What is a chronic condition?
Arthritis? Multiple sclerosis? Diseases that limit people’s lives and linger with them endlessly. Diseases that can be both visible and invisible, constant and episodic, crippling and costly.
For governments, employers, insurers and Canadian families, the question also stands as a barrier to helping people receive better treatment and increased support, to enjoying more productive lives and having the freedom to live more fully.
Recently, the Public Policy Forum, backed by a handful of health charities and major employers, took a comprehensive look at the issue of chronic conditions – how we can do more to reduce their incidence and, just as importantly, make improved accommodations for those living under this burden. The result is captured in the report ‘Condition Chronic: How Focusing on Workplace Wellness Helps Us All
’, offering an integrated analysis of the challenges and an integrated, broadly informed set of recommendations for action.
The statistics are arresting: Half of Canadians over the age of 20 live with a chronic disease. In fact, 15% of us live with two such diseases or more. Measured in terms of lost economic productivity the impact is enormous. The annual cost has been estimated by Sun Life Financial to be around $122 billion – or the equivalent of 6% of GDP. Measured in terms of quality of life, the cost is even greater: Parents unable to pick up and hold their children, people unable to keep their jobs and enjoy the dignity of work. Lives lived less actively.
Creating workplaces that promote wellness and help those with chronic conditions remain active is therefore both the decent and the economically prudent thing to do. Many governments, employers and health charities have been taking helpful and well-intended actions. The challenge however, is significant and requires a more comprehensive and integrated response.
For example, not all chronic diseases are obvious or uniformly debilitating. Some, such as arthritis, can often be invisible to employers and colleagues. Others might manifest to differing extremes depending upon the individual, complicating the application of universal approaches and policies. Medical coverage can be difficult to obtain. Workplace accommodations are often inconsistent. Understanding and awareness remains a huge challenge. To confront these many problems, it is apparent that the private, public and third-party sectors will have to combine and coordinate efforts.
The Public Policy Forum has identified at least five key areas for action:
- Defining Disabilities Accurately – to unlock appropriate policy responses we need more nuanced definitions of disability that reflect the full complexity of chronic conditions in contemporary Canada. BC, for example, has adopted two definitions: Persons With Multiple Barriers (PPMB) and Persons With Disabilities (PWD). This sophistication permits more tailored policies and closes gaps that emerge from more restrictive terms.
- Flexible Work Programs – workplace benefits and supports need to adapt more fully to the reality of chronic conditions, providing not just standardized policies that fit traditional notions of disability but that respond to episodic and irregular conditions.
- Base Legislative Approaches on Best Practices – innovative approaches are being pioneered in a variety of jurisdictions. For example, Germany requires employers to have disability management plans in place and New Brunswick is overhauling its disability supports through the Employment Action Plan For Persons With a Disability. Cataloguing and adapting such innovative approaches should be undertaken widely.
- A National Strategy For Employers – governments should work with insurers, employers, workers, health-policy experts and others to implement a national strategy that would facilitate the adoption of best practices. Such an approach should include a set of measurable indicators that can be used to objectively guide efficacy and implementation as well as a mechanism to share innovations.
- Surveillance Data – to boost evidence-based decision-making and guide future policy decisions, it is vital to collect and analyze data on those living with chronic conditions. Building a rich reservoir of such information will be the foundation of future actions.
Ultimately, genuine success in addressing the epidemic challenge of chronic disease in the workplace must begin with a recognition of the problem itself. For decades, people have struggled to have all but the most overt conditions acknowledged and supported. That attitude is changing. It must change still further.