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Richard Smith: “Wellness,” an emerging market

21 Jan, 11 | by BMJ Group

Richard SmithWellness, whatever it might be, is an emerging market, and there is serious money to be made. This was the main message from last night’s meeting of the Cambridge Health Network, a thriving network where men in expensive suits and smartly dressed women, most of whom are consultants and CEOs of companies, mix with public servants and social entrepreneurs, some of them in pink jumpers, to grow wise, feel the pulse, and do deals. It has an atmosphere wholly different from the worthy world of public health.

Wellness might be described as the “upstream part of health care,” and, as we all know “health care” means “sickness care”–just as the “defence industry” is actually the “war industry.” The wellness market is a collection of products and services designed to avoid ill health but also to keep you young, beautiful, thin, sexy, and feeling good about yourself.

It may not be easy to define wellness or measure the size of the market, but the network is sure that it’s growing. There are four main drivers. Firstly, there is the rising tide of morbidity, particularly obesity and diabetes. Secondly, consumers are pursuing wellness. Almost half the population is trying to lose weight. Gyms are busy. Sales of fruit, vegetables, vitamins, and health supplements are soaring. Thirdly, employers are becoming very keen on wellness programmes to reduce absenteeism and increase productivity. Fourthly, there is an increasing amount of technology to support the pursuit of wellness. These new entrants are good at empowering and boosting consumers to pursue wellness, people agreed, whereas doctors despite their best intentions are mostly disempowering.

There was debate about whether the government’s intended spending of £3 billion on health and wellbeing would also grow the market. These business folks were generally sceptical, preferring to rely on people paying for themselves. There seemed to be agreement, however, that it was a good thing that these funds had been shifted from the NHS to local authorities because local authorities had more levers to pull to improve health and because the NHS should “stick to its knitting of treating illness.” “General practitioners,” said one observer, “are not really about primary care. They are the first line of secondary care. People don’t go to them and say ‘Keep me healthy, doc.’”

Nuffield Health, most of whose income comes from private hospitals, took the strategic decision in 2005 to pursue the wellness market and acquired a chain of gyms in 2007. They are also very active in the employee wellness market and have created a whole new profession of wellness practitioners. They have trained 200 “wellbeing advisers” who can graduate to become “wellbeing physiology practitioners.” Traditional health services, they observe, don’t seem to be interested in wellness. To avoid the charge of being simply about the well off they have introduced bursaries and tried to interest GPs and PCTs. Few GPs were interested, and an invitation to all the PCTs didn’t produce a single reply.

 The meeting heard as well from social enterprises—MEND and Participle– who are working with people who are not necessarily well off, but, Stanford Business School graduate that I am, I imagined how one of my many left wing public health friends would feel about the meeting. “Appalled” is probably the word. Their conclusion might be: “All this stuff is OK for making a fast buck from the young and well off but will have minimal impact on the overall population, particularly the poor, in an obesogenic environment where a whole range of social determinants are driving ill health.”

But I’m a “big tent guy.” I wish that there were more meetings where everybody—from CEOs of big companies to the most left wing of trade unionists—got together to talk about and act on these issues.

Competing interest: RS is employed by the UnitedHealth Group, a “health and wellbeing company.” He’s also a fellow of the Faculty of Public Health, although he hasn’t paid his fees for a few years and they don’t seem to have noticed. In addition, he is an unpaid trustee of C3 Collaborating for Health, an organisation that promotes prevention of chronic disease and believes in bringing all parties together.

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  • Julian

    Among nutritional supplements, is the oil of the evening primrose back in, or stll out?

  • Joanne Shaw

    Did anyone point to an evidence base on wellness programmes reducing absenteeism and increasing productivity?

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