friends and family, and it’s no surprise that expats can experience very high levels of stress. This can all be compounded by the emotional disruption that results from relocation.

The best organisations acknowledge their corporate responsibility to help their workforce cope with stress. For the best results, wellness programmes should include ways for their employees to get and stay physically healthy, manage their stress levels as well as help with financial, social and emotional health. These are essential to improve well-being and morale, and foster productivity and loyalty to their employer.
“If companies want to remain competitive in the war for talent, they need to address mental health as a priority in their wellness programmes.
“Mental health is one of the greatest business challenges of our time. However, helping people manage their well-being proactively is one of the greatest opportunities we have. It’s imperative that leaders get fully behind the mental health and well-being agenda, show vulnerability and compassion, and create cultures that allow people to thrive in the workplace.
“While the statistics from this survey highlight worrying gaps, there is still cause for optimism. In recent years, we’re seeing stigma broken down, people feeling more able to disclose the mental health challenges they are facing, more open cultures and better support in the workplace.” Rob Stephenson, Founder, Inside Out and mental health influencer
We spoke to several Aetna International experts about employee health inertia, tackling stress triggers in the workplace and the importance of adopting a holistic approach to health.  
Q 6.1. What can employers do to help support and motivate employees towards making informed decisions about their mental and physical health and wellness?
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Finding 7: Having local insight is a must for talent loyalty and company culture
Obesity and lifestyle-related diseases (also known as non-communicable diseases or NCDs) such as heart disease, strokes, metabolic syndrome and type 2 diabetes were once a well-known problem in the West, but relatively uncommon in the Middle East and Asia. The prevalence of obesity among people in the Gulf region is rising due to changes in food consumption, socio-economic and demographic factors, physical activity and urbanisation. As a result, diabetes is now widespread in the Middle East. Within the region, the UAE has one of the largest populations with type 2 diabetes, with 17% of people affected. Most of the adult population in the UAE is made up of expats, and a recent large-scale study of the expat community has revealed that more than four out of 10 UAE adults are overweight, and three out of 10 are obese. One of the resulting problems for individuals and society is that these diseases are impacting people in the prime of their lives when they should be at the height of their productivity, investing in their careers, families and economic stability.
Expat stress
Tackling lifestyle and making behavioural changes to prevent and manage NCDs requires commitment from governments, businesses and individuals, all of whom need to work together to pass legislation, and to monitor and make the commitment to promoting healthier lifestyle choices. In some countries, governments have passed legislation enabling health care providers and health benefits partners to monitor and analyse data and to take both preventative and remedial action against the growth of lifestyle-related health conditions.
Focus on the UAE and Singapore
Private medical insurance is mandatory in the UAE and is governed by the government and health authority of each emirate. Although not mandated in Singapore, private medical insurance is considered essential as access to public health care only extends to citizens and permanent residents. We would expect to see corporations in countries such as the UAE and Singapore back the government and do all they can to tackle this health crisis, yet our research reveals an even greater mismatch between expectation and reality in this region. It is therefore even more important to choose a global health and wellness benefits provider with local expertise — an extensive network and regional specialists — something that Aetna International prides itself on.
·         Workers in the UAE rate access to ongoing programmes to support wellness as the poorest globally, with only 20% ranking them as good.
·         However, 76% of HR Directors in the UAE rate access to wellness programmes as good, the highest number internationally.
·         Our survey also found that workers in Singapore were just as concerned as those in the UAE about lifestyle-related conditions:
·         Employees in Singapore and the UAE are more concerned than those in the UK and the US that lifestyle diseases will affect their ability to work in the future.
·         In Singapore, employees were most likely to feel that flexible working hours would benefit their health.
·         More than 40% of workers in the UAE and Singapore said that more awareness from the government about the importance of health check-ups would make them more likely to go to the doctor — compared to less than 3% in the UK and US.
In 2017, the UAE’s Ministry of Health and Prevention (MOHAP) launched e etmenan, a smart app that allows users to assess their health and individual risks of lifestyle-related diseases by filling in an electronic questionnaire. Developments like these are a step in the right direction, yet clearly more needs to be done.
“Some societies are collectivist while others are individualistic, and it is beneficial for health campaigns to have an awareness of the social, psychological and structural differences within societies. In the UK and the US, the message might be ‘make health changes for the good of yourself and your family’. In the UAE and Singapore, it might be ‘make health changes for the good of your society’.” Dr Meg Arroll, specialist health behaviour change psychologist at 10 Harley Street and author of The Shrinkology Solution (Quadrille)
We asked several Aetna International experts about the importance of understanding local culture, regulations and health care landscapes when building health and wellness benefits programs for workforces.
Q 7.1. Why is it important for employers to consider the local culture as well as the regulatory landscape when it comes to designing health and wellness programs?
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Q 7.2. How can connected care, big data, technology and mindset help put people on the path to better health?
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Q 7.3. How does Aetna International help employers cater to workforces around the world?
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Conclusion: Helping companies tackle workplace polarisation
The insights revealed in this survey suggest that companies will see a return on their wellness investments if they ensure healthy habits are embedded within that organisation’s culture and supported by leadership. It is only in this way that employers can future-proof their organisations, ensuring they continue to attract and retain talent, foster loyalty and productivity, build a culture of mutual respect and, ultimately, thrive.
1.   How employers can meet the health and wellness needs of employees 
Analyse the needs of workforces through tailored, confidential means to make the right choice for that population. Whether an organisation offers a comprehensive, holistic wellness programme or something smaller, it must:
·         be positioned as an employee benefit.
·         be designed to help people on their own terms.
·         enable individuals to choose from a menu to personalise the experience.
2.   How to tackle mental health stigma and make provision for emotional well-being and mental wellness
Raising awareness through communication and encouraging openness and acceptance can help overcome mental health stigma in the workplace. Provision should include:
·         confidential employee support services such as:
·         mindfulness-based stress reduction services.
·         one-on-one counselling either virtually or in person.
·         training managers in mental health first aid.
·         addressing the root causes of stress in the workplace, such as aggressive management styles, through training.
3.   Design health and wellness benefits packages to help employers contain health-related costs
Exploit the experience of benefits providers with a history of local and international experience to help benchmark risk profiles. Use them to find a range of options to address the key cost drivers and meet employee expectations as well as local market and cross-border regulations.
4.   Workplace policies need attention to keep pace with talent expectations
Employers need to build tailored health and wellness benefits programmes while addressing workplace policies to create a corporate culture that addresses the holistic needs of its talent pool. Employers need to show commitment to communication and social activities that foster an open, supportive, accepting culture. Companies need to build a culture that empowers individuals to seek help and take time when needed to help prevent long-term/chronic illness.
5.   Breaking the stress-poor sleep cycle
Companies need to support healthy sleep. They need to tackle the root causes of stress in the workplace, as well as making provision for services that can help people address non-work-related stressors — for —example, economic and financial stresses. This needs to be delivered as part of a menu of options that are confidential, i.e.: not tied to the workplace, to remove the feeling of it being ‘the company checking up on you’. One way to do this is by positioning the service as a ‘life’ assistance programme.
6.   Address both the root cause and the symptoms of stress
Organisations need to be conscious of the stress triggers in the workplace, for example: aggressive management styles, an ‘always-on’ culture, employees moving internationally and coping with a change in culture and workplace expectations. Leaders and managers need help, support and training in recognising and combatting the signs of stress — not only in the staff they manage, but also in themselves. For the best results, wellness programmes should include ways for their employees to get and stay physically healthy, manage their stress levels as well as help with financial, social and emotional health.
7.   Seek out expert advice on understanding geographical challenges and solutions
Understanding the influences of local culture, corporate culture, local health care regulations and compliance requirements, local talent expectations will all help employers build appropriate health and wellness programmes and workplace policies.
With support from a world-class health and wellness benefits provider that understands the challenges facing business leaders today, organisations can see their workforces thrive — happy, healthy staff that have the care and guidance they need, when they need it. And, as a result, they will see key performance indicators like productivity and employee retention increase, further reinforcing the investment in medical insurance provision.
And finally, our experts sum up Aetna International’s mission to meeting people where they are, and to help put them on the path to better health.
Q8. What does Aetna International do to help employers tailor health and wellness packages to suit the needs of their workforces? And what does the company offer its own employees in terms of support?
Transcript
“Employers may tend to view health and wellness benefits through a duty of care or an obligatory lens, whereas employees will have culturally influenced expectations. Whether an organisation offers a comprehensive, holistic wellness programme or something much more limited in scope, it’s critical that it is viewed as an employee benefit designed to help people on their own terms, not a self-serving employer initiative.”

Simon Miller, Senior Director, Customer Proposition, Aetna International
Appendix
Acknowledgements
Thank you to the following contributors:
·         Dr Lori Stetz, Senior Medical Director, Aetna International
·         Dr Mitesh Patel, Medical Director, Aetna International
·         Simon Miller, Senior Director, Customer Proposition, Aetna International
·         Ker Tyler, Managing Director, Fit for Leadership
·         Dr Meg Arroll, specialist health behaviour change psychologist at 10 Harley Street and author of The Shrinkology Solution (Quadrille)
·         Rob Stephenson, Founder, Inside Out and mental health influencer
·         Cate Darroue, Senior Director, Product & Marketing, EMEA, Aetna International
·         Damian Lenihan, Executive Director, Distribution, UK, Aetna International
·         Dr Anushka Patchava, Global Proposition & Strategy Lead, vHealth, Aetna International
Future-proof your organisation for 2020 and beyond
Leading companies — large and small — recognise that their future growth and success depend on their people. A culture of well-being is the foundation for a flourishing, high performing workforce and is now a key differentiator in the market.
The insights in this report provide an invaluable opportunity for organisations to keep pace with evolving value-based employee and investor expectations, market forces and technologies around the world.
At Aetna International, we believe in the power of partnerships and putting people on the path to better health. Our consultants and experts are here to help you build healthy, happy, productive workforces. Ultimately, when your workforce thrives, your business thrives.
For more information on the data sets and experience that inform our insights, visit us or contact us. Whether you’re an employer, health care broker or intermediary, we’re here to help.
Additional sources:

https://www.aetnainternational.com/en/about-us/explore/future-health/tackling-polarised-perceptions-in-corporate-health-and-wellness.html?_lrsc=6c95e71a-e341-4447-bf79-b40a6f141b8d&cid=soc-linkedin-elevate

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