Edington’s Zero Trends – What Does this Mean for Wellness Coaching

By dougnau on Jun 26, 2009 in Miscellaneous, Wellness Coaching

This morning I sat in on a compelling webinar presented by Dr. Dee Edington (University of Michigan) made available by WellSteps.com. Dr. Edington has been involved with health promotion programs, and more compellingly the accrual of data from health promotion programs for over 20 years. The presentation is a summary of the data compiled as well as his personal suggestions on how we approach the health care dilemma that we face in the U.S. and globally. The seminar is a one hour summary of a 6 hour conference, so it was quick and packed with information, just a glimpse of the research which he has been conducting. He had some really interesting conclusions from the data that was presented which are relevant to explore further.

Primary Goal - Don’t get worse

Interestingly, one of the fundamental lessons that Dr. Edington has drawn is the concept that our targets at this point in time should be simply not to get worse. A significant percentage of workforces in particular are healthy, and on average over a several year period, the trend has been that the workforce as a whole increases controllable risk factors over time. Low risk individuals are considered to have 0-2 risk factors, moderate risk have 3-4, and high risk are 5 or more (risk factors include smoking, obesity, alcohol, driving safety, exercise habits, nutritional patterns etc).

Rather than saying that companies should try to improve those with a high number of risk factors (ie: change people’s behavior patterns), their first goal should be to provide an environment in which their primary health objective is to stay where you are at. By not increasing health risks with time, a company is directly reducing future costs which increase at a very predictable rate when looking at large companies. Staying the same turns out to be quite a big accomplishment!

What does this mean to Wellness Coaches?

If you are a wellness coach, I believe this has several implications. For those that work with private clients, this has little impact on what you might consider your approach to be. By default, a person that has paid to engage in wellness coaching is motivated, highly interactive, and ready to make lifestyle change. Dr. Edington looks at large populations as a whole, where there can be variations in individuals, but singled out results don’t heavily sway the data.

For lifestyle management coaches/wellness coaches that work within corporations, I believe that the conclusions drawn here are quite significant. While some individuals want to reduce risk factors (lose weight, stop smoking, eat better), those that would be considered high risk are really the most challenging group to glean results from. Certainly, it feels great when someone loses 100 pounds and can be a program champion, but those results are infrequent, not always maintainable, and difficult to attain. Any coach can attest to the potential frustration of working with someone that seems unwilling or unable to change what they know to be unhealthy. The real success is in coaching healthy people to stay healthy!

Furthermore, Dr. Edington states that the goal for those that are in moderate to high risk categories, should be again to – not get worse. This is a totally different mindset than society takes on today, and for any coach that has data which seems to indicate that they’ve done nothing to improve overall health of a population, one must keep in mind that if things have not deteriorated, that someone’s actually had a significant impact.

The most difficult target population

Dr. Edington stratifies populations into risk clusters. Low risk (those having very few risk factors), risk takers, biometrics, and psychological. To stratify populations, he uses Health Risk Assessment data, and from this has determined who the highest cost cluster is. Low risk are clearly the lowest, risk takers comprise of those with habits like smoking or alcohol use, the biometric group includes those with high blood pressure, cholesterol, body mass index, etc., and the psychological cluster includes those with low life satisfaction, high stress, etc. Which group would you think costs the most in terms of health care? Not surprisingly its those that have been attributed to the psychological cluster. Mental health is a significant contributor to physical health. What’s this mean for coaches?

This is a tough one. In these cases obesity, smoking, high blood pressure, stress are the symptoms of a deeper concern that coaching around lifestyle wont address. A coach is not a substitute for a psychotherapist, but we can be a media through which a client can lean on for support. Similarly, knowing the underlying concerns may give us insight as to how to work with a client we suspect may be having some psychological challenges. Refer to a specialist, or make the conversations light, informative, unburdensome, and set a goal of maintainance if they feel that is reasonable. Find ways to support the client in addressing the underlying problems using resources available to them/you, and then potentially in the future they may be interested in looking at physical wellness.

What’s this mean for corporations

Well, I suggest that you listen to the full recording and draw your own conclusions. The link to the webinar is provided at the bottom of this page. In short, it means that a fundamental change in mindset would need to occur to improve overall health. Rather than continuing to spend money on those that are in poor health to decrease risk factors, we spend money on those with good to moderate health such that they don’t move into a higher risk category. Its the complete opposite of our traditional health care system. Some companies are beginning to do this as they learn about data such as this seminar presents.

What does this mean for coaches

Personally, this information provides empowerment. When I consider the population of clients that I coach, I can attest to the accuracy of data that is presented in this seminar. I know that someone dealing with psychological problems, self esteem issues, and a lack of self confidence has challenges reaching goals. I also know that I am energized to meet with the client that is doing everything right and is excited to do whatever possible to stay on track. I believe its exciting that those energizing meeting are the ones which are statistically being shown to have the impact on health care reform.

I encourage you to watch the full hour webinar hosted by WellSteps at the following link.

http://www.wellsteps.com/resources/resources_webinars.php

Be Well