IN a lunchtime speech to the Chamber of Commerce this week, Cindy Campbell, executive vice- president of the Argus Group, told the assembled business leaders that they should promote wellness ? "just for the health of it".

Ms Campbell, a Bermudian wife and mother of two, is a qualified accountant with an MBA from the University of North Carolina at Greensboro. She barely allowed her audience to tuck into their "brown-bag" lunches on Tuesday before launching into some unpalatable facts about the health of Bermuda's workforce.

It may have been no surprise to learn that Bermuda has the highest medical costs per capita in the world.

"The average resident in Bermuda spent nearly $6,000 in the health system in 2004," said Ms Campbell, one-third more than Americans and more than twice as much as Canadians. "Expenditure for health care will rise by 12.4 per cent to $422 million this year."

The Argus Group, and Ms Campbell, were in no doubt that the high cost of health care in Bermuda was exacerbated by preventable diseases tied to destructive behaviour and poor choices.

"According to 2001 research by the National Drug Commission," Ms Campbell advised, "40 per cent of Bermudians were regular alcohol users, 13 per cent were regular smokers, five per cent were marijuana users, and one per cent used cocaine, crack or heroin."

Also, nearly 13 per cent had diabetes, and the 2000 National Census showed that the five medical conditions which most affected Bermudians were high blood pressure, asthma, diabetes, arthritis, and heart conditions; of these, all were preventable but arthritis.

Ms Campbell, who came to Argus from Ace in 2001, is responsible for the largest department in the company: group health, group life and disability.

She told her audience that health care costs had been rising steadily over the last five years at rates considerably higher than inflation, between ten and 15 per cent, and that the situation called for urgent remedy.

"At Argus, we strongly believe that work-site wellness programmes stand alone as the long-term answer for keeping employees well in the first place, and slowing the rise in healthcare premiums and claims over the longer term," explained Ms Campbell.

She used the example of the US multinational Motorola, whose employee population for health care purposes approximates the number of Bermudians, to illustrate the improvements in health and health care costs which can be attributed to the company's determination to "enhance the education and development of wellness and promote a healthy culture."

Motorola "introduced disease management programmes for asthma, diabetes, and depression . . . and provided flu immunisations, cancer screenings, and health risk appraisals", advised Ms Campbell. They even provided a 24/7 nurse telephone line solely for employee use.

The results were dramatic and successful: for every dollar invested in "wellness benefits", Motorola saved nearly four dollars, an annual saving of $6.5 million from "lifestyle-related diagnoses", compared to non-participants.

"At Argus, we recognise that employees don't get healthy, or stay healthy, by chance," she explained. "Many people need extra encouragement to recognise and achieve their wellness goals. It's not easy to stop smoking, lose weight, or cut down on drinking.

"That's why the Argus group recently launched Bermuda's first insurance-led wellness programme, which is being provided free to all our health insurance customers; it provides all of the necessary resources to improve the health and wellness of employees, and will support people through the challenges of getting healthy by providing advice, encouragement and structure."

Ms Campbell noted that the wellness concept is no longer seen as a fad or employee perk by companies facing escalating bills for the alternative; wellness programmes in the US have increased in number and sophistication, and they encourage not only regular exercise and balanced nutrition, but also incorporate stress management and the reduction or elimination of various detrimental behaviours.

companies should invest in health promotion and wellness programmes because medically high-risk employees are expensive employees.

"In the US, medical costs for people with chronic illness now account for more than 75 per cent of national medical care costs," Ms Campbell warned.

"Bermuda is reaching similar levels, and as the population ages substantially over the next few decades, the prevalence of chronic diseases and their impact on our health care costs will likely increase."

Other than the use of tobacco and the abuse of alcohol, the health of Bermudians is most affected by obesity.

"Being overweight significantly affects health, quality of life, and life expectancy," said Ms Campbell. "Studies show that 80 per cent of obese adults have diabetes, hypertension, coronary artery disease, gallbladder disease, high cholesterol levels or osteoarthritis.

"It is estimated that 18 per cent of the US population is obese, but in Bermuda, that number is closer to one-third. More shockingly, the prevalence of obesity in adolescents has almost tripled in the past 20 years."

Research has found that health care costs rise in direct relation to body mass, and that obesity may account for a 36 per cent increase in costs for in-patient ambulatory care ? a greater increase than that attributed to ageing 20 years.

Ms Campbell told the that while there were some wellness programmes on the island, they were not as comprehensive as the Argus programme.

"Argus is unique, in that most wellness programmes have been developed primarily for the US market by large US companies. We are an insurance company providing this service for our clients, and most of our clients are smaller; I have over 800 clients with less than 25 employees. We worked hard to develop a programme that is not too strenuous to administer."

Ms Campbell said that we all knew what we should do, or not do, to live healthier lives.

"We are supposed to follow a low-fat diet, and exercise, and not smoke, and not drink too much," she said. "But, until recently, companies would look at employees more non-judgmentally, thinking that as long as the work got done between nine and five, what people did on their own time, whether they smoked, or drank too much, or were obese, was thought to be of no concern of employers.

"Now employers are thinking that it is, to some extent, the company's business, because the employer is footing 50 per cent of that bill. We know you can't discriminate, and you can't force someone to stop smoking who doesn't want to, but what we can do is encourage a different approach to wellness.

"Instead of seeing your doctor once a year, and hearing that you should stop smoking, and lose some pounds, and promptly forgetting the advice until the next year, when you hear again that you should stop smoking and lose even more pounds, we want to make wellness part of your life year-round.

"It should become part of the lifestyle, the culture of the company, to encourage employees to make choices that constitute a 365-day reminder of the benefits of healthy living."

is aware that not all of its employees are perfect representatives of the corporate wellness culture, and it is determined that the most enthusiastic respondent to the new wellness ethos will be Argus.

"We have a horrible claims history here at Argus, so we are starting in our own backyard, with our own employees.

"For myself, I have known that I have had some weight to lose since my daughter was born ten years ago," Ms Campbell confessed, "but once I started putting this programme together, I 'bought into it'. I have read the statistics, and I know what they mean for my longevity, and breast cancer risks, and so on.

"I am now exercising five days a week, getting up at 5.30 a.m. every morning, and I exercise for an hour and watch what I'm eating, and I have lost some pounds and feel much fitter.

"But there are a lot of smaller, incremental things people can do if they can't face the gym at 5.30 in the morning, like taking the stairs instead of the elevator, and taken together, these small efforts will add up and absolutely affect your health in the long run."

Ms Campbell assured weightier readers with the occasional unhealthy habit that wellness was not about everyone being turned into paragons of healthful virtue.

"When you start looking at the cost of health care and the dramatic impact that health risk factors have, you would want to know what that means to you.

"If the person who lives a healthy life with no specific risk factors costs, say, $100 per year, a person with one risk factor, say smoking, costs 2.4 times that; but most people don't stop with one risk factor, with just being overweight, say.

"So, if you have two risk factors, say a smoker who's overweight, the cost multiple is 4.25 times, and three risk factors, an overweight smoker with diabetes, is seven times the cost of the healthy person, and four risk factors is an 11-times multiple."

Ms Campbell explained that the programme had been designed to allow employers to offer financial incentives to employees, if the employer preferred that approach. The programme is so new that materials are only being sent out to employers this week.

"Right now, I am targeting my larger clients, because we can cover two-thirds of our group lives with a manageable number in the programme.

"We must be realistic; with an ageing population, this effort will at least help mitigate premium increase. We don't want to ignore technological advances, or pharmacological advances, so the only thing we can control is utilisation.

"We have hired a wellness co-ordinator, who will go out and work with these companies, but we will not ignore our smaller companies; wellness is available to everyone."