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Alberto Ogata -BRAZIL
The Workplace: a Key Setting to Fight Chronic
Disease in Emerging Countries
BRAZIL WORLD
Own a cell phone 100% 77% Live in urban area 84% 51% Are between 15-‐64 years 69% 66%
Are part of labour force 54% 46%
Use the internet 43% 32%
BRAZIL A developing country
But with many challenges..
§ Education
§ Infrastructure
§ Inequalities
§ Health – double burden
Brazilian Health System ü 1988 - social right to health with universal access to healthcare and the establishment of a Unified Health System (SUS) ü Some of the factors that have been big success stories for Brazil include improved tobacco control, reach universal coverage of vaccination and prenatal care and the world's largest free HIV/AIDS drug distribution system ü private plans are offered by commercial insurers and companies with self insured plans regulated by the National Regulatory Agency for Private Health Insurance and Plans (ANS) - 48.7 mi of private health plan users. ü overlaps between the public and private sectors linked to the insurers for rendering health services.
Brazil – Occupational Health and Safety
ü Complex legal framework for occupational health regulation. Professional staff requirements are defined by law ü Workers' compensation function was fully integrated into the nation's larger social welfare system which required all employers to insure their employees ü The employer continues to pay full wages for the first 15 days of lost time, at which point the public system takes over with continued full wage replacement.
ü population-based, national cohort study with more than 39 mi employees.
ü There were 3.5 times more non-work-related than work related claims. ü The main diagnoses were injuries, musculoskeletal disorders, and mental disorders. ü Rates increased with age up to 59 years. The incidence of sickness benefits is higher among female workers
Source, WHO,2012
BRAZIL
Metabolic risk factors trends - Brazil
Source: WHO,2012
Mortality trend by NCD in Brazil, 1996-2007
Effect of physical inactivity on NCD worldwide: an analysis of burden of
disease and life expectancy
Lancet, 380(9836),219-229,2012
Obesity trends – 2006-2011 (Vigitel)
Man Woman Total
28%
ü A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face ü Around 30% of respondents reported a 12-month disorder ü Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders ü Only one-third of serious cases had received treatment in the previous year.
(Andrade et al,2012)
Working Well: A Global Survey of Health Promotion Strategies Brazilian Employers 2012
Issues Driving Health Promotion
Brazil
Africa/ Mid East
Asia
Australia
Canada
Europe
United States
Stress 1 1 1 1 1 1 6 Workplace safety 2 3 1 2 9 2 11 Physical activity 3 2 2 6 3 3 1 High blood pressure 4 6 6 13 5 12 5 Nutrition/healthy eating 5 4 4 9 6 7 2 Depression/anxiety 6 13 11 3 2 5 9 Psychosocial environment 7 12 10 5 10 6 14 Chronic disease 8 8 9 11 4 10 3 High cholesterol 9 11 8 14 8 13 7 Work-‐life issues 10 10 12 12 11 9 11 Tobacco use/smoking 11 15 14 8 14 14 4 Sleep/fatigue 12 15 13 6 12 10 12 Personal safety 13 8 5 4 13 8 13 Obesity 14 17 14 9 14 14 4 Substance abuse 15 13 17 15 15 15 16 Infectious diseases (HIV) 16 6 16 17 17 17 17 Maternity/newborn health 17 16 15 16 16 16 13
Source: Buck Consultants, 2012
Employer Objectives Driving Health Promotion Strategy
Brazil
Africa/ Mid East
Asia
Australia
Canada
Europe
United States
Absenteeism 1 2 3 2 2 2 3
Presenteeism/productivity 2 1 5 3 3 3 2
Workplace safety 3 5 1 1 7 5 7
Morale/engagement 4 3 2 4 1 1 7
Org. values/mission 5 6 7 6 6 6 5
Attract and retain 6 7 8 7 5 7 8
Maintaing work ability 7 4 4 4 8 4 6 Social Responsibility 8 9 9 9 10 9 10
Health Care costs 9 8 10 10 4 10 1
Promote image/brand 10 10 6 8 9 8 9
Source: Buck Consultants, 2012
• The Laboratory has been launched to produce and disseminate knowledge from health innovations developed in the health systems. • The Innovation Laboratories are spaces for the product ion of evidence and knowledge management, from practices, processes, tools, innovative programs and policies in the healthcare area. It is based on the idea that health system of Brazil is a huge 'laboratory' in which many innovations are produced from good ideas and initiatives of local managers. • Innovation Laboratories seek to provide visibility to innovations and the process of production, incorporation and sustainability, to develop a network of innovators and promoting a culture of innovation in health. • www.apsredes.org
Nutrition Physical Activity Stress Management Relationships
Preventive Behavior
Lifestyle
Physical environment Social environment Personal fulfillment Wages and benefits Social relevance of work
Work Conditions
A comprehensive approach At workplace
Quality of Life Index
Nahas, 2010
§ Brazilian Quality of Life Associa t ion (ABQV) is a national non-profit organization founded in 1995.
§ Joins more than 400 members that represent a universe of 2,100,000 employees.
• Connection with IAWHP • I Latin American IAWHP Summit
• Sept,29th – São Paulo, Brazil
v No country in the world can be competitive in the world economy with unhealthy workers v The workplace setting can play a major role in encouraging people to adopt healthier lifestyle There is still a great deal to be done......
Joana Godinho, WORLD BANK
