Is fat the past tense of fit? WorkHealth assessment

Several years ago the board of  WorkSafe Victoria decided to fund a $A600 million health assessment program for workers from the workers’ compensation fund. The WorkHealth program has not been without its critics but WorkSafe announced this week that 1 in 4 Victorian workers have participated in the WorkHealth program.  Given this significance I undertook a work health assessment at the Safety In Action trade show.

The WorkHealth stand at the trade show had no waiting so I signed up for an assessment. The form asked basic questions about age, health, family illnesses, amount of exercise, alcohol consumption, smoking and dietary intake. I wrote that I was a fat, fifty, sedentary, moderate drinker who does not eat enough fruit.

A second form asked whether I would object to being contacted by A WorkHealth representative for a post-assessment follow-up.  No objection as I would be interested in hearing what they ask and what they advise.

I was shown into a white curtained booth.  The walls were a stark white which surprised me as doctor’s surgeries usually include medical advisory posters and I would have thought that WorkSafe would have placed its latest poster series.  However this may have been a conscious decision and not an oversight as the nurse advised me to relax when having my blood pressure taken.  It was hard enough to get to “that relaxing place”, (the nurse suggested an island but I was thinking that my bed was cheaper) and perhaps a poster of an injured worker would compound the difficulty.

Recently there have been grumblings in some sectors of the safety community that much is being made of the results of the WorkHealth program even though the health assessments do not follow standard medical procedures. To gain an accurate medical diagnosis most blood tests are taken after a period of fasting.  This is not the case with WorkHealth and I could easily have undertaken this test after climbing several sets of stairs and consuming lunch.  I asked the nurse about this and she stressed that the WorkHealth assessment is not a medical diagnosis but an identification of risk markers that may indicate the need for further assessment with a general practitioner.

The nurse drew blood from a finger prick, an experience I had not had since secondary school.  No litmus paper here.  She was able to draw an impressively thin vial of blood from the pin prick and insert it in a small beeping “blood reader” (clearly I didn’t ask for technical details as I was there because I was a fat man having his health assessed).

I was taken through my health results which were written up in a very colourful booklet containing lots of big pictures of fruit and tiny pictures of full beer glasses. The summary of my assessment is below

  • double the intake of fruit and vegetables.
  • do not increase my alcohol consumption
  • increase my exercise to 30 minutes each day
  • high risk body shape
  • (only just) high blood pressure
  • low Cardiovascular Disease Risk Score
  • an “at risk” level of total cholesterol but an almost normal HDL cholesterol
  • normal random glucose levels but a high risk of diabetes

In summary, I am not high risk, at the moment, but should increase my fitness and seek further advice from my doctor.  This may be the recommendation for everyone who participates in a WorkHealth assessment as it is very generic even though it is sound.

Men have much less understanding of their body than women have of theirs.  I do not know what a calorie or a kilojoule is although I think too many is a bad thing. I was told that I have a waist measurement that places me with a high risk body shape.  The measurement was in centimetres but I don’t measured my waist that way.  I asked the nurse to translate the measurement into trouser size as I know what size pants I wear.  Her not knowing was the only indication in the whole assessment that the way men think about their own health needs more consideration in the WorkHealth program.  If men are ignorant about their own health, and perhaps personally uninterested, the health risks need to be simply communicated.

It may sound brutal to some but I think men would respond to advice such as

“You’re getting older, you’re fat, your diet is crap, your fitness is non-existent and if you keep drinking and smoking, you’ll be lucky to enjoy any retirement or see any grandkids”.

or, from an employer,

“You are so unfit that you can’t perform your job effectively.  Fix your health or there may not be a job for you here”.

It is not appropriate for health advisers to use such terms but a family doctor may get away with this type of advice.  WorkHealth has extended their program to include WorkHealth coaching to encourage workers to act on the recommendations of the health assessment.  The contact may be by phone, email or fact-to-face.

The WorkHealth program seems like a sensible way of improving the general health of workers but the data claims still need to be considered with great caution.  Proof that the WorkHealth program has directly improved the health and longevity of Victorian workers is unlikely to ever be available.  What WorkHealth can claim is that it has increased the health awareness of 25% of Victoria’s workforce.  It may also be able to claim that it has increased health-related doctors visits by Victorian workers.  These achievements, substantial in their own way, should be enough for WorkHealth.

Kevin Jones

Categories alcohol, campaign, evidence, government, hazards, health, OHS, risk, safety, wellness, WorkSafeTags , , , ,

6 thoughts on “Is fat the past tense of fit? WorkHealth assessment”

  1. I hear what you’re saying about the langauge used to communicate the health issues and I think your example for blokes is spot on.
    From a personal perspective – Like Kevin I’m fat, in my 50s, sedentary, and don’t eat enough fruit. I’m not even a moderate drinker – maybe 1 a week. But I am on blood pressure medication (as was my father and is my mother – genetics?) and they’ve been keeping my blood pressure in the ‘safe’ range for over 5 years now.
    I also think there has been so much information provided from so many directions for so long about healthy living that we are overwhelmed by knowing what we NEED to do. And a ‘new’ message focussing on ‘work health’ just adds to the overload.
    But knowing ‘what’ and ‘wanting to’ are 2 different things. My own condition is: I know what I NEED to do to get healthy, but I’m just not motivated to do it.
    I’ve known a fair few men (and women) who got motivated after an adverse health condition reared it’s ugly head threatening their lives.
    I even recently experienced some chronic pain in one foot and am now using orthotics in my shoes – My Dr told me I NEED to lose some weight and he put me in touch with a dietician, who recognised I KNEW all the right things to do – but even that experience didn’t motivate any effort to change.
    My job is relatively sedentary so my physical fitness rarely affects my capacity to do my job. But my job, as a WHS&IM Advisor, is demanding on an intellectual and interpersonal level – consuming significant mental and emotional energy each day and leaving me mentally drained and incapable of ‘driving’ myself to expend physical energy in an attempt to improve my fitness.
    And my spouse, though in a different job, has similar work related factors, and so we have ‘got fat and unhealthy’ together over the past 20 or so years (we weren’t always this way).
    So what am I trying to say?
    Just as the language of Risk Management can become a barrier to recognising ‘hardship’ at work (see ‘Just Workplace Hardship’ elsewhere on this blog site) I think we need to find a way to MOTIVATE one another to achieving fitness rather than just cramming our heads with the LANGUAGE of healthy living.

  2. Bula Kevin, Iam from The Fiji Islands and your points raised on Work Health assessments should be taken seriously because it seems that there is a lot to be learnt if the procedures are mainly focused on issuing a pretty faced result rather than the critical issues of Health and safety

    Sailasa FNU

  3. Hello Kevin ,another statistic that could be of interest if you can get hold of it is ,how many adults are fit enough to work at 55 then 60 to often workplace injuries ,lifestyle choices ,take a toll on adults being able to work till retirement , we might be able to work 30-40 years in one career but another you would struggle for twenty years ,
    There is an easy temptation for employees to discriminate against older employees for younger fitter employees when the consequence of accidents and recovery times are statistically more favourable,
    they can then claim against ageism discrimination by reverting to their duty of care

  4. Hi Kevin
    Had a near identical experience. Trouble with diabetes score is that yu need a score of 11 or less to have low risk. Being my age gave me 8 points, plus another 3 for being a male = 11. And as I take medication that was another 4 = 15. Nothing there seems to indicate high diabetes risk.

  5. Interesting quantity, that $A600 million. That’s pretty close to the government’s rip-off from the funds that ensure that WorkSafe has no unfunded liabilities.

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