Global Health TrendsRebecca H. MejiaPublic Health Manager

The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES

AGENDAMarch 14 2019

• The Filipino Seafarer• The Determinants of health & Wellbeing• Global Health Trends• Re:fresh Health Risk Assessment• Health Promotion

Global Claims Data

Heart is #1 illness type for Ph Seafarers 2018

Compound Annual

Growth Rate

2008-2017CAGR

The Root Causes of NCD’s

NCD = Non communicable disease (lifestyle related)

USD pent – split in% (Ph seafarer)Inf: 7%Non-inf: 30%Lifestyle related: 63%

The cause behind the causeWhat areas can we address?

63% of global deaths yearly.

48%21%12%3.5%

NCD Mortality

Dea

ths

per

ye

ar

36 M

2008

44 M

2020

52 M

2030

TobaccoInactivityAlcohol

Diet

Estimated deaths by non communicable diseases (lifestyle related) by 2030.

Health Expenditure by Country

TypeDelta1994-2015

X2

Highincome

X6

MiddleIncome

X4

Lowincome

Health related expenses have grown x6 in countries like the Philippines between 1994-2015.

Factors influencing health and spending

Determinants of Health and MLC 2006Maritime Version of whatdetermines H&W for a seafarer.Non-medical causes of illness.

Wellbeing

INDIVIDUAL ENVIRONMENT

…a state of complete physical, mental and social well-being

and not merely the absence of disease or infirmity - WHO

TheJourney

Re:fresh2018 India

3,712 seafarers

2016 Philippines

2,405 seafarers

BMIWHO 2008 / 2010

24.54

Less than 18.5 18.5 - 22.9 23.0 - 24.9 25.0 - 29.9

Waistto

Height

Ratio1%

OK OW OB

23% 76%

TIME ON RISK: 2 YEARS 23 DAYS

CalorieIntake

3,2641,600

BMR

600

Activity

Excess1,064

TDEE

DietpH Level based on food frequency intake

5.53

Our ideal pH level should be slightly alkaline: 7.30 to 7.45 .Basically, an imbalance of pH in the body allows diseases and illness to take root, primarily if your body is tooacidic. To make it easy; eat real food, as close the it’s natural form as possible. Stay away from highly processedfood (chips, fries, coke, sausage, factory made cookies, etc. and increase vegetable and fruit intake. Reduceprocessed carbohydrates in the form of bread, cakes, pasta & rice.

Diet then and now

9 meals/day3.4 meals/day

90% not ok

10% OK

WtH

R: 7

3-9

1%

WtH

R: <

60

%

Blood Pressure

40.6%

10.0%

37.9%

9.1%

2.3%

37Expected Fitness Level 49 VO2 MAX

ActualFitness Level 47 VO2 MAX

43

FitnessCalculator

This indicates 40% higher risk of dying from cardiovascular disease the next 20 years than if the

seafarer had an expected fitness level or higher.

LEVEL 85%

FoodFor

Thought

IN RELATIONTO OBESITY

31% Higher probability forworkrelated injuries / accidents

6 D Reduced productivityequaling 6 days

3 D Additional 3 days absent from work

ays

ays

300 For ship owners with Filipino CrewMill USD in extra annual costs

The part can never be well

unless the whole is well.

Plato

StressDepressionHappiness

SatisfactionFloweNPS

700 million people globally are estimated to have a mental disorder.

Stress

26.0

21.0

16.0

11.0

6.0

Global: 13.0

Indian Seafarer: 19.1

Indian Officer: 20.0

Indian Ratings: 18.0

Stress

19.1

19.0

Stress

All Well

Mild

Depress

ion

Moderate

Depression

Severe

Depression

88%

12%

Depression88% all well12% Mild to moderate

92% all well7% Mild to moderate

1 IN EVERY 2 SHIPS

DepressionMonths onboard

Result: Depression is relatively stable from 0 to 9 months onboard, but is growing exponentially from 10 months.

FLOW

The Balance betweenSkills and Challenges

A person in Flow is happy, motivated, focused, and in control. Usually, they perform 5 times better and are less prone to risks.

35%

42%

23%

When challenges and skills are out of balance, 65% pose some kind of risk.

0.2%

77%

71%

63%

62%

EmployeeSatisfaction

Index

DETRACTOR PASSIVE PROMOTER

0-6 7-8 9-10

13% 37% 50%37% or

8.2

18% 39% 43%25% or

8.0

17% 39% 44%27% or

8.0

eNPS – Employee Net Promoter ScoreCompany Ambassador

Employee Net Promoter

Score eNPS

Company ambassador

PROMOTER

• Happier• Less stressed• Less depressed• Sleep better• Exercise more often, longer and

harder• Are more fit – lower fitness age• Enjoy their work more• More productive• Less lonely• Less overall worries• Less heart issues• Promoters take care of their

health

Have been RepatriatedCorrelation Coefficient to eNPS: -98%

Repatriation

For Individual Company, the correlation coefficient is -35%

eNPS

SubjectiveHappiness

If FILIPINO Seafarers were their own nation,they would rank # 5

5.24

Other Concerns - IndustryFeelings of loneliness, social relationships activities on board

13% are lonely36% feel they don’t have anyone to talk to48% feel they need more group activities onboard.

Social MediaSocial Media Platforms Used

99% have a smartphone

Working days: 2 hrsOff days: 4 hrs

Social relationships are crucial for

survival.

Lack of social connection is a risk factor for premature mortality.

NOW WHAT?

The Cause behind the

Cause

Health Expenditure and GDPWhen the change in HE% > GDP%->> it makes sense to invest in health

WORLD BANK

An ounce of prevention is

worth a pound of

cure.

Thomas Edison

Health Promotion at the WorkplaceHealth as an Investment

Health is not valued until

sickness comes

Prevent the preventable

Practical Tips

Successful Initiatives

FROM EXPERIENCE:• Require a hobby• Fun Sunday• Regular & organized

physical activites• Music• Limit WiFi – time & space• Healthy food – limit junk

food – brown rice• Group activites – both

fun and work• Psychological test – PEME• Create meaning• Be proud of job –

abandon victim mentality

THANK YOU!

Sum-upBack to BasicsSo simple yet so difficult