A presentation I gave to the British Dietetics Association Annual Conference on Health, Wealth and Productivity in 2017

1. Health, Wealth and Productivity:
a key public health opportunity
DrJustinVarney
NationalLeadforAdultHealthandWellbeing
Justin.varney@phe.gov.uk

2. Health, wealth and productivity
Health, wealth and productivity are inextricably linked for
individuals, communities, populations and nations.
At an individual and family level being able to remain in
active employment provides an income that enables
choices and autonomy as well as potentially significant
benefits to mental and physical health.
At a community level businesses provide infrastructure and
investment that underpins vibrant and engaging public
spaces like high streets.
At a national and population level the level of economic
productivity links directly to tax based income for the
welfare state and public expenditure.
2 Health, Work and Productivity

3. The costs of ill health
3 Health, Work and Productivity

4. 4

5. Link between health and sickness absence
Employee productivity can be difficult to
measure without relying on self-reported data.
But a number of studies have looked at the
impact of health and wellbeing on
productivity:
• An Australian study has suggested that
employees who are healthy can be nearly
three times more productive than
employees in poor health.
• A Canadian study examining the link
between an employee’s emotional
wellbeing and their work productivity found
that a 20 percent drop in an employee’s
level of wellbeing leads to a 10 percent
drop in their performance.
5 Health, Work and Productivity

6. Context of unemployment in England
Unemployment measures people without a job who
have been actively seeking work within the last 4
weeks and are available to start work within the
next 2 weeks.
The unemployment rate is the proportion of the
economically active population (those in work plus
those seeking and available to work) who are
unemployed.
The unemployment rate for people for the latest
time period, July to September 2016, was 4.8%, the
lowest since July to September 2005.
The proportion of people, aged from 16 to 64, not in
work and neither seeking nor available to work is
known as the economic inactivity rate. Four main
causes for economic inactivity are:
•Studying (2.32m)
•Caring for family member (2.23m)
•Ill health (2.01m)
•Early retirement (1.15m)
6 ONS (2016) UK labour market: Nov 2016
Unemployment rate (16-16yrs) trend 2011-2016
Economic inactivity rate (16-16yrs) trend 2011-2016

7. Focusing on closing the disability employment gap
Economic inactivity due to ill health is significant individual, social and economic burden that is potentially
preventable.
We are taking a social model of disability, i.e. the lack of appropriate supported work disables the person
with the impairment from finding sustainable employment. This requires action by employers as well as
through health and social care services to change the social context and aspiration of people living with
health conditions.

8. Health-related welfare in England
8 Health, Work and Productivity

9. Green Paper on Health and Work:
Improving Lives
• Joint green paper between DWP &
DH
• Consultation closed 17 Feb 2017
• Outlines the Government’s vision
on the potential and commitment to
workplace health
9 Health, Work and Productivity

10. 10 Presentation title - edit in Header and Footer

11. Building Our Industrial Strategy
Investing in
science, research
& innovation
Developing skills
Upgrading
infrastructure
Supporting
businesses to
start & grow
Improving
procurement
Encouraging
trade & inward
investment
Delivering
affordable energy
& clean growth
Cultivating world-
leading sectors
Driving growth
across the whole
country
Creating the right
institutions to
bring together
sectors & places
11 Health, Work and Productivity
Consultation closes on 17th April
2017
Aim is to improve living standards and
economic growth by increasing
productivity and driving growth across
the whole country.
Ten core thematic strands.
Opportunity to develop a clear
narrative between health, wealth and
productivity

12. Tools and Resources to support action
on work and health
12

13. Evidence-based workplace accreditation
Provide an employer roadmap for
implementation of evidence-based
guidance (e.g. NICE guidance)
Opportunity to link employers with
local public health offer and reduce
replication of services
60% local authorities have a scheme
in place, with some emerging sector-
specific schemes
13 Health, Work and Productivity

14. PHE’s support for all local evidence-based
workplace accreditation
• Support and encourage all local evidence-based workplace health
and wellbeing schemes which adhere to the National Standards.
• Develop business to business tools for employers who do not want
to commit to a holistic accreditation e.g. Mental Health Toolkit for
Employers
• Support sectoral approaches e.g. Blue Light Framework. To be
published in March 2017.
• Guidance for local authorities on commissioning local workplace
health and wellbeing accreditation schemes for publication before
Summer 2017
• Developing a workplace health page on gov.uk
14 Health, Work and Productivity

15. National standards: Healthy Eating
Commitment
7.1 A healthy eating statement is in place and employees are aware of it.
7.2 Appropriate, acceptable and accessible information on healthy eating is provided.
7.3 Any kitchen facilities or beverage areas are in good condition and conform to the highest possible
standards and requirements of food hygiene.
7.4 Wherever possible, eating facilities that are clean and user friendly are provided away from work
areas. Use of these facilities is promoted to enable regular breaks away from the work area.
7.5 All workplaces have access to fresh drinking water.
Achievement
7.6 Any on-site catering facilities provide healthier options that are actively promoted.
Excellence
7.7 A corporate healthy eating food plan, guidelines or similar has been produced in consultation with
staff that covers:
• Corporate hospitality
• Catering provision
• Local sourcing of food using local providers
• Vending/in-house catering pricing strategy to promote healthy options
• Local healthy food availability for staff considered as part of facilities management.
7.8 Tailored programmes to improve understanding and take-up of healthier diets are offered.
7.9 Internal or external support is on offer for those who wish to lose weight.
7.10 Rolling schedule of planned events to promote the importance of healthy eating are in place.
15 Health, Work and Productivity

16. Case studies: Impact of the Workplace Wellbeing
Charter, RAND Report
16 Stefan et al. (2013) Lancet Diab Endocrinol
YMCA Cornwall
Days lost through absence went down
from 8.37 per employee in 2010/11 to 4.75
in 2012/13 (the first year of gold
accreditation)

17. Employer toolkits
Produced ‘with business for
business’ and developed with
leading experts
Enables employers to manage
key health challenges to their
staff
Aimed at SMEs but applicable
to large businesses
Mental Health Toolkit published
in May 2016
17
Just launched March 2017:
• Musculoskeletal health
• Suicide prevention
• Suicide post-vention
Health, Work and Productivity

18. One You
18
 One You is an integrated social marketing campaign to help adults to live more
healthily.
 Specific segment on diet and eating well.
 Employers can support One You in the workplace by ordering an employer toolkit,
which includes conversation starters and dispensers, posters, wall charts, guerrilla
stickers and bunting.
 The quiz can be accessed: https://www.nhs.uk/oneyou/hay
 229 employer partners supporting One You launch – including commercial, non-
commercial, national and regional organisations
 1,662,137 employees reached
 Notable employer organisations included British Airways, Jaguar Landrover, Ministry
of Defence and BT
Health, Work and Productivity

19. Work with NHS England
1. A suite of interventions across 10 NHS pilot sites,
involving:
 On-site NHS health checks
 Better access to talking therapies, physiotherapy and weight
management services
 A local physical activity offer
 Accreditation under the Workplace Wellbeing Charter
2. A new nationally-specified occupational health service for GPs
3. National action raising food standards through catering contractors
and PFI providers
4. Supporting the with the 2017/18 CQUIN
19 Health, Work and Productivity

20. Health NeedsAssessment (HNA) Tool
• Developed with SMEs in mind
• To be published in Spring 2017
• Includes example question on diet
• Designed to help employers find out
about staff health needs within their
organisation and to set a baseline of
employee health.
• Provides businesses with a short set of
survey questions to use as indicators.
• The questions aim to gather information
from employees which can also be
compared with national data so
employers know how their workplace
compares
20 Health, Work and Productivity

21. Britain's Healthiest Workplace
• 2013 Inception
• 400 companies and 100 000 employees have taken part in the study.
• Expert Advisory Board, chaired by Dame Carol Black
Benefits
• Free to take part
• Most comprehensive UK workplace wellness study
• Holistic focus on health/wellbeing
• Dual survey completed by employer/employees
• Receive an organisational health report, employee health
assessments
• Participants receive recommendations and expert consultation
• Small, Medium, Large winners recognised in several categories
www.healthiestworkplace.co.uk
21 Health, Work and Productivity

22. Call for evidence: Identifying what works for workplace
health and wellbeing interventions.
In spring 2017, PHE will be doing a doing a call for evidence (based on
Nesta standards of evidence) of interventions that support improving
health in the workplace.
Aims of the project:
• Contribute to the development of evidence based practice in workplace
health and evaluation of what works
• Support the development of methods to benchmark the state of evidence
around what works in improving health and wellbeing in the workplace
• Generate a platform of evidence to inform future initiatives and investment
in workplace health and wellbeing
• Sharing good practice in workplace health including behavioural and
organisational change and impact/outcomes
22 Health, Work and Productivity

23. Disseminating information and best practice
• Topic guides covering 9 core areas in which work place
interventions should target and guidance on how to do so
• PHE is developing an ROI tool on the cost savings for the NHS
and local government on getting an individual from
unemployment to employment
• PHE pump-primed a national academic network focused on
health and work
• National Health and Work infographics published in September
2015.
• Worked with partners to publish the following evidence reviews:
o Measuring employee productivity rapid review (2015)
o Physical environments - impact of on workplace health
(2015)
o Interventions to prevent burnout in high risk individuals stated
(2015)
o Peer support and employment (2016)
23 Health, Work and Productivity

24. Supporting action through partnership
• PHE Briefing on Local Enterprise Partnerships and health and wealth
connection
• Local fingertips data tool on wider determinants of health, including
specific datasets on employment and health indicators
• PHE Centres enabling collaborations between local partners such as
work in East of England to link Job Centre Plus and Local Authorities to
collaborate on developing work and health coach type model through
roll out of health trainer training in JCP.
24 Health, Work and Productivity

25. Future Drivers of the Health of Londoners is a
joint ADPH & PHE horizon scanning project
25
Background
Activity to
date
• Aims to generate conversation on:
1. What drivers of change can we expect to see in London?
2. How might these impact on health needs?
3. What might this mean for public health teams in the future?
Webinar contributors:
• Desktop research - published
literature, reports from similar
projects, blogs from theme
experts, etc.
• Five webinars – Providing a
platform for conversation
between experts and the public
health workforce.
• Analysis of webinars –
capturing key issues
Health, Work and Productivity

26. We identified clusters of drivers of change in London
26
Digital Big Data
Employment
People
Power
Health Trends Financial Climate
London’s
Population
Housing and
Transport
Integration of Health
and Social Care
Devolution Place Based
Policy
Health, Work and Productivity

27. Employment
What are people talking about?
 45% of the workforce is educated to a minimum of Level 4
(degree) 16
 Younger workforce compared to the national average (59%
are 39 years or younger) 16
 London has a higher employment rate than England but the
rate of unemployment in 16-24 year olds is 2.5 times higher
than those aged 25-64 years in London 13
 Worklessness in the capital has consistently fallen, but
number of temporary and involuntarily temporary contracts
has increase 25
 Businesses are concerned that the housing crisis will impact
on employment and the ability to attract a highly skilled
workforce 25,16
 ENDIES – people in employment but with no disposable
income or savings 26
Two of the top 5 concerns for businesses in London are; retaining top talent and
retaining appropriately skilled staff15
27 #FDPHwebinars Discussed in Webinar 2
 Low and middle income earners are being priced
out of London or forced to make significant
adjustments/compromises to their living
standards in order to stay in London 26
 Similar to the housing crisis there is high
demand for workspace in London and this is
needed in order to promote economic growth 20
 Polar opposites: businesses offering wage
premiums to attract talented people and high
competition for some jobs driving people to
accepting lower wages 20
 57% of businesses surveyed in London feels
that the housing crisis impacts negatively on
employment, 70% felts the increased strain on
London’s infrastructure will impact on business,
49% would like to see improvements in digital
connectivity 25
 London Living Wage/ National Living Wage to
ensure adequate standard of living places
pressures on employers

28. Looking ahead at the future of health
and work

29. Assumptions
Life expectancy continues to expand
but so does the proportion of life lived
with disease and disability.
Fertility rates remain relatively constant
and although migration patterns may
change the overall picture is of
population growth.
Significant shifts in global political and
economic landscape and local political
turmoil within individual country states
with more.
Increasing shift to city based living
aligned with mobilisation of sustainable
tech harmonised living.
29
Estimated and projected total population, UK, year
ending mid-1971 to year ending mid-2089 (ONS 2015)
Percentage change in the size of the usual resident
population in urban and rural areas 2001 to 2011 (ONS)
Health, Work and Productivity

30. Futurology is not an exact science
30 Health and work: to infinity and beyond

31. Emerging contextual shifts
Climate change and ecological
stability
Potential for instability in
water/food resources
Globalised multi-nationals working
with ‘crowd sourced’ businesses
Collective decision making
influencing policy
Potential for increasing inequalities
and social division
31 Health, Work and Productivity

32. Evolution of the business landscape
32 Health, Work and Productivity

33. If current trends run a steady path, in 2030 the UK
workforce will be multi-generational, older, and more
international, with women playing a stronger role. While
the highly skilled will push for a better work-life balance,
many others will experience increasing insecurity of
employment and income.
As businesses shrink their workforces to a minimum using
flexibly employed external service providers to cover
shortfalls, a much smaller group of employees will be able
to enjoy long-term contracts.
The future of work: jobs and skills in 2030
UK Commission for Employment and Skills
2014
33 Health and work: to infinity and beyond

34. New types of work: Ten Jobs of the Future
34
Emerging post 2025
6. Space Tour Guide
7. Personal content
creator
8. Rewilding strategist
9. Sustainable power
innovator
10.Human Body
Designer
1. Virtual Habitat
Designer
2. Ethical technology
advocate
3. Digital cultural
commentator
4. Internet of things
data creative
5. Freelance
biohacker
Health and work: to infinity and beyond

35. Jobs that didn’t exist
10yrs ago
Digital Marketing Specialist
Cloud service specialist
App Developer
Data scientist
Uber driver
Youtube content creators
Social media manager
Sustainability manager
Drone operator
35 Health, Work and Productivity

36. Looking ahead
Health, work and productivity are complex and require whole system
partnership approaches
Upstream as well as downstream solutions
Upstream integration of health and work issues into undergraduate and
postgraduate education
Integration of work as a clinical outcome into routine healthcare
professional practice
Promote sector as well as locally led approaches , nationally and
globally
Build national and international employer led narrative on workplace
health, productivity and public health
Build approaches that utilise supply chain for impact as well as direct
employee health and wellbeing
36 Health, Work and Productivity

37. 37 Public Health Futurology