-Adherence to multiple lifestyle-related healthy behaviors has been associated with positive health outcomes.

-Adherence to 4 specific behaviors is of interest and we refer to this cluster as the “optimal lifestyle metric” (OLM):
1. Non-tobacco use
2. Being physically active
3. Eating five fruits and vegetables each day
4. Moderate use of alcohol

-OLM addresses close to 40% of the actual causes of death in the United States in 2000.
-OLM behaviors cluster and show a significant degree of inter-correlation.

-Adherence to OLM behaviors has been associated with:
1. Improved functional health
2. Increased compliance with clinical preventive services
3. Lower overall mortality (14 years)
4. Lower cause-specific mortality (cardiovascular causes)
5. Increased longevity
6. Lower 11-Year incidence of stroke
7. Lower 8-year incidence of other chronic conditions:
~Diabetes 93%
~Myocardial infarction 81%
~Stroke 50%
~Cancer 36%

-Despite its association with positive health outcomes, OLM adherence is low in the population:
~Between 3% and 6% in the U.S. population
~Approximately 3% in the HealthPartners health plan population (based on Clinical Indicator Report)

-Given its potential to impact overall and more specific indicators of health, it is worthwhile to investigate how adherence to multiple health behaviors as quantified by OLM impacts incidence of chronic conditions.

•For employers, this impact should be considered in the short-term, i.e. 2-year incidence.
•An improved understanding of the short-term impact of OLM on new diagnoses will support health policy and resource allocation decisions. This may be especially true for employers and health plans.
•The purpose of this investigation was to study the association between OLM adherence and short-term, 2-year incidence of chronic conditions among adult
employees.

Conclusions:

Short-term, 2-year impact of OLM adherence on incidence of chronic conditions indicates significant health benefits:
1. Adherence to the PA component of OLM reduces incidence risk by:
~40% for heart disease
~19% for high cholesterol
~49% for diabetes

2. Adherence to 3 of the OLM components reduces incidence risk by:
~44% for diabetes
~31% for back pain

Adherence to all 4 of the OLM components reduces incidence risk by:
~56% for back pain

As adherence to OLM components improves, dramatically lower short-term, 2-year incidence rates of chronic conditions are noted
~Rate reductions observed range between 15% for hypertension and 66% for diabetes, respectively

•The reductions appear to occur in a dose-response manner.
•Employers and health plans should consider the impact of OLM on prevention of disease when making resource allocation decisions on strategies for cost containment and setting health policy.
•Results of this study support the value proposition of primordial and primary prevention in health care cost
containment and health care affordability.