In the wellness industry, 2018 is ending just like it began: Vendors Behaving Stupidly.
Along with about 12 other need-a-lifers, we traditionally attend a “Nerd-a-Thon” on New Years Eve (tonight), where we play board games, including home Jeopardy. One Jeopardy answer might be:
A: “Roughly 3 seconds.”
The correction question would be:
Q: “What is the length of time required for a beam of light leaving intelligence to reach Interactive Health?”
Yes, Interactive Health is ending the year just as they began it, by setting new standards for cluelessness. They started the year by offering unsuspecting and no doubt somewhat befuddled employees a “smoking recession program,” and are ending it by proving that their 2017 and 2018 Deplorables Awards were well-earned.
Here is their posting:
Let’s look at it carefully. They crammed four mistakes/fallacies, plus a unique hashtag (#HealthareCosts) into two lines. First, anemia is not “33% more likely” among women under 45. To the contrary, if they had wanted to step out of character and make an actual true statement, it would have been pretty much the opposite: “Women 15 to 40 are 26% less likely to be anemic than women 40 to 69.”
Perhaps this information will come as much of a surprise to them as it did to me — the difference of course being that I didn’t just post the opposite to 12,162 chronically misinformed followers.
There is an asterisk in case anyone is keeping score at home — pregnant women of any age are at higher risk for anemia. That is the most clinically significant factoid about anemia in the working-age population, a factoid which naturally Interactive Health overlooked. One of their specialties is finding issues that don’t exist while overlooking issues that do. Another one of their specialties is posting random statistics on Linkedin that even a college intern could debunk. Or hyperventilating that the number of cases of Alzheimer’s is expected to double by 2060 without mentioning that the senior population as a whole is expected to double by that year as well. They also claimed that there was a dramatic increase in heart attacks, but in reality the actual rate is about half what it was 40 years ago.
Another possibility is that this anemia data isn’t a surprise at all to them. They are aware of it (it is pretty easy to come by), but telling the truth would have undermined their new revenue enhancement strategy, which is to convince companies to screen the stuffing out of millennials, by “debunking” the “commonly held misperception” that you should adhere to well-resesarched, widely accepted, official US Preventive Services Task Force (USPSTF) clinical guidelines, guidelines which say, unsurprisingly, that you should definitely not screen the stuffing out of millennials.
Second, it doesn’t cost $10,000/year to treat iron-deficiency anemia. It costs about 5-10 cents a day, or $36.50 a year. So Interactive Health is off by a factor of 300. That’s a lot even for them.
Oh, wait, maybe they were talking about hospitalizations for anemia, not garden-variety anemia. Hospitalizations would cost $10,000 or more. However, in the immortal word of the great philosopher Rick Perry, Oops. Looks like young women have far fewer hospitalizations than older women:
To help Interactive Health interpret this data since apparently they could use some assistance, 32.1 admissions per 100,000 women 18 to 44 means 0.3 admissions per 1000 female employees in that age bracket.
In other words, nobody. The average company with 20,000 to 40,000 total employees of normal age and gender distribution would probably have 1 admission for anemia.
And we would bet that whoever is hospitalized for anemia already knew they had anemia before Interactive Health started harassing them. My guess is most of these admission longshots would be either complications of pregnancy or anemia of unknown origin, or a rare disease.
Third — no surprise given that statistic — the USPSTF does not recommend lining up women to be screened for iron-deficiency anemia. (Even for pregnant women, who are at much higher risk than non-pregnant women, they find insufficient evidence to screen them.) “Hunting for disease,” which my colleague Alan Cassels has written extensively about, is rarely a good idea, and this is no exception — which is one reason it isn’t recommended.
Finally, why screen for something that you can’t easily address if someone fails the screen? The other reason it isn’t recommended is that iron supplements for women who are technically anemic but have no symptoms also aren’t a good idea. Liquid iron, like this…
…can, among its many other charming attributes, blacken your teeth. (The good news is that, as the label says, this supplement is gluten-free!) Iron supplementation in general can cause side effects like nausea, vomiting, and diarrhea, while high doses are so downright dangerous that iron pill overdoses are the #2 reason for emergency room visits among all vitamin and mineral supplements.
The good news is, here is another Jeopardy A&Q:
A: “High.”
Q: “What is the likelihood that in 2019 Congress is going to pass a law preventing vendors from penalizing employees who refuse to participate in non-USPSTF-recommended wellness screens like Interactive Health’s?”
They Said What? 
Have you heard Al if any Rep or Senator is preparing to submit a bill?
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Yes but no sense tipping our hand. The language will be pretty unopposable since it’s not anti-wellness in the slightest, only anti-dishonest-wellness-vendor.
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Great. And I wouldn’t want you to tip your hand! :-))
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How do these people stay in business?
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Interactive Health’s customers are even stupider than Interactive Health. I know a few of the smart ones and have already convinced them to switch.
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Very simply Sam – they are making a profit. Aside from stating the obvious, the BELIEFS related to worksite wellness are very strong and run very deep. I would suggest that employers believe they are doing the right thing by their employees because they don’t know any different (and why should they?) Health is not their area of expertise. Secondly, I would argue that most worksite wellness practitioners don’t know any better either. Many have probably never heard of the USPSTF or their recommendations. Early in my career I completed 4 different worksite wellness program certifications and in all 4, I was taught that an annual HRA and screenings were the best practice standard to achieve. It is probably still being taught today to new practitioners. (I am just guessing here…and maybe I am hopefully wrong!)
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Thoughtful comment as always, Bill. But at some point don’t you have to hold people responsible for not doing the occasional internet search? 3-4 years ago, I’d agree with you but now, well, so much stuff has been in the news about the epic fail of wellness that it’s poor job performance not to check it. Like before choosing Wellsteps, google on Wellsteps? (That is unfortunately the only vendor where They Said What appears on the front page.)
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In an ideal world Al what you say is true. But as I stated, worksite wellness beliefs are strong and run deep. I have had colleagues tell me that they have either blocked you and Jon or just ignore you both because they are tired of the constant negativity and name calling. Unprofessional on their part? Maybe. But I understand it. It is called survival. I am fortunate in that my survival is not dependent upon my needing to sell a worksite wellness related product or service. My 35 years in government service took care of that for me. This gives me the opportunity to be a little more open minded I hope. While we may not always agree Al, there is no doubt that you, my CORA certification and Jon have influenced my thinking a lot, especially after drinking all the wellness Kool-Aid I did before becoming aware of you and your work. But I am still a believer. Just at a different level now. And I believe our association is certainly for the better. As for accountability, good luck with that. We don’t hold people accountable in the greater society, so why should accountability when it comes to worksite wellness be any different? It won’t be. 2019 has begun. Happy New Year. Let the games continue!
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Thanks for the note. As you know I have a lot of respect for your opinions and while occasionally we disagree, your opinions always make me think. I am a believer in both screening according to guidelines voluntarily, and doing wellness for employees rather than to them. Another place I part company with the Koop Award cabal and others is in the integrity department, where we obviously have much different standards.
Technically, the name-calling is more of a Goetzel/Paul Terry wont (see below) but the difference is they operate in the shadows (until they get outed –see below again) whereas I am perfectly happy to challenge them. https://theysaidwhat.net/2016/04/12/hero-finally-forced-to-reveal-poison-pen-letter-they-circulated-to-the-media/
PS Also, it doesn’t surprise me that the Sergeant Schultz crowd would rather not hear the messaging. I (and Jon) aim for the 60% in the middle, to complement our existing 20%. We will never reach the other 20% residing in their own bubble, so if they want to block us, good for them. Hits/post on this blog are up about 30% since 201y. Funny, they are flat overall because I post about 30% less because the Wellness Ignorati no longer post obvious nonsense to be deconstructed, such as the aforementioned Koop Awards, knowing that they will be outed. The last 4 Koop Awards have ended up backfiring. Wonder why…
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Bill, the difference is that when Al calls someone stupid, it’s because they objectively are stupid, a perfect example being the subject of this post. This is not name-calling. It is a fact that this is a stupid claim by a vendor whose stock-in-trade is stupidity.
This is giving Interactive Health the benefit of the doubt. It’s possible they are deliberately lying.
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Sorry to confuse you Sam. My reference was not to Interactive Health’s screening program but to something else.
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Sorry to confuse you Sam. My reference was to something else and not Interactive Health’s screening.
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Interactive Health blocked me. They might not understand the way blocking works. They may think nobody can see me now. (I on the other hand love to read criticism of my work. THat’s how you learn, through criticism. That’s why I read your stuff carefully.)
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