Prolonged Sitting: Current Concepts on the Physiological Effects of Seated Postures at Work

Preventable lifestyle diseases are on the rise. Obesity, diabetes and heart disease have become more prevalent, placing an enormous strain on the U.S. healthcare system (Hammond & Levine, 2010). According to CDC (“Overweight”), in 2012 more than one in three Americans was obese, up from 15% in the 1960s. During the late 1970s, the percentage of Americans who were overweight was a little more than 40%; today it is estimated at more than 70%. Similarly, diabetes incidence has risen dramatically during the same period and is predicted to exceed 30% of the population by 2050 (American Diabetes Association, 2013). The rise in obesity, diabetes and cardiovascular disease has affected the U.S. on many levels. From poor health outcomes and quality-of-life indicators to medical expenses, the rise in preventable diseases has taken a heavy financial and social toll. The U.S. spent 17.9% of it gross domestic product (GDP) on healthcare in 2011, a figure that is expected to grow 4.2% in 2012 and 7.4% in 2014. From 2015-21, the expected rate of increase in healthcare spending is projected to average 6.2%. This will not keep pace even with an estimated GDP growth rate of 3.8% (CMS, 2012). The treatment of obesity and overweight-related illness consumes a significant amount of the nation’s medical costs (Cawley & Meyerhoefer, 2012; Lehnert, Sonntag, Konnopka, et al., 2013). The direct medical cost associated with obesity has been estimated by Finkelstein, Trogdon, Cohen, et al. (2009) to comprise more than 9% of total U.S. healthcare expenditures. Diabetes creates an even greater financial burden on the country’s healthcare system; American Diabetes Association (2013) estimates that in 2012 diabetes-related healthcare expenditures topped $240 billion. In 2010, the average health plan in the U.S. cost more than $5,000 for an individual and more than $13,000 for a family, 66% of which was provided as an employee benefit (Kaiser Family Foundation, 2013; National Center for Health Statistics, 2011). Private health insurers and consumers are not the only ones affected by the rise in preventable diseases. This trend has also had significant ramifications for employers. Research evidence strongly supports a correlation between obesity and workers’ compensation costs, lost workdays and increases in costs per work-related injury (Finkelstein, Fiebelkorn & Wang, 2005; Thompson, Edelsberg, Kinsley, et al., 1998; Tucker & Friedman, 1998). The Duke Health and Safety Surveillance team found that employees with body mass index (BMI) scores greater than 40 were almost twice as likely to experience a work-related musculoskeletal disorder (Ostbye, Dement & Krause, 2007). Self-insured employers also face higher costs related to claims that fall outside of the workers’ compensation system. Durden, Huse, Ben-Joseph, et al. (2008), found that private health insurance claims positively correlated with obesity and high BMIs for self-insured employers. They found that as workers’ BMI increased so did their usage of medical services outside of work for various medical conditions. In addition to injury rates and medical costs, worker weight, obesity and diabetes can reduce productivity and cause lost workdays (Bungum, Satterwhite, Jackson, et al., 2003; Ricci & Chee, 2005). Gates, Succop, Brehm, et al. (2008), reported a decrease in productivity for those with a BMI greater than 35 that equated to $507 per worker. IN BRIEF •Preventable lifestyle diseases such as cardiovascular disease, diabetes and obesity are on the rise throughout the U.S. •Evidence suggests that sitting may affect many such disorders. The shift toward more sedentary, computer-based work and away from manual labor may be combining with an increased amount of sitting during leisure hours to adversely affect public health. •The business and healthcare communities have begun to combat the adverse health effects of sitting by raising awareness of the issue and encouraging increased physical activity in the workplace and at home. This article reviews literature on the topic and describes potential solutions.