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Standing at Your Desk – A Healthy ‘Fad’?

Since mid-October, I have been experiencing a pinched nerve in my lower back. Anyone who has experienced this type of condition knows the pain can be excruciating, as my symptoms also include numbness or weakness of my lower back and left leg. Lumbar radiculopathy is typically caused by a compressed spinal nerve root, which results with pain in the leg rather than in the lumbar spine. Why this happened to me is unknown, but I would speculate it gradually developed from daily running when not biking. Having ‘additional’ birthdays may also be another reason!

With the help of a physical therapist, I perform various daily exercises at home (or in the office). Despite PT, however, the searing pain persisted enough to have an MRI performed, confirming the Lumbar 4 location. As I wait for the next elevated level of care – most likely an epidural steroid injection – I judiciously use Tramadol, a synthetic analgesic opioid medication that is used to treat moderate to moderately-severe pain. For me, the best relief is to simply sit down, which allows me to forgo Tramadol. Accordingly, I spend more time sitting at my desk working on projects that don’t require traveling to outside meetings. Needless to say, having these physical limitations are wreaking havoc on my daily activities…and exercise routine.

I share this ‘protected health information’ because I am intrigued by the latest craze – the stand-up desk – a desk that allows you to stand up while working at the computer. You will find ads in newspapers, magazines and the internet about these desks, often touting why it is so much healthier to be working on your feet rather than, well, your bottom.  The purported health benefits of these desks are both broad and deep. One website listed at least seven potential health benefits when using such desks:

  1. Standing Lowers Your Risk of Weight Gain and Obesity
  2. Lowers Blood Sugar Levels
  3. Lowers Risk of Heart Disease
  4. Appears to REDUCE BACK PAIN!!!
  5. Helps Improve Mood and Energy Levels
  6. May Boost Productivity
  7. May Help You Live Longer

Fantastic! I want…no…I NEED to have a stand-up desk!

Due to our sedentary office jobs and daily living habits, American workers burn around 140 fewer calories per day compared to 59 years ago (1960). In July 2016, The Lancet issued study results that indicated 60 minutes of daily physical activity (e.g. brisk walking, pleasure biking, etc.) may help offset health risks of having to sit eight hours a day at the office. This November, The Department of Health and Human Services (HHS) issued updated activity guidelines for Americans to help combat the fact that nearly 80 percent of U.S. adults and adolescents are insufficiently active. The health benefits of exercise are clearly not fake news, as there is too much scientific research to refute the naysayers.

Cautionary Note

Before buying into the aforementioned stand-up desk ‘craze,’ one might want to consider some research that at least tempers its glowing accolades.  Aaron Carroll, professor of pediatrics at Indiana University School of Medicine, writes well-researched blogs about healthcare and policy. Recently in the New York Times, Carroll wrote a compelling piece about why standing-desks are ‘overrated,’ winnowing fact from fiction.

I will not take up my sitting time by regurgitating Carroll’s article, but I would like to summarize his ‘finding’ with the following: Exercise is important for our health, but merely standing is NOT considered to be ‘exercise.’ Sitting may not be the problem on why we are unhealthy, but rather, it may be a “marker for other risk factors that would be associated with higher mortality.”

Personally, I’m intrigued about standing while working at my computer. But first, my lower back must heal before I can stand for any period of time. For now, my lofty expectations about using a stand-up desk have been adjusted at a more reasonable (and comfortable) level…that of my office chair!

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Fast Food – Our Habit of Convenience

Habits we acquire happen over a period of time. They typically begin with a cue and a perceived positive reinforcement of a reward.

Maybe we bypass going to the fitness center or take a bike ride because it is more pleasant to sit on the couch and watch Netflix. It’s just too convenient to press the TV remote (cue) and then become engrossed in countless shows that are entertaining, educational – or both (reward). Doing this too often may develop into a new habit that could detract from a previous habit (e.g. gym or bike). We exchange one habit (exercising) for another, less-healthy habit (TV binge-watching).

According to a recent Centers for Disease Control and Prevention report, 36.6 percent of Americans eat some kind of fast food* each day, with men being a bit less discerning about what they eat (37.9 percent) than women (35.4 percent). When you think about it, fast food is always accessible throughout the day, making it just too convenient for many of us to pass up.

On a typical day, almost 23 percent of Americans will eat breakfast from a fast-food outlet, while about 44 percent of us will pick up a ‘quick’ meal during lunch. Not to be left out, fast-food dinners draw another 42 percent of Americans.

Ethnic group and age also provide differences when it comes to the daily consumption of fast food.

Ethnic Groups:

  • Black Americans – 42.4 percent
  • Whites – 37.8 percent
  • Latinos – 36.5 percent
  • Asian-Americans – 30.6 percent

Age Categories:

  • 20–39 years-old – 45 percent
  • 40-59 years-old – 38 percent
  • 60+ – 24 percent

Take-A-Way from This Report?

The conventional wisdom about fast food is that people eat it when they can’t afford something better (and healthier). However, this report suggests this wisdom is not necessarily true. For example:

  • Higher income equates to more fast food: The more money we have or make, the more likely we are to eat fast food on any given day. For example, about 32 percent of people who earn less than 130 percent of the federal poverty level eat fast food daily. However, over 36 percent of middle-income families (earn between 130 – 350 percent) purchase fast food daily, while 42 percent of people with incomes above 350 percent consume fast food daily.

This finding is interesting because healthier food can cost a bit more than fast food, and yet, regardless of having the ability to pay for more expensive, healthier food, we often elect the more convenient food that is available at our finger tips (often using the drive through). Additionally, with our younger population consuming more fast food compared to older generations, younger families (and their children) will be more likely to establish unhealthy eating habits – creating health issues later in life (obesity, heart disease, dementia, etc.). The intake of calories, fat, and sodium eventually adversely affects our health in many different ways.

Iowa Youth Obesity Rate is High

Another report recently released by The National Survey of Children’s Health compares the obesity rates of children (ages 10 to 17) for all 50 states. Almost 18 percent of our youth in Iowa are obese, ranking our state as the 10th highest state for youth obesity. Iowa’s white (non-Hispanic) youth are significantly higher than the national rate.

The implications of having overweight and/or obese youth present future challenges to our state. For one, employers desire to have healthy and productive employees in their workplaces, and having unhealthy employees will continue to leverage up their health insurance costs due to higher healthcare usage. No one wants a poor quality of life, but often this is a result of the choices and habits that have been established much earlier in our lives.

Per a recent Harvard T.H. Chan School of Public Health report, we are still trying to come to terms with the dietary fat we consume – fat that is good and fat that is bad.

This much we know. Establishing a habit based on mere convenience may not be the smart choice we should make for ourselves, individually – or as a society.

Now, where did I put my channel changer…

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*NOTE: For this survey, fast food was broadly defined as any item obtained from a “fast food/pizza” establishment. It is possible that some people may interpret fast food differently from one another – e.g. takeout sushi, etc.

By 2028, Iowa Employer Health Insurance Family Premiums Could Be…

As we enter the holiday season, I’m somewhat hesitant to share something that could spoil the holiday spirit – our projected health insurance premium 10 years from now. But to put a positive spin on this, especially as we prepare for Thanksgiving day, it is safe to assume the health insurance premiums that we are currently paying will be a ‘bargain’ compared to what we may be paying in 2028.

From our latest 2018 Iowa Employer Benefits Study©, we learned the average annual Iowa family health insurance premium is $17,448. Yes, this is a very inflated amount, especially when we compare it to 10 years earlier in 2008 ($11,520). Yet, this Iowa average is actually a bargain compared to the 2018 Kaiser Family Foundation national average of $19,616! Another positive spin for you!

The five-year average (2014 – 2018) increase for Iowa employer health insurance premiums is 7.7 percent. This figure represents all survey respondents, regardless of employee size and industry. It is important to acknowledge that this number represents the average increase BEFORE employers made adjustments to their health plans to keep the rate increase more manageable. Such adjustments typically include increasing deductibles, copayments and other plan features that require employees (and their dependents) to assume more of the medical costs when seeking healthcare through providers. Either way, the rate increases adversely affect employees’ the take-home pay.

The graph below calculates the average Iowa family premium rate trending forward for the next 10 years (compounded annually at 7.7%) and showing the annual employer and employee contributions (based on the Iowa employer contributing 68 percent of the total cost – another five-year average). One squeamish by-product of inflated health rates not shown on this graph are the plan design alterations that will surely be made by employers to shift costs to employees in order to keep the rates ‘manageable.’ One primary example of this cost-shifting is the family deductible, which was $1,963 in 2008 and is now at $3,900 in 2018 (99 percent increase over 10 years).

The family premium in 2028 could become $36,636! This amount is 110 percent more than today’s average family premium in Iowa.

Also worth noting, the trend line above the premium represents the estimated annual household income (HHI) in Iowa, compounded annually by 1.5% to 2028. The bubble above the $57,947 HHI for 2018 represents the percentage of family premium to HHI. This percentage is projected to almost double by 2028 if we cannot control healthcare costs. In short, over half of our household income (54 percent) could evaporate due to healthcare costs.

As we cast 10 years into the future, it is safe to give ‘thanks’ for what we are paying today in health insurance premiums. This is my best attempt to find some good in something that clearly is not.

Sorry to share this information.  Now, it’s time for the other turkey…

Have a wonderful Thanksgiving!

*DISCLAIMER:
I am NOT predicting that family premiums in Iowa will be $36k by 2028. Rather, based on past behaviors, employers will continue to find ways to alter their plan designs to keep their premiums lower than the initial increases they experience. Because of this, health plans will look considerably different in 10 years than they do today.

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