Pareto applied to promoting health: Do you know the Optimal Lifestyle Metric?

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Following this monograph week regarding the business experience of  PrevenControl in Harvard,  today we present the study An Optimal Lifestyle Metric: Four Simple Behaviours That Affect Health, Cost and Productivity”,  relating to the optimization of resources for the application of measures to promote health within our company. This research has been reviewed and analyzed in one of the sessions that we have attended.

The Pareto principle

In the early 20th century, Vilfredo Pareto observed that 20% of Italian society owned 80% of the land. By contrast, 80% of the Italian population owned only the remaining 20%.

Far from being an isolated case, the ostentation of most variables (core) by a minority of individuals today defines our model of the distribution of wealth and resources in the world.

Without realizing it, we also apply this principle to our daily life: a few variables (family, love, friends, work…) make up most of our joys or concerns.

This “universality” of the Pareto distribution, extrapolated to many fields of science and life, applies equally to our performance as OHS technicians. In this post we will see an example of how four healthy habits can influence the health of workers, health costs that arise and the costs accrued by the company.

Starting point

In 2000, the American Center for Disease Control and Prevention(CDC) conducted a study in which how four inherent risk factors of an unhealthy life were related to approximately 40% of deaths occurring in the United States. These four risk factors are:

  1. The regular consumption of tobacco
  2. The lack of a balanced and healthy diet
  3. The lack of physical activity
  4. Abusive consumption of alcohol

Furthermore, it was concluded in the study mentioned that the simultaneity of two or more of those factors was related to approximately:

  • 80% prevalence of chronic diseases
  • 75% of medical costs in the country.

As a result of this data, Nico Pronk (researcher and associate professor at the Harvard School of Public Health) decided to study the levels of incidence of chronic disease in a sample of workers exposed to one, several or none of the four risk factors mentioned above.

The Optimal Lifestyle Metric?

Criteria have been established for the degree of support of workers to the Optimal Lifestyle Metric:


The sum of these four parameters results in the worker’s degree of support to the Optimal Lifestyle Metric, with a range of values ​​from 0 (no support) to 4 (total support).

Once the parameters have been defined, data were collected from 500,334 workers whose companies had undertaken a health assessment –in which information was gathered about their habits– as a result of their respective health programmes. These employees were subsequently broken down according to their degree of support to the matrix. Let’s see the results:

opt 2

Once this breakdown has been obtained, workers are categorized into five categories, depending on the number of criteria they met: OLM-0, OLM-1, OLM-2… Subsequently, a representative sample was chosen from each of these categories, assuming a total of 6,838 workers.

Finally, these people were monitored for a period of two years. The goal? See to what degree the incidence levels of chronic diseases have diverged (diabetes, heart disease, cancer, hypertension, back pain and high cholesterol) depending on the category of support to which they belong.

Results obtained (health, costs and productivity)

Relating to health

Once the two years had passed, an assessment was carried out of the health status of the members of the sample to identify presumed differences between the various categories, in terms of the onset of chronic diseases. The following results stand out:


    • The members of the OLM-3 category (support of three of the four parameters that make up the Optimal Lifestyle Metric) have a 44% lower risk of developing diabetes.
    • In addition, OLM-3 workers have a 29% less chance of getting new backaches.
    • Employees who meet the four healthy criteria (OLM-4), meanwhile, are 66% less likely to develop back pain.

    It was found that support of any of the habits that form the OLM, especially those relating to physical exercise, contribute to a significant decrease in risk for any of the aforementioned chronic diseases.

Results in terms of health care costs

The study also analyzed the impact in terms of health expenditure generated by each of the categories analysed. The main findings in this regard are mentioned in the following:2

    • The costs incurred for medical care per person fell by 4.7% for each additional day a week that they were physically active.
    • Health care expenditures generated by regular users of tobacco were 18% more compared to non-smokers.

    In addition, two groups were chosen from the sample: low risk and high risk. The low-risk group were non-smokers, who performed physical exercise 3 times a week and whose body mass index was 25 kg/m2. On the other hand, the people included in the high-risk group were regular users of tobacco, did not perform physical exercise and their BMI was 27.5 kg./M2. Between these two groups, broken down based on their gender and ethnicity, the following divergences in health spending generated were presented:

Impact on productivity

As we have seen, leading a healthy life or not largely impacts our health and health spending. And for the employer? Would it add costs to have a staff with some unhealthy habits?3

To address this hypothesis, an analysis was made as to the levels of absenteeism (work time lost) and presenteeism (loss of efficiency in the performance of work) for each of the categories defined (OLM-0, OLM -1 …). In order to unify the criterion of cost/person, an annual stipend of $ 50,000 for each of the people in the sample was established. The results in terms of costs accrued in annual productivity loss are included in the accompanying graph. As you can see, the difference between the OLM-0 and OLM-4 categories is more than considerable, assuming the annual cost of the first one is 455% with regard to the persons supporting the four healthy habits under study.

As we can see, only four habits for a healthy life can have a big impact at different levels. Still, one must be cautious in defining an action plan for promoting health: each company has an intrinsic reality that can alter the degree of importance of these four “capital” habits. The key is to conduct a thorough analysis, identifying essential habits that motivate action and allocate appropriate resources to each of these habits.


PrevenControl es la firma especializada en seguridad y salud laboral que propone soluciones eficaces e innovadoras para la mejora del negocio y la reputación de sus clientes a través de la consultoría, el uso de la tecnología y la formación.

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