Putting Physical Health at the Heart of Workplace Policymaking

The future of work could be substantially different from today. From embracing the benefits (or being wary of the risks) of artificial intelligence (AI), to supporting young people in designing their future, the potential of transitioning to new models is exhilarating. As part of this transition, it is vital to address a growing cause for concern: the physical health of the workforce.

It is undeniable that the health of the Western workforce has deteriorated substantially in recent decades. The headlines are this: obesity has quadrupled since 1980; 70% of Americans and 55% of Europeans are overweight (36% and 25%, respectively, are obese). After smoking, obesity is the world’s leading cause of preventable deaths. Obesity increases the risk of diabetes, heart disease, most cancers, and numerous other diseases.

But what does this mean? The unhealthier the population, the fewer people are able to work. The fewer people in the workforce, the lower productivity, output, and economic performance. When the balance of productivity tilts too far, geopolitical shifts in industry occur. Think of the post-Brexit move of several industries from the UK from a combination of a reduced workforce and regulatory red tape. At the same time, the population of Western countries is aging. That will leave fewer people in the workforce, with lower productivity and economic output, before even factoring in a labor pool further reduced by preventable ill health.

It is uncomfortable to suggest that governments and employers should do more to improve public health when that contradicts personal choice. However, we are now close to a tipping point, and more must be done.

HOW DID WE GET HERE?

To propose areas of future improvement, it is important to understand where we are, how we got here and why we are not yet at a tipping point. During World War II, rationing heavily restricted diets. War demanded industrial production, a critical employer for many countries, diminishing attention to food production. These trends continued into the 1950s and 1960s. And then, in the 1970s several major economies deindustrialized. Coal mines in Britain closed, and the European Economic Community (as the EU was then called) was established to protect the steel, agriculture, wine and coal industries, among others. While the collapse in heavy manufacturing presented major risks, it did have possible longterm benefits: reduced workplace injuries and limited exposure to chemicals, such as asbestos, that were considered safe. In theory, the workforce had the potential to become healthier if the right employment replaced heavy manufacturing.

The situation changed in 1975 when the rise of computing began. In the U.S., Microsoft was founded, and the internet soon followed. Over time, this created the demand for a more agile services economy. This meant that the working day was sedentary for a greater number of people. In 1970, only two in 10 Americans (and a comparable number of Europeans) were in jobs classified as “light activity”, or behind a desk. Today that figure is now closer to eight in 10 in some EU member states. In the U.S., over 40% of adults sit more than 8 hours per day, with younger adults now reporting to be more inactive than ever before.

The explosion in computing, the collapse of heavy industry, and the movement towards a more sedentary lifestyle continued throughout the 1980s, 1990s and 2000s. But another important shift was taking place during this time. Heavy manufacturing was declining in the U.S. and EU, but manufacturing of processed food was beginning. Processed food started to become commonplace, meaning that consumers were buying pre-made ingredients and foods. While undoubtedly convenient, the combination of a sedentary lifestyle paired with the consumption of unhealthier foods began a cruel cycle. Ultra-processed foods, commonly accepted as those with more than five ingredients, began to be accessible to the masses, though they were not classified as ultra-processed until 2009.

At least two other relevant factors arose in the 2010s and 2020s: the rise of delivery services (enhanced by digital technologies) that rely on ultra-processed foods and the COVID-19 pandemic lockdowns. In the UK, the U.S. and the EU, the number of people reporting as too sick to work increased massively post-pandemic.

Government action to tackle obesity has not worked. Levels continue to rise. This is in part because U.S., European, and British authorities are reluctant to take away personal choice from individuals. These authorities tend to rely, as they did during the pandemic, on the “common sense” of the people. But this is not always the most effective approach and does not allow for long-term planning to improve the health of the workforce. Several measures are needed (see below) before the health of the workforce changes irreversibly.

HOW GEOPOLITICS COMES INTO PLAY

There are two broader geopolitical points at play in the discussion around the health of the European and American workforce.

First, the U.S. and the EU are becoming more protectionist to secure the benefits of developing green technologies in their markets. This means granting significant tax breaks and incentives to companies willing to develop them and aggressively targeting rules of origin and tariffs. What does not receive enough attention is a trend by markets to try and bring back heavy-industry production facilities, or, in effect, to “reindustrialize”. This could mean more people who work and, potentially, more people in physically demanding, long-term jobs.

Second, reduced productivity and declining populations (in countries such as Italy and Japan) will lead to changes in balance of power. At the end of World War II, the global population was a little over 2 billion. By 2060, some projections have it nearing 10 billion. In the 1950s, countries that had existing heavy manufacturing and supply chains were able to benefit from this and center themselves as global leaders. Now, other countries and regions have developed heavy industry and are powering it with increasingly young populations. Some economies in Southeast Asia, South America and Africa are growing significantly and, as in Nigeria for example, are developing reputations as manufacturing and technological hubs. As they grow, these countries’ GDPs and productivity levels could well portend a shift in geopolitical power. It is vital for Western markets and governments to consider if they are prepared for this.

POLICY RECOMMENDATIONS

What should be done? This paper has identified three critical factors causing the long-term decline of physical health in the workforce: sedentary jobs, sedentary lifestyle and a poor diet. But there are solutions. None of these will be easy to implement, but the limited action to date has failed.

INCENTIVIZE REDUCING THE CONSUMPTION OF ULTRA-PROCESSED FOOD

In the U.S., 75% of the average diet is comprised of ultraprocessed food. While the EU figure is lower, it is still high, at almost 60%; in the UK figure it is 64%. This is resulting in soaring childhood obesity (more than 30% in the U.S. and the UK, 22% in the EU). These foods contain additives and emulsifiers, are cheaper to produce and have a long shelf life. But they cannot be digested effectively and have poor macronutrient content. In short, they are unsuitable for a longterm diet. Higher taxation or a ban on such items could limit the amount of ultra-processed food that an individual consumer can buy.

a. There is, of course, a significant socioeconomic consideration for those who use ultra-processed food. They are cheaper to produce and buy. In many markets, a bottle of water is more expensive than a bottle of soda. Organic fruit and vegetables are more expensive than a microwave meal, which is also easier to cook. The production of ultra-processed food could be offset if more land were given to agriculture, with a greater focus on producing organic food, and subsidies introduced to lower prices. Healthy eating is becoming the preserve of the rich.

b. Employers could take more responsibility for the health of their workforce. Many, such as Blackrock, EY and Deloitte, already provide mental health support and tools. These include mindfulness apps, allowing for movement breaks throughout the day, and opportunities for yoga memberships. Many also provide health insurance or rely on national health care systems. But this is all aimed at responding to or treating a condition, not preventing it. Employers can start providing healthy eating modules. These modules provide macro-nutrient information for foods and healthy recipes for employees to make. Check-ins for staff can also be useful and may include annual physicals.

INTRODUCE MOVEMENT INTO THE WORKPLACE

Numerous studies have proposed a daily step count of 10,000. Most Americans manage just 3,000 per day. A Japanese company selling pedometers put forward the higher figure; it is, therefore, not without prejudice. But more steps are undeniably better since increased activity leads to improved health. For onsite workers, governments should support (and model) movement breaks that occur outside the lunch break. Many employers, including the UK and French civil services, run yoga classes, athletic events and similar activities, but they take place after work or during the lunch hour. Busy people may find the timing inconvenient. Healthy movement during the workday would boost productivity and reduce medical costs.

COORDINATE A GLOBAL OBESITY CONFERENCE

This is not an issue for any one country. There are numerous industry-wide global platforms for cybersecurity, pandemic preparedness and malnutrition, among other critical issues of our time. Obesity and preventable disease, issues facing all major economies, should also be topics of discussion. Countries should share information on them and more effectively cooperate on tackling them. Given its success in coordinating international forums on Ukraine, cancer, COVID-19 and other issues, the EU could take the lead in organizing such an effort.

The current approach is simply not working. We must act now before it is too late.

Print