This week the financial services start-up Zerodha created a flutter in the employee wellness industry by linking financial incentives to health. According to the founder Nitin Kamath, the employees would be given as high as half their monthly salary as a health bonus if they can keep their BMI below 25. There were added incentives to maintaining their health as well. BMI or Body Mass Index is a measure of body fat based on height and weight that applies to adult men and women. The announcement created mixed reactions with proponents and critics alike weighing in on the pros and cons of using BMI as a measure. I personally believe that the debate is necessary but misses an important strategic shift.
Employee wellness has long been regarded as an area for immediate imperative action as it moves our health initiatives from being reactionary to being proactive. As we all know India does not have the infrastructure to administer inpatient care to most citizens, so our strategic health thinking has to be proactive health intervention in areas like nutrition, early detection and engaging in programs to keep physical and mental fitness.
Most corporate wellness programs restrict themselves to providing health insurance for admissions along with programs like Yoga, Zumba, Medication or talks from eminent doctors and healthcare leaders. Programs like Arogya World, where I have been an auditor for some assessments go deeper, looking at parameters like nutrition, smoking cessation, physical exercises, policy around work life balance among others.
I think Nitin Kamath and Zerodha have taken a revolutionary step in the right direction and this is the philosophy if we have to adopt if we have move India to a preventive care paradigm.
I was recently reading a report from McKinsey that talked about the advancement that we have made in the critical area of life expectancy. Most countries across the globe have made tremendous progress in increasing life expectancy. India for example has increased life expectancy from the mid 40’s in 1960s to almost 70 today. This is indeed a remarkable achievement and should be celebrated. But interestingly the percentage of our lives that we spend in ill health has not changed. Since the 1960’s almost 50% of our life is spent in illness and 12% in very severe illness. The worrying part is that this percentage has not changed. Despite the increase in life expectancy the quality of our life as a percentage has not improved. There is a need therefore to increase the percentage of the life spent in good health as well as to improve overall health standards.
In my book Own Your Health I had discussed some of these challenges that affect our daily lives. I had documented many of my conditions that affected me including Vitamin D deficiency, Thyroid as well as my battle with diabetes which is coming up due to the family of diabetes that I carry in my family. I strongly believe that no amount of intervention from policy and government would be helpful if we as individuals are not ready to take charge of our own health. Below I want to outline some key areas that one has to focus on.
- Data-Driven Intervention- Today we have the ability to collect data and analyse it to help understand what we can do to identify key disease markers and identifiers. While this has been available for a while, there is a gap in keeping track of parameters, which robs of valuable longitudinal data. Most patient records are locked up with various hospitals, labs, or with physicians. Though there is a move to have interoperable data that can leverage the national health stack, to convert the data into information that can be tracked longitudinally.
- Smart Phones – The smartphone has revolutionised the way health can be monitored. Today these devices can give us a 360-degree view of our health, right from nutrition, fitness parameters, and key signs like heart rate and BP. Though the accuracy of some of these devices has some way to go, already we see examples of how the Apple Watch was instrumental in preventing a cardiac arrest in more than one occasion
- Digital Health– Adding on to the above two areas are the plethora of health interventions that are available today for doctors to help with better and faster diagnoses. Start-ups working in areas like Oncology, Digital Pathology, Radiology and others are working with the doctors for early intervention and diagnosis. This is improving care at a scale that was previously not possible. Similarly, platforms that help with Telemedicine, to ensure remote consultation and treatment have changed the way patients and individuals approach consultation. To add it the implications of genomics are immense as well.
- Health Ecosystem– All this is possible with the development of the health ecosystem. Today we see that all these components of health are coming together to empower individuals to take ownership of their health. This involves the Government, Employers, Hospitals, Doctors, Medical Device Organisations, Pharmaceuticals, Health Insurance and Bio Tech Firms
Health is a very individualistic concept, and it is very specific to their DNA. Genomics is showing a lot of promise and it will give a further boost to preventive interventions. The future of health belongs to prevention and data is key to creating a framework to help individuals to manage their health.
The article was also published on CSR Mandate, the link is here – https://www.csrmandate.org/data-driven-approach-to-preventive-health/