259703 Private Sector is Leading the Way: The Vitality Program

Tuesday, October 30, 2012 : 5:04 PM - 5:19 PM

Deepak Patel, MD , Discovery Vitality, Johannesburg, South Africa
Derek Yach, MBChB, MPH , Global Health and Agricultural Policy, PepsiCo, Purchase, NY
INTRODUCTION: Chronic diseases account for an increasing burden of disease and health costs. There is increasing interest in health promotion programs that use financial incentives to encourage behavior change. Discovery Health covers 2.5 million lives in South Africa and has developed a comprehensive health promotion program (Vitality). Vitality enrollees earn points for wellness (e.g. visiting gym, buying healthier food at grocery store) and preventive activities (e.g. receiving mammogram, immunizations, HIV test). These points translate into rewards like movie tickets, discounted plane flights, and discounted groceries. The Vitality program is voluntary, costing ~$20/month per family, serving 1.5 million members.

METHODS: Descriptive statistics are presented. Retrospective longitudinal data on program engagement, particularly with the fitness activities, and cost outcomes are examined.

RESULTS: In a multivariate model controlling for age, gender, plan type, and family size, compared to non-members, Vitality members were $128 more profitable. Members who remained highly active in years 1–3 had a lower probability (p<.05) of hospital admission in years 4 to 5 (20.7%) compared with those who remained inactive (22.2%). The odds of admission were 13% lower for two additional gym visits per week (odds ratio, .87; 95% confidence interval [CI], .801–.949).

DISCUSSION: There is a robust and dose-response association between membership in this financial incentive program and cost and clinical outcomes. How much of the effect on cost and clinical outcomes is due to the incentive program versus selection bias from volunteers is unknown. Disentangling these effects is on our research agenda.

Learning Areas:
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
1. Describe the history of public health practice and how it has been effective in reducing infectious diseases and alcohol, tobacco related morbidity and mortality by aggressive regulation; 2. Analyze whether similar approaches are relevant for obesity control; 3. Describe current approaches to obesity control, and whether they are sufficient.

Keywords: Chronic Diseases, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I headed global health at the Rockefeller Foundation, have been a Professor of Global Health at Yale University, and a former Executive Director of the World Health Organization (WHO). At the WHO, I served as cabinet director where I led the development of WHO’s Framework Convention on Tobacco Control and the Global Strategy on Diet and Physical Activity. I established the Centre for Epidemiological Research at the South African Medical Research Council.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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