The Associated Press ran a story (in the Chicago Tribune of 5 December 2006) from New York on corporations “pushing their employees to eat their vegetables and go outside to play”. The article reported that LL Bean Inc mandates five-minute stretches during manufacturing line shut-downs three times daily “to prevent the most common injuries workers suffer”. Other examples of employers 'wellness' programs include organized walks, bike-loan schemes and a company-wide screening of “Fast Food Nation”.

At the same time other employers are manipulating cafeteria options to encourage healthy eating habits. One plan that would upset free-market economists is the manipulation of cafeteria food prices, so that prices on fatty foods are increased to subsidize reduced prices for healthy sandwiches, fruit and salads. The report describes these (so-called) Twinkie taxes as being in place in up to 10 percent of company-run corporate lunchrooms.

It is time that health-care facilities ... promote healthy lifestyles for our employees and set an example for other employers

Indeed, I recall that when our hospital built a new cafeteria the arguments for including healthy food options were undermined by the increased costs of such foods. How ironic that the US government continues to subsidize corn farmers, when their excess crop production is directly linked to increased manufacture of high fructose (corn) syrup, which contributes—immensely—to the obesity epidemic. This support is not quite as ironic as government subsidies for tobacco growers; however, the resultant costs to society are greater with corn than with tobacco subsidies. My understanding is that corn subsidies lead to obesity with resultant increases in obesity-related disorders such as diabetes and heart disease, which are all chronic diseases that require prolonged health expenditure. Tobacco subsidies lead to acute problems such as lung cancer, heart attacks and emphysema with intense, but short-term, societal health costs.

Turning back to employers (in contrast to the government) corporate decisions based on economic grounds make the most sense. Healthy employees are likely to be more productive, take less sick leave and, most importantly, require less health-care expenditure than unhealthy employees; health-care expenditure is an ever-increasing cost, given that in the US (unlike most other countries) health insurance is paid for by employers rather than by the government.

We in the health-care industry should be leading the charge. Our hospitals should consider cost-shifting in our food services, with surcharges for unhealthy food that offset subsidies for healthy foods. We should be offering exercise programs for our employees before and after work, and at lunch (or break) time. Stair use should be encouraged (our hospital used to advertise “up one, down two” as a means of reducing elevator congestion) as a healthy option; provision of adequate bicycle storage facilities, changing rooms and shower facilities would encourage positive, healthy behavior. It is time that health-care facilities 'step up,' promote healthy lifestyles for our employees, and set an example for other employers.