Seated woman with aching back looking down

Sitting Vs Smoking: What’s The Scale Of The Risk?

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You might want to stand up to read this article: too many people are sitting for too long each day. There is a growing consensus that excess sitting is having serious effects on peoples’ physical and mental health, and that companies could be less productive as a result.

The problem could be bigger than many realize. A study in the British Journal of Sports Medicine found that those who sit – for example watching TV – for an hour reduce their lifespan by 22 minutes, whereas smokers shorten their lives by 11 minutes on average per cigarette. One study in Diabetologia, the journal of the European Association for the Study of Diabetes, confirmed the danger by comparing those who spent the most time sitting versus those who sat the least. Those who sat the most faced a 112 percent increase in diabetes, a 147 percent increase in death from cardiovascular events, a 90 percent increase in death from cardiovascular causes, and a 49 percent increase in death from all causes.

Sitting has also been linked to obesity, backache, dementia, and muscle degeneration. In the UK, the Trades Union Congress estimates that back pain costs businesses £5 billion per year in employee absenteeism.

Some studies have found excessive sitting to be so widespread, and to have such a negative impact on health, that comparisons with smoking are becoming increasingly common. It is a problem that is increasingly being recognized, and research is underway to incorporate healthier habits into office layouts. In 2013, the American Medical Association adopted a new policy: encouraging employers to offer standing workstations.

But what can both individuals and organizations do to reduce the potential harm of too much sitting?

In Depth

Worldwide, about 40 percent of the people who have cardiovascular disease, diabetes or cancer do not achieve the minimum health recommendation of 150 minutes per week of moderate physical activity. In Europe and North America, that figure is about 70 percent. As many as 25 percent of Americans are primarily sedentary in their daily lives, according to Stephanie Pronk, Senior Vice President and leader of Aon’s U.S. National Health Transformation Team. “They just do a bare minimum of activity each day.”

Public Health England, the government body responsible for public health issues in England and Wales, recently commissioned an expert statement on the status and impact of prolonged sitting in the office, which compiles some eye-opening research. On average, Brits walk sixty fewer miles a year than they did in 1975. They burn up 175 fewer calories each day than they did in 1960, which represents a 20 percent drop in physical activity. They walk or cycle less often and spend more time at home sitting in front of computer or television screens. Worse, over the same period, manual jobs have been replaced by sedentary office-based jobs.

Consequences Of Sitting For Too Long

In recent years, a growing body of research has linked sitting for more than four hours a day to reduced calorie burning (metabolic rate), disrupted blood sugar levels, increased insulin and blood pressure levels, and leg muscles ‘switching off’ through inactivity. “If people sit for more than six hours per day, studies show that about 20 percent of men and 40 percent of women are more likely to die prematurely than those who are more active,” says Pronk.

Sitting for too long can also take its toll on mental and emotional health. According to a paper published in the American Journal of Preventative Medicine, women who sat for more than seven hours a day and did no physical activity were three times more likely to show depressive symptoms than women who sat for less than four hours a day and did some physical activity.

The Cost Of Sitting

These activities are bad for budgets too. Pronk says that research has shown that inactive American adults pay $1,500 a year more in healthcare costs compared to those who are active.

There is also a cost to businesses. More health issues for their employees can reduce their performance in the workplace, and increase the number of sick days taken, having a significant cumulative impact on overall productivity. With sick days costing employers £29 billion a year in the UK alone, according to one study, and losing employers around 2.8 percent of working time, according to another, this is a significant concern in today’s uncertain economic environment.

Organizations that pay for their employees’ health insurance will suffer financially if ill health means they need to make claims against it. One study published in health journal The Lancet found that sedentary lifestyles resulted in healthcare issues that cost global health services $67.5 billion a year. This propensity for sitting to raise companies’ health insurance costs gives firms an immediate financial incentive to ensure that their employees behave in a healthier way.

Sitting is just one of the causes of non-contagious health issues, of which business leaders are increasingly aware. Aon’s 2015 Health Care Survey, for example, found that many US employers want to implement “more opportunities and support to connect health and wealth” in their rewards system.

Creating Healthy Cultures: 4 Ways to Rethink the Workplace

Like smoking, change is likely to be gradual, and happen at four levels: cultural attitudes, individual activities, organizational practices, and physical changes to office layouts.

1) Changing Corporate Cultural Attitudes

Pronk says that a major – and perhaps subtle – challenge is in changing an organizations’ attitude.  She describes one large company that invested in a gym to encourage healthier habits among its workforce.  However, the culture of the organization was that of “presenteeism” – the expectation that employees are seen to be working during office hours – so very few actually used the gym, and those who did felt obliged to hide their gym gear. The corporate culture was such that sitting at one’s desk meant that one was working. Not being at the desk – for whatever reason – could be interpreted as slacking off. “Unfortunately, there is negative perception with not being at a desk.  If someone takes ten minutes to go out and take a walk, the assumption might be that they’re not a hard worker,” she explains. The first step toward encouraging healthier behavior is to address these attitudes, and educate teams that time away from the desk can have a real business benefit in reduced absenteeism and reduced healthcare costs.

2) Encouraging Individual Activities

For most employees, moving more means making small changes to daily routines, such as altering posture regularly, taking a walk to a colleague downstairs rather than emailing them, taking the stairs rather than the elevator, or regularly breaking up periods of seated work by working standing up, at a higher desk if necessary.

3) Revising Organizational Practices

Reminders from managers and HR teams may be necessary to encourage this small, but important, first step to a healthier lifestyle for individual employees. Companies can shift their culture toward one that encourages more movement at work as well, by encouraging people to stretch, perhaps by incorporating it at the start or end of meetings, and moving towards having short meetings while walking.

Companies might encourage physical activity by recommending that employees walk or move every ninety minutes. They might consider raising the perceived seriousness of the issue by combining information about the potential dangers of excessive sitting with other health issues, such as cutting down on drinking and smoking and eating a nutritious diet.

4) Creating Physical Changes To Office Environments

Employers can also encourage employees to stand by making changes to the workplace itself. They can remove chairs from meeting rooms to force meetings to be held standing up, which often makes them shorter as well, further boosting focus and productivity. Some companies introduce walking treadmills, pedals under the desk to encourage employees to move their legs, or even invest in a gym. The layout of the office might also make a difference – can meeting rooms and desks be arranged in a way to encourage staff to walk a little further?

Introducing ‘sit to stand’ work stations – desks which can be adjusted upward easily so that the user can alternate between sitting and standing – can make a surprising difference. One recent study found that stand-capable work stations can boost productivity by up to 53 percent.  The American Medical Association recommends that people take walking meetings and sit on fitness balls at their desks if possible. And a study in the Oxford Journal of Public Health found that sit-to-stand desks were effective in reducing children’s sitting In Scandinavia, more than 90 percent of workers who use computers work at sit-stand adjustable desks but currently, only 1 percent of UK workers have access to them. Users are 78 percent more likely to report a day without pain than those without.

Next year, research at the Well Living Lab – a lab built to conduct sophisticated and reproducible scientific studies on how workplace design affects human health and performance – will research the healthiest ways to avoid sitting too much while working.

Sitting Versus Smoking: The Scale Of The Risk

Employers and employees alike are only beginning to understand the full extent of the risks of sitting for too long each day, and medical research is ongoing.

Considering that everyone sits while only some smoke, sitting may be an even greater threat to global public health than cigarettes. But while research into the health impact of smoking has been going on for decades, research into the impact of sitting is still in its infancy, and the evidence is not yet conclusive.

Is sitting really the new smoking? The evidence is certainly growing that it is harmful – but it is often just one element of a broader challenge of tackling sedentary lifestyles. This isn’t as simple as just getting everyone to stand up more often – but taking that first step towards a healthier way of living and working is always the most difficult. Support and encouragement from employers to live healthier lives could be the first step that’s needed.

Talking Points

“The chair is out to kill us.” – James Levine, endocrinologist, the Mayo Graduate School of Medicine

“It’s becoming more well known that long periods of sedentary behaviour has an adverse effect on health, so we’re looking at bringing in standing desks.” – GE Engineer, Jonathan McGregor

“There are benefits to standing. But there are also issues to prolonged standing… What we know is that prolonged postures need to be changed and staff need to move around.” – Jane Pierce, Work Recovery

Further Reading