Wayne N Burton

• MD
• Professor (Adjunct) at University of Illinois Chicago

Lifestyle medicine uses evidence-based therapeutic changes to address lifestyle factors that impact health, performance, and injury risk and recovery. This guidance is for occupational health professionals to address tobacco, substance misue, nutrition, physical activity, overweight/obesity, sleep, mental wellbeing and social connectedness in the c...

Lifestyle Medicine (LM) utilizes evidence-based therapeutic lifestyle changes to address lifestyle factors that impact health, performance, and injury risk and recovery. By integrating LM principles into clinical care, workplace policies, and programs, along with other evidence-based methods, occupational and environmental medicine clinicians and m...

Objective: To compare employees of a US school district based on their social determinants of health (SDoH). Methods: Employees (N = 5006) were categorized into low, medium, or high need SDoH tiers. Of them, N = 2469 also participated in a health risk appraisal in 2019. Subjects' average healthcare costs, health risk factors, and self-rated job...

Objective To understand the needs and interests of occupational medicine physicians (OMPs) as they transition to retirement. Methods An electronic survey was distributed through member organizations in the US (ACOEM), UK (SOM/FOM), India (IAOH), South Africa (SASOM), and Medichem. Results 497 OMPs at various career stages responded, including 282...

The role of the Corporate Medical Director (CMD) has received increased attention during the COVID-19 pandemic and has continued to evolve. This updated guidance addresses the role and value of the CMD in: health policy, strategy, and leadership; fostering a culture of health and well-being; supporting worker health and productivity/performance; ad...

The role of the Corporate Medical Director (CMD) has received increased at- tention during the COVID-19 pandemic and has continued to evolve. This updated guidance addresses the role and value of the CMD in: health policy, strategy, and leadership; fostering a culture of health and well-being; supporting worker health and productivity/performance;...

The role of the Corporate Medical Director (CMD) has received increased attention during the COVID-19 pandemic and has continued to evolve. This updated guidance addresses the role and value of the CMD in: health policy, strategy, and leadership; fostering a culture of health and well-being; supporting worker health and productivity/performance; ad...

Objective Knowledge of health-related employer benefits is considered a core competency by the American College of Occupational and Environmental Medicine (ACOEM). This study seeks to understand how this translates into practice. Methods An electronic survey was e-mailed to members of: ACOEM Corporate Medicine and Health and Human Performance Sect...

Objective: Demographics, health risks, pharmaceutical utilization, and other characteristics of adults with and without migraine who were employed by a school district in the southern U.S. were compared. Methods: 4528 employees completed a health risk appraisal. A diagnosis of migraine was reported by 11%. Employees with and without migraine wer...

Objective: Migraine affects about 15% of the world's population and disproportionately affects adults who are working age. It is associated with higher healthcare costs, absenteeism, and lost productivity. A metropolitan school district in the southern U.S. offered a virtual migraine education program to their teaching employees. Methods: Sevent...

Objective: This study examined demographics, health risks and conditions, preventive services, and health care experiences of lesbian, gay, bisexual, transgender, or questioning (LGBTQ) adults who are employed in the United States. Methods: Male and female gay, lesbian, or bisexual employees (N = 1191) from seven companies participated in an onl...

Many people spend years dreaming about their retirement. Unfortunately, today’s workers will likely work longer, suffer greater economic uncertainty, and might have poorer health status compared with retirees in previous generations. Preserving good health during the working years is associated with a more consistent employment record, greater fina...

Objective: Higher risk for developing severe forms of COVID-19 has been associated with health risk factors and medical conditions which are common among workers globally. For at risk workers, return to work may pose unique risks which require protective policies and procedures. Methods: A review of the medical literature was conducted on health...

A significant amount of illness has origins in oral microorganisms. The current SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has reduced the general population’s access to and use of routine and nonemergency dental care. This creates a dangerous situation in which oral bacteria, fungi, and viruses may remain unchecked and a...

This blog post argues that the COVID-19 pandemic has made necessary a much more proactive approach to advancing social connection. This approach needs to balance high-bar scientific prerequisites and the plight of the afflicted in the here and now.

The issue of employee productivity has become a major concern for companies. Inefficiency can occur at every stage of production either as poor design, worker limitation, or other factors. It is generally assumed that a healthy worker is more productive than an unhealthy worker. As early as 1776 Adam Smith observed and published in The Wealth of Na...

This post argues that "social distancing" is a mixed message that is hindering the uptake of pandemic guideline-appropriate behaviors. Use of the term, "Physical distancing, social connection", is not only more accurate. It will ultimately be more effective at promoting the behaviors needed to "flatten the curve" of new COVID-19 cases.

The cost of medical care in the United States is increasing at an unsustainable rate. The lifestyle medicine (LM) approach is essential to influence the root causes of the growing chronic disease burden. LM addresses health risk factors in primary, secondary, and tertiary prevention of developing disease rather than limiting resources and medical e...

The cost of medical care in the United States is increasing at an unsustainable rate. The lifestyle medicine (LM) approach is essential to influence the root causes of the growing chronic disease burden. LM addresses health risk factors in primary, secondary, and tertiary prevention of developing disease rather than limiting resources and medical e...

BACKGROUND: This study describes the effects of common health conditions associated with absenteeism and presenteeism in a population-based sample of workers in Brazil. METHODS: Data were analysed from the cross-sectional São Paulo Megacity Mental Health Survey on 1,737 employed residents aged >18 years old conducted from 2005 to 2007. RESULTS: P...

: The role of the corporate medical director (CMD) has evolved over the last 300 years since Ramazzini first identified diseases of Italian workers in the early 1700 s. Since then, there has been a gradual blurring of the boundaries between private and workplace health concerns. Today's CMD must have intimate knowledge of their corporation's indust...

Objective: To conduct a comprehensive literature review to develop recommendations for managing obesity among workers to improve health outcomes and to explore the impact of obesity on health costs to determine whether a case can be made for surgical interventions and insurance coverage. Methods: We searched PubMed from 2011 to 2016, and CINAHL,...

Introduction: Employee engagement is a key factor in work performance and employee retention. The current study seeks to examine the relationship between employee engagement and health risks and productivity. Methods: In 2012, employees of a global financial services corporation participated in a health risk appraisal (HRA) which measured employ...

Objective: This study examined differences in health risks and workplace outcomes among employees who utilized preventive dental services compared with other employees. Methods: A retrospective observational study of employees of a large financial services corporation, with data from health risk appraisal questionnaires, medical claims, pharmacy...

Sleep disturbance is negatively associated with workplace productivity. This study sought to identify whether or not changes in sleep from 2012 to 2013 were associated with changes in health risks, medical conditions, or workplace economic outcomes. Employees of a Fortune 100 financial services corporation were categorized based on changes in self-...

Health and health care in the United States are being jeopardized by top-end spending whose share of the gross domestic product continues to increase even as aggregate health outcomes remain mediocre. This paper focuses on a new approach for improving stakeholder role performance in the marketplace, value-driven population health (VDPH(SM)). Devote...

Objective: Poor sleep can impact occupational functioning. The current study examines health risks, medical conditions, and workplace economic outcomes associated with self-reported hours of sleep among employees. Methods: Employees of a global financial services corporation were categorized on the basis of their self-reported average hours of s...

Introduction: Poor sleep is common among working adults. Chronic sleep deprivation is associated with health problems. A healthy sleep educational program (using webinars and other intranet-based resources) was offered to employees of a financial services corporation. Methods: In 2015, a total of 357 employees (50% completion rate) completed bot...

Objective: Migraine affects approximately 10% of working-age adults and is associated with increased health care costs, absenteeism, and presenteeism in the workplace. A migraine education program was offered to United States employees of a global financial services organization. Methods: Two hundred forty three employees (46% response rate) com...

This study is an analysis of a workplace diabetes management program offered to employees of a Fortune 100 financial services corporation located in the United States. The 12-month worksite-based educational program was for employees who were at risk for diabetes, had prediabetes, or were diagnosed with diabetes. This employed population, with heal...

Up to 84% of the general population has been found to report low back pain (LBP) at some point during their lifetime. This session focused on a recent study by a major self-insured employer to cultivate evidence on issues key to a successful program focusing on illness/injury prevention, reduction of workers’ compensation claims, and disability and...

To better understand how integrating health and safety strategies in the workplace has evolved and establish a replicable, scalable framework for advancing the concept with a system of health and safety metrics, modeled after the Dow Jones Sustainability Index. Seven leading national and international programs aimed at creating a culture of health...

Objective: To examine employees' self-reported physical activity and metabolic syndrome (MetS) risks and their association with health-related workplace outcomes. Methods: Employees participated in a health risk appraisal in 2010. Generalized Linear Modeling was used to test the association between MetS risk factors, physical activity, and the o...

Consumer-directed health plans (CDHPs) are popular among employers in the United States. This study examined an employee wellness program and its association with employee health in an organization that recently initiated a CDHP. This retrospective observational analysis compared the health risks, employer-paid health care costs, and short-term dis...

There is an increasing awareness among employers and health care providers that health care needs to be tailored to address the diversity of the workforce. Population-based data have shown significant differences in health behaviors and health risks among different racial/ethnic groups in the United States. The purpose of this study was to examine...

To investigate predictors of behavior change intention and discuss potential implications for practitioners. Health risk appraisal (HRA) data from 2 organizations were used to develop and confirm a path analysis model for predictors of intention to change behavior. Lower self-rated health perception and higher ratings of stress corresponded to high...

Objective: To explore issues related to the aging workforce, including barriers to integrating health protection and promotion programs, and provide recommendations for best practices to maximize contributions by aging workers. Methods: Workgroups reviewed literature and case studies to develop consensus statements and recommendations for a nati...

Physicians and businesses share a common goal—to advance better health. Employers are finding that it makes business sense to promote workforce health and productivity, recently linked to $576 billion in costs due to medical and pharmaceutical use, lost productivity, and wage replacement.1 Many medium- and large-sized employers, motivated by their...

Abstract The objective of this study is to describe briefly the burden of dyslipidemia, and to discuss and present strategies for health professionals to improve dyslipidemia management, based on a review of selected literature focusing on interventions for dyslipidemia treatment adherence. Despite the availability of effective lifestyle and pharma...

This keynote session juxtaposed a recent private sector case study linking attention to indirect cost measures with striking reductions in total health burden on one hand with, on the other, the omission of indirect cost measures from the framework that the Center for Medicare & Medicaid Services recently issued in its Final Rule for evaluating ACO...

Quantify the incremental health care costs and workplace absence and short-term disability costs, to payers and employers, of patients hospitalized for acute coronary syndrome (ACS). Retrospective study using medical insurance claims for the years 2002 to 2007. Patients were aged 18 to 64 years and hospitalized for ACS between January 1, 2003, and...

Bernardino Ramazzini, the father of occupational medicine, recognized the association of the health of workers and their on-the-job productivity in his book Diseases of Workers, published in 17131. Productivity loss associated with workers is related to time off work, termed absenteeism, and decrements in on-the-job productivity, termed presenteeis...

To develop a claims-based scale for treatment-resistant depression (TRD) and estimate the associated direct cost burden. Retrospective, observational study of patients receiving antidepressant therapy between January 2000 and June 2007 (N = 78,477). The Massachusetts General Hospital (MGH) clinical staging method for treatment resistance (assigning...

Statin medications are recommended for patients who have not achieved low-density lipoprotein cholesterol (LDL-C) goals through lifestyle modifications. The objective of this retrospective observational study was to examine statin medication usage patterns and the relationship with LDL-C goal levels (according to Adult Treatment Panel III guideline...

Evidence suggests that migraine is associated with decreased productivity. This article describes the results of a systematic literature review of peer-reviewed publications that measured the impact of migraine on workplace productivity in the United States and provides recommendations for future research. A MEDLINE search was conducted from Januar...

Evidence suggests that migraine is associated with decreased productivity. This article describes the results of a systematic literature review of peer-reviewed publications that measured the impact of migraine on workplace productivity in the United States and provides recommendations for future research. A MEDLINE search was conducted from Januar...

Objective: To estimate the direct medical and indirect (absenteeism and short-term disability) cost burden of Crohn's Disease (CD) and Ulcerative Colitis (UC). Methods: Data were obtained from 1999 to 2005 MarketScan databases. Twelve-month expenditures for patients with CD and UC were compared to expenditures among an equal number of propensity sc...

To investigate the prevalence of metabolic syndrome in an employed population and its association with health risks, health perception, illness days, work limitation (presenteeism), and short-term disability (STD). Five thousand five hundred twelve employees of a financial services company responded to an on-site health risk appraisal which include...

To examine the association of a three-tier pharmacy benefit plan with prescription drug spending and utilization, employee health status, and short-term disability (STD) absences in a large financial services corporation. Retrospective observational study of approximately 17,000 employees enrolled in the company's pharmacy benefit plan in anyone ye...

To estimate the direct medical and indirect (absenteeism and short-term disability) cost burden of Crohn's Disease (CD) and Ulcerative Colitis (UC). Data were obtained from 1999 to 2005 MarketScan databases. Twelve-month expenditures for patients with CD and UC were compared to expenditures among an equal number of propensity score matched comparis...

Purpose – Depression and other mental health disorders have a large impact on the quality of life and productivity of millions of individuals worldwide. For employers, mental health disorders are associated with increased health care costs as well as productivity losses in the form of absenteeism, short‐term disability absences and reduced on‐the‐j...

Depressive disorders are a major health issue in the US workplace. They are responsible for significant direct and indirect costs to the employer in terms of medical and pharmaceutical costs, time absent from work and decreased productivity while on the job (presenteeism). The Corporate Medical Director (CMD) or occupational health physician must b...

The cost of the biological drug abatacept may be partly offset by reductions in the cost of productivity losses due to employee absences and reduced effectiveness at work because of rheumatoid arthritis (RA). This was a 1-year productivity cost model based on epidemiologic and economic data. The setting was private industry in the US and the primar...

To evaluate the relationship between antidepressant medication adherence and short-term disability (STD) in an employed population. Retrospective observational cohort study of 2112 employees with a new episode of treatment with an antidepressant medication (selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors). Bo...

The objective of this study was to assess the association between body mass index and short-term disability in a working "white collar" population. The authors collected cross-sectional data from 19,061 health risk appraisals completed by employees of a large financial services corporation from 2000-2002. The self-reported information for demograph...

This study at a major financial services corporation sought to investigate the association of arthritis with on-the-job productivity, also termed "presenteeism." Using a modified version of the Work Limitations Questionnaire (WLQ) incorporated into a Health Risk Appraisal (HRA), 17,685 employees responded to the survey in 2002. Of the 16,651 respon...

This prospective study investigates whether changes in health risks are associated with changes in presenteeism (on-the-job productivity loss). A total of 7026 employees of a national financial services company responded to a health risk appraisal (HRA), which included a modified version of the Work Limitation Questionnaire (WLQ) in both 2002 and 2...

The objectives of this study were to estimate medical expenditures, absenteeism, and short-term disability costs for workers with rheumatoid arthritis (RA) and to estimate the relative costs of RA over a 12-month period. Using data from nine U.S. employers, direct and indirect costs for 8502 workers with RA were compared with costs for a matched gr...

Rheumatoid arthritis (RA) is a chronic, debilitating disease with a significant impact on workplace productivity. To perform a systematic review of studies of the relationship between RA and reduced workplace productivity. Screening of 307 titles identified in bibliographic database searches resulted in 38 articles subject to systematic review. Pro...

Decreased on-the-job productivity represents a large yet poorly characterized indirect cost to employers. We studied the impact of employee health risk factors on self-reported worker productivity (presenteeism). Using a brief version of the Work Limitation Questionnaire incorporated into a Health Risk Appraisal, 28,375 employees of a national comp...

We sought to examine the associations between participation in a worksite fitness center and worker productivity. A modified Work Limitations Questionnaire (WLQ) and employees' short-term disability claims were used as productivity measures with multivariate logistic regression models to control for health risk, age, gender, and work location. Nonp...

This study examined the loss of productivity and health risk status associated with employees who provide care for an ill dependent. A total of 16,651 employees (23% response rate) of a major financial services company completed a confidential Health Risk Appraisal (HRA) that included an eight-item version of the Work Limitations Questionnaire and...

The purpose of this study was to examine the relationship of health risk level to charged medical costs and determine the excess cost of higher risk individuals compared to low risk. Two years of medical claims from six corporations were used to determine costs of health risk assessment (HRA) participants and nonparticipants. A total of 165,770 emp...

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A self-reported measure of four domains of work impairment based on the Work Limitations Questionnaire was completed by 16,651 employees of a large financial services corporation. Using a multivariate model to control for coexisting conditions, age, and gender, significant relationships were observed between medical conditions and patterns of impai...

Corporations have engaged in sponsorship of health management programs and, more recently, disease management programs to facilitate healthy and productive work environments. The purpose of this review is to examine the health and financial outcomes from these corporate-sponsored disease management programs. This article focuses on seven diseases o...

This study demonstrates the relationship between self-reported health risk factors on a health risk appraisal and pharmaceutical expenditures for a large employer. A total of 3554 employees who were participants in a pharmacy benefit plan for the entire year of 2000 completed a health risk appraisal. As the number of self-reported health risk facto...

Many chronic illnesses that affect the working population can cause losses in productivity. The extent to which these productivity losses can be reduced by pharmacological treatment is of particular interest to employers, who bear the productivity costs and subsidize the cost of employees' health care. In the past several years, the effects of phar...

The executive physical examination has been advocated in the United States for almost 100 years. A MEDLINE search of the literature found very few studies that document the potential impact of a worksite physical examination program on medical and disability costs. Bank One has performed executive physical examinations at its corporate headquarters...

The executive physical examination has been advocated in the United States for almost 100 years. A MEDLINE search of the literature found very few studies that document the potential impact of a worksite physical examination program on medical and disability costs. Bank One has performed executive physical examinations at its corporate headquarters...

Large, epidemiologic survey studies have established that migraine headaches affect approximately 6% of men and 18% of women in the United States and that the condition peaks during the prime working years (25 to 55 years of age). The consequent economic burden experienced by employers is substantial. The majority of this economic burden is realize...

Diabetes mellitus (DM) affects approximately 5.9% of Americans and was estimated in 1997 to account for $44 billion in direct and $54 billion in indirect costs. The average annual medical care cost in 1992 for a person with diabetes was $11,157 versus $2,600 for a person without diabetes. The Diabetes Control and Complications Trial (DCCT) demonstr...

Non-occupational asthma is a common disease affecting approximately 6% of the US population. Asthma accounts for an estimated 3 million workdays lost each year in the United States and for reduced employee job productivity. Although asthma disease management programs are relatively common in managed care organizations, they generally have not been...

Asthma accounts for an estimated 3 million workdays lost each year in the United States in addition to reduced worker productivity. Although asthma disease management programs are relatively common in managed care organizations, they have generally not been offered at the workplace. Seventy-six employees participated in a five-session worksite-base...

Allergic disorders are a chronic and highly prevalent condition in the general population and the workforce. Their effect on workers and corporate costs go beyond the direct cost of treatment, as the condition can lower a worker's productivity. Previous research includes estimates of the decrease in productivity associated with allergic disorders....

Migraine is a highly prevalent, nonfatal disorder typically characterized by recurrent episodes of headache associated with such symptoms as nausea, vomiting, photophobia, phonophobia and impaired functioning. The attacks may be infrequent and relatively mild; more often they are frequent, severe and disabling. They are 3 times more common in women...

This study describes a proactive in-house program for managing short-term disability (STD) in the workforce of a very large banking system. The goals of this program were to (1) minimize the personal and economic impacts of STD by early intervention, (2) validate the extent and duration of STD, and (3) coordinate medical services and provide guidan...