Data from a panel discussion at SxSWi 2013: We all know the sad truth: the majority of working Americans are chained to their desks – namely, their computer screens – for eight hours per day and the “massive” obesity epidemic persists. Recent research suggests that sitting is killing people and the industry continues to debate the harmful health effects stemming from sedentary lifestyles, with many arguing that technology is only adding fuel to the fire. So if sitting is killing us, then can mobile save us? Forget traditional wellness programs - the healthiest workplace is one where employees are actively mobile. Hosted by Sharon Mandler, VP, Senior Digital Strategist of Saatchi & Saatchi Wellness, this session will bring together a group of leading health experts who will challenge old thinking about healthy workplaces and take a deep dive into the new technologies and devices that are coming to the rescue and mobilizing America’s workforce.

1. Sitting will kill you.
Can mobile save us?
Illustration by Chris Silas Neal

2. The Panel
Sharon Mandler
(moderator)
Digital Strategist,
Saatchi & Saatchi
Wellness
Believes digital strategy Jane Dr. Peter Fran
will save the world Sarasohn-Kahn Katzmarzyk Melmed
@Saatchiwellness Health Co-founder, CoHealth
@sharonmandler Economist, Fierce Head researcher: and Context
Health Blogger The Dangers of Our Communications
Sedentary Behavior
@healthythinker Redefining workplace
wellness.
@femelmed
2

3. Physical inactivity is now
the fourth leading cause of
death throughout the world.
More than 90,000 new cancer
cases per year in the US may
be due to physical inactivity
and prolonged periods of sitting.
3

4. Every 2 hours spent just sitting reduces
blood flow and lowers blood
sugar, increasing the risk of
obesity, diabetes and heart disease.
JAMES
A. LEVINE,
MD, PhD
Sitting for more than 3 hours a
day can shave a person’s life
expectancy by 2 years.
PETER T.
KATZMARZYK,
PhD
For people who sit most of the
day, their risk of heart attack is
about the same as smoking.
MARTHA
GROGAN,
MD, PhD
4

5. “Slow Motion Catastrophe”
Non Communicable Diseases
kill 2 in 3 people on the planet
63% of the world’s deaths are
due to chronic disease: CV, Ca,
respiratory, and diabetes
• 4 lifestyle contributors:
- Tobacco use
- Physical inactivity
- Harmful use of alcohol
- Poor diet/nutrition
5
Source: Global status report on noncommunicable diseases 2010, WHO, April 2011.

6. Sitting Time and Mortality from All Causes,
Cardiovascular Disease and Cancer
Canadian Fitness Survey: 12-year Mortality Follow-up (1981-1993)
17,013 male and female survey respondents
CUMULATIVE SURVIVAL (%)
100%
93.5%
90% 91.4%
88.3%
86.2%
80% 81.4%
Time Spent Sitting
None of the time 1/2 of the time All of the time
1/4 of the time 3/4 of the time
0 YEARS 2 YEARS 4 YEARS 6 YEARS 8 YEARS 10 YEARS 12 YEARS
6
Source: Katzmarzyk P, et al. Med Sci Sports Exerc. 2009:41(5);998-1005.

7. Sitting Time and Mortality from All Causes,
Cardiovascular Disease and Cancer
Canadian Fitness Survey: 12-year Mortality Follow-up (1981-1993)
17,013 male and female survey respondents
AGE-ADJUSTED ALL-CAUSE DEATH RATE PER 10,000 PERSON-YEARS Time Spent Sitting
None of the time
180
1/4 of the time
1.86 1/2 of the time
3/4 of the time
All of the time
1.50
120
1.21 1.40
1.31
1.00 0.99
1.00 1.01
0.92
60
INACTIVE ACTIVE*
(p <0.0001) (p=0.008)
*ACTIVE defined as ≥7.5 MET-hr/week.
7
Source: Katzmarzyk P, et al. Med Sci Sports Exerc. 2009:41(5);998-1005.

8. Television Watching and Other Sedentary Behaviors
in Relation to Obesity and T2 Diabetes Risk in Women
Nurses Health Study: Relative Risk* Over 6 Years
Women 30-55 years-of-age
RELATIVE RISK Hours Watching TV/Week
0-1 21-40
2.1
2-5 >40
6-20
1.94
1.65 1.7
1.6
1.42 1.44
1.3
1.22
1.09
1.00 1.00
0.8
OBESITY T2 DIABETES
(p <0.001) (p <0.001)
*Adjusted for age, smoking, alcohol use, hormone use, physical activity, total fat and calories and glycemic load.
8
Source: Hu F, et al. JAMA. 2003:289(14);1785-1791.

9. Television Viewing and Risk of Type 2 Diabetes,
Cardiovascular Disease, and All-Cause Mortality
A Meta-Analysis: Dose-Response Relationship
95% CI for fitted trend
RELATIVE RISK
2.0 2.0 2.0
1.5 1.5 1.5
1.0 1.0 1.0
0.5 0.5 0.5
TYPE 2 CARDIOVASCULAR ALL-CAUSE
DIABETES DISEASE MORTALITY
0 2 4 6 8 0 2 4 6 8 0 2 4 6 8
TV VIEWING (h/d) TV VIEWING (h/d) TV VIEWING (h/d)
9
Source: Grøntved A, Hu F. JAMA. 2011:305(23);2448-2455.

10. Sedentary Behaviour and Life Expectancy in the USA:
A Cause-Deleted Life Table Analysis
The analyses indicates that, in the US,
population life expectancy would be:
2.0 higher if adults reduced their time
YEARS
spent sitting to <3 hours per day
and
1.4 higher if they reduced their TV
YEARS
viewing to <2 hours per day
10
Source: Katzmarzyk P, Lee I. BMJ Open. 2012;2:e000828. doi:10.1136/bmjopen-2012-000828.

11. 11
Source: www.medicalbillingandcoding.org/sitting-kills/

12. 12
Source: docandrewmurray.com/category/infographics/

13. “Inertia” by Jason deCaires Taylor—Cancun, Mexico
13

14. How Sitting Affects Your Health
14
Source: Spine Health Institute. www.visual.ly/how-sitting-affects-your-health

15. Smoking vs Inactivity
An inactive person
will spend
Regular exercisers are
37%
Tobacco smoke
20% to 50% 86%
is estimated to
more days in the hospital
less likely to be affected
thanhave caused about
an of lung one, make
active cancer
by serious and expensive
illnesses, 60,000 stroke,
5.5% including visits,
deaths in Britain
more GP
are caused by
cased of cancer in
cancer, heart disease,
13% more specialist
obesity tobacco
services andin 2010
Britain diabetes
12% more
smoking
nurse visits than an
active person
15
Source: img.metro.co.uk/news_focus/Inactivity.png

16. What‟s Really Behind Your Belly Fat?
16
Source: www.dietpilluniverse.com/diet-articles/fattest-states-in-the-us-infographic/

17. How Did This Happen?!
A 2008 Vanderbilt University study of 6,300 people
published in the American Journal of Epidemiology
estimated that the average American spends 55%
of waking time (7.7 hours per day) in sedentary
behaviors such as sitting.
17
Source: www.juststand.org/tabid/674/language/en-US/default.aspx

18. Driving is Why You‟re Fat
18
Source: awesome.good.is/transparency/web/1008/driving-and-obesity-3/flat.html

19. 19
Source: www.sustainweb.org/resources/images/other_pics/CFC_ObesityGamesInfographic_lrg.jpg

20. Physical Activity is on the Decline and it‟s Dangerous
20
Source: visual.ly/30-minutes-longer-life-how-exercise-reduces-your-risk-premature-death

21. Obesity is an Epidemic
21
Source: visual.ly/30-minutes-longer-life-how-exercise-reduces-your-risk-premature-death

22. What Makes What We Spend
Us Healthy On Being Healthy
22
Source: bipartisanpolicy.org//projects/lotstolose/infographic

23. 23
Source: visual.ly/spending-healthcare-north-america

24. 24
Source: www.hsph.harvard.edu/news/magazine/f12-infographic-chronic-disease/

25. We Spend 2.5x More Than Other Countries On Health
Care, But Don‟t Have the Highest Life Expectancy
25
Source: www.hitconsultant.net/2012/08/29/rising-healthcare-costs-infographic/

26. US Healthcare Spending
26
Source: www.misfitwearables.com/references

27. If Healthcare Costs Continue to Rise at This Rate, We
May Be Paying A Lot More in 2021
27
Source: www.hitconsultant.net/2012/08/29/rising-healthcare-costs-infographic/

28. The Financial Impact of Poor Health on Employers
28
Source: info.totalwellnesshealth.com/blog/bid/240490/Why-Your-Worksite-Needs-to-Make-Wellness-a-Priority-Infographic

29. The Financial Impact of Poor Health on Employers
29
Source: info.totalwellnesshealth.com/blog/bid/240490/Why-Your-Worksite-Needs-to-Make-Wellness-a-Priority-Infographic

30. Stress in the Workplace
30
Source: visual.ly/stress-workplace

31. Stress in the Workplace
Stress in the workplace
can have a negative
impact on employee
productivity and health.
Implementing a
workplace wellness
program provides
employees with the tools
to manage stress
effectively so that they
can perform their best.
31
Source: visual.ly/stress-workplace

32. 32
Source: www.thejanedough.com/hot-to-minimize-stress/

33. Six Healthcare Consumer Segments
33
Source: visual.ly/meet-today%E2%80%99s-health-care-consumer-infographic

34. 34
Source: GetHotseatApp.com

35. Don‟t Just Sit There!
GetHotseatApp.com
Turn short breaks into
meaningful activity.
35
Source: GetHotseatApp.com

36. 36
Source: www.sciencedaily.com/releases/2013/01/130129100118.htm

37. 37

38. The Health Benefits of Walking
38
Source: www.everybodywalk.org

39. To Combat Stubborn Belly Fat
39
Source: www.dietpilluniverse.com/diet-articles/fattest-states-in-the-us-infographic/

40. 40
Source: suffolkfitnessblog.com/category/a-to-z-benefits-of-exercise/

41. 30 Minutes of Exercise: Secret to Weight Loss
41
Source: visual.ly/30-minutes-longer-life-how-exercise-reduces-your-risk-premature-death

42. 30 Minutes of Exercise: Boost Your Brain Power
42
Source: visual.ly/30-minutes-longer-life-how-exercise-reduces-your-risk-premature-death

43. 30 Minutes of Exercise: The Key to a Happier,
Healthier You
43
Source: visual.ly/30-minutes-longer-life-how-exercise-reduces-your-risk-premature-death

44. 12 Mental Benefits of Exercise
1 Exercise will make you feel better
Exercising releases endorphins, making
you feel happy and positive about yourself.
7 Self discipline
Exercise helps you develop the skills of
compliance and adherence. These skills
can be useful in several aspects of life.
2 Overall mood booster
Exercising regularly will release tension.
This translates into solved problems with 8 Exercise can help with addiction recovery
and depression
depression and stress. Exercise induces “happy chemicals”
which can act as a replacement for an
3 Confidence
When you exercise and relieve tension while
taking care of yourself, you can‟t help but be
addictive substance as well as temporarily
relieve symptoms of depression.
proud of your accomplishments. You feel like a
brand new you, and you know you look good. 9 It also helps combat depression
Depression is caused by a chemical
imbalance in the brain. Exercise induces
4 It helps your body to have a high pain tolerance
Exercise can make you sore sometimes. At first,
it might be horrible, but after it happens a few
“happy chemicals” to be produced more
abundantly.
times, you learn how to deal with it. This leads
to an overall increase in your pain threshold. 10 Fitness reduces anxiety
Using your energy in an effective
way helps you to relax better.
5 Work to improve your brain power
Exercise causes your body to create more
connections between brain cells, enabling 11 Ever heard of “runner’s high”?
That‟s right! Vigorous exercise can
a greater capacity for learning and memory. make you feel great.
6 Exercise improves your character
Sticking to an exercise routine will help you to
develop the qualities of
12 Concentration
Exercise can boost your concentration
and mental awareness.
discipline, dedication, and determination.
44
Source: www.treadmillreviews.com/blog/mental-benefits-exercise

45. Listen to Dr. Benjamin, US Surgeon General
We can't look at health
in isolation. It's not just
in the doctor's office...
...It’s got to be where
we live, we work, we
play, we pray.
45
Source: Surgeon General discusses health and community. Los Angeles Times. March 13, 2011

46. People Define Health and Wellbeing Beyond
the Absence of Disease
Health Engagement Barometer: Physical, Mental/Emotional, Appearance, Financial
Physical health 94%
Mental/emotional health 91%
Personal appearance/hygiene/self-care 87%
Financial health 82%
Social connections with others 79%
Level of achievement/accomplishment 68%
State of the economy 64%
State of your country 64%
State of your local community 57%
Spirituality 57%
46
Source: Edelman Health Engagement Barometer. October 2008.

47. 47

48. Employers Willing to Spend Money to Boost Employee
Participation in Health Management Programs
Employer-Sponsored Health Plans Survey: (%)
EMPLOYERS PROVIDING FINANCIAL INCENTIVES OR
PENALTIES FOR HEALTH MANAGEMENT PROGRAMS Year
2010
75%
2011
65% 2012
52%
50% 48%
43%
33%
27%
25%
EMPLOYERS WITH 500+ EMPLOYEES EMPLOYERS WITH 10,000+ EMPLOYEES
48
Source: Mercer‟s National Survey of Employer-Sponsored Health Plans.

49. Google‟s Next Headquarters is an Environment That
Fosters Health and Wellness
49
Source: data.qz.com/2013/explore-googles-next-headquarters/#

50. Value-Based Purchasing in Health
50

51. Upping the Ante on Wellness
51
Source: news.xerox.com/news/Buck-Consultants-A-Xerox-Company-Survey-on-Global-Wellness-Programs

52. Wellness Programs Gain Attention
52
Source: www.prudential.com/media/managed/Wellness_Programs_Gain_Attention_Infographic.png

53. The100 Best Companies to Work for Provide for
Wellness on the Job
53
Source: www.greatplacetowork.com/publications-and-events/blogs-and-news/714

54. The More Activated a Patient Is, the Less Their
Health Costs
Patient Predicted Per Ratio of Predicted Costs
Activation Level Capita Billed Costs Relative to Level 4 PAM
Level 1 (lowest) $966 1.21
Level 2 $840 1.05
Level 3 $783 0.97
Level 4 (highest) $799 1.00
Source: Hibbard JH, et al. Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should
54
Know Their Patients‟ „Scores‟. Health Affairs. 32, no. 2 (2013):216-222.

55. 55
Source: relevantlin.com/2013/02/20/health-and-fitness-it-translates-to-work-too/

56. 56
Source: www.ifpma.org/uploads/RTEmagicP_Wellness_infographic.jpg

57. 57
Source: visual.ly/stress-workplace

58. 58
Source: www.hitconsultant.net/wp-content/uploads/2012/12/6-Characters-Rebooting-Medicine-and-Health.jpg

59. Mobile Health Market: A Snapshot
59
Source: www.instant.ly/blog/2013/01/how-mhealth-will-transform-the-health-of-billions/

60. The mHealth Platform Ecosystem
60
Source: mhealthwatch.com/infographic-88-percent-of-doctors-want-patients-to-track-healthcare-at-home-17767/

61. How mHealth is CombatingHIV/AIDS, Malaria and
Other Diseases
61
Source: www.gsma.com/mobilefordevelopment/wp-content/uploads/2012/12/mHealth_MDG6_Infographic.png

62. Download a Health App and Call Me In the Morning
62
Source: healthpopuli.com/wp-content/uploads/2013/02/eclinicalworks-infographic.jpg

63. Envisioning the Future of Health Technology
63
Source: www.hitconsultant.net/wp-content/uploads/2012/09/Envisioning-The-Future-of-Health-Technology-Infographic.png

64. Get Moving!
64