From Generic to Genuine: Adapting existing US focused cancer control resources for use in workplaces in India and Mexico

Global Workplace Wellness Programmed hand-holding: incentivizing employer uptake and implementation assistance in Mexico

38-T5

Disclosure of interest: None

Luz Myriam Reynales Shigematsu, MD, MSc, PhD. Chief of Tobacco Research Department National Institute of Public Health. Mexico

Background

Leading Risk factors in Mexico

Over 70% of adults are overweight or obese; the prevalence of diabetes diagnosed by a physician is currently at 9.7 percent.

Excessive alcohol consumption is also problematic, rising quickly to the most recent figure of 42% of adults reporting at least occasional abuse.

At present, obesity, unhealthy diets, low levels of physical activity and binge alcohol drinking all make greater contributors to disease burden in Mexico.

Data from the 2015 (GATS) indicate that the overall national prevalence, 16.3 % in adults. This prevalence translates to 14.3 million smokers and the at-risk population for smoking comprised of adolescents and young adults is nearly 28 million.

With regard to other major risk factors for NCDs, Mexico’s profile is highly unfavorable.

Methods Economically Active Population (PEA) stood at 53.8 million people, representing 60.4 % of the population 15 years or older who lives in Mexico, National Survey of Occupation and Employment (ENOE).

A mix of 10 national and multinational

companies in 5 different cities in Mexico. (Mexico City, Estado de Mexico, Pachuca, Puebla and Cuernavaca)

The workforces ranged in size from < 100 to > 5,500 employees. A wide variety of industries were surveyed: manufacturing and manual labor

based work to more office based employers in financial services and academia.

Health Culture Public

Social Security Department of public Health, SESA

Private

Sector

Government contribution

Employer contribution

Workers' contribution

Federal contribution

State contribution

Subjects

Workers

Popular Health Insurance

Fund

Recovery fees

Private insurers

Purchasers

IMSS

ISSSTE

PEMEX SEDENA

NAVY

Hospitals, clinics and

doctors of this institutions

Department of public health

and SESA

Hospitals, clinics and

doctors of this institutions

IMSS- Opportunities

Hospitals, clinics and

doctors of this institutions

Self-employed , workers in the informal sector and unemployed

Private suppliers

Population able to pay

Workers families

Formal sector workers

Retirees

Suppliers

Users

The Preventive Program “PREVENIMSS”

Cancer: 8/10 Promotion, Early detection and Vaccination (HPV vaccine).

Physical activity: 80% of corporates indicated some type of physical activity program within the workplace.

Tobacco control and cessation: Half of respondents indicated their workplaces were smoke free. Some corporates implemented tobacco cessation programs including workshops, but none mentioned a sustained cessation program.

Nutrition: Half of corporates surveyed stated there was a nutritionist onsite who designed healthy meals for the cafeteria. Multiple corporates mentioned employee resistance to these programs and their preference to traditional Mexican cuisine.

Communication of programming Wellness programming communication tactics varied by job type:

Internet communications such as emails (Computer station)

Posters and physical message boards (Labor station)

Word of mouth from managers or in-house doctors and nurses. (common)

The use of mobile technologies was not a common mode of communication,

but one corporate developed an app which will provide health information as well as track steps, to drink water and consume fruits and vegetables. Notably, one corporate indicated literacy as a communication barrier and

emphasized the importance of face-to-face interaction.

Rationale and Motivation The majority of corporates indicated a financial investment in

workplace wellness. return on investment: Only half of the corporates surveyed

indicated ROI was the motivation behind wellness programming. corporate social responsibility: Those that did calculate ROI

highlighted the decrease in absenteeism and major medical expense for costly illnesses such as cancer. Recruitment and retention: Some corporates noted the

importance of keeping their workforce happy and healthy in order to recruit and retain talent.

Challenges in health programming The most commonly cited challenge was raising awareness about health.

Corporates cited low education and health literacy levels as main factors for this challenge. “Back to the health culture here…Most of them are not highly educated. They just don't think it's

important, um, health-wise. So yes, it has been very hard for them to, to raise an awareness.”

The economics of working with a low- and middle- income country (LMIC) population was not commonly mentioned, but one interviewee explained the role income plays in healthy behaviors: “We have to develop awareness in health to avoid these type of diseases, to avoid obesity, for

people to be agile. But, you know what? Some people don't have the opportunity to prepare their own meal and, because even if they prepare it, the heat, … will make their food spoil, and sometimes because of economic situations it's easier to spend just 20 pesos instead of a proper meal that's low in fat, that's nurturing. Because obviously there are people's economies, just the way it is, it just marks them, that's fact."

Stakeholders and Partners Private support: Most corporates also receive support from private

business including pharmaceutical, healthcare, food, and beverage companies.

ACS: The majority of respondents were not aware of the role of ACS in Mexico. Another respondent indicated awareness of ACS’ role in the United

States, but not in Mexico.

The majority of those who were not aware of ACS’ role in Mexico were interested in receiving support from the organization.

Public Policies developing

Capacity buiding Education Programs

Health Promotion

Advocacy Capacity buiding community level

Health Education

Social marketing

Research

A change of paradigm is required: the preventive perspective

Source: The Cancer Atlas 2015

Recomendations Social security (PREVENIMSS, PREVENISSSTE) programming and commitment to cancer

screening could serve as an entry point for ACS into workplaces across Mexico.

Assessment: Corporates noted the need for assessment of existing health programming. Utilizing the Workplace Health Assessment and Tobacco Policy Planner.

Physical Activity: 80% of corporates had already instituted some kind of physical activity programming. A program such as Active for Life would fit naturally with current programming.

Corporate Recognition : ACS Corporate recognition into Mexico may serve to be a motivator to implement sustained wellness programming while also fostering a community of workplace wellness providers among management. Corporate Association (COPARMEX).

This program might be a part of National Comprehensive Cancer Control Program in Mexico oriented to support some of the objetives: 1 and 2: Primary prevention for preventable risk factors and Early detection (screnning), so they can support also the cancer patients survivors and family.

Gracias! Thank you! Merci!

www.insp.mx www.controltabaco.mx

Thanks to the Global Wellness Project Research team Mexico: Maria Guadalupe Flores, Moisés Ortíz, Néstor Mendoza and Omar Elizalde.

A special thanks to the companies that participated in this project for their time and information to improve the health and wellness programs in the workplace in Mexico.