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Jan 11, 2024
The health risks of shift work: Clocking in to a holistic care plan

Shift workers – including those in health care, law enforcement, manufacturing, and construction – represent a crucial segment of the U.S. workforce, providing essential services and labor around the clock. They are also more likely than non-shift workers to have unhealthy behaviors, which may increase their risk of chronic conditions such as obesity, cardiovascular disease, and diabetes, also known as cardiodiabesity.

Considering the variety of risk factors related to shift workers' health and productivity, employers should take a holistic approach to support workforce well-being and to ensure employees receive individualized, condition-specific care. Leveraging the strength of integrated medical, pharmacy, and behavioral clinical and coaching programs can help reduce health complexities and the costs and complications that they bring.

Shift workers and health risks

Data suggests that shift work, specifically the night shift, can have a negative impact on workers’ health. Shift workers tend to get less sleep, get less physical activity, and suffer from the effects of poor nutrition. They also may work irregular schedules. All of this can contribute to long-term health issues, which can lead to missed work and lost productivity.

Shift work and sleep disorders

Shift work sleep disorder, which affects up to 40% of people who work nontraditional shifts, can cause issues with falling asleep or sleepiness during waking hours. Shift work also disrupts the circadian rhythm, which interrupts insulin production and increases the risk of developing diabetes.

Shift work and obesity

Poor diet and nutrition for shift workers adds another level of cardiodiabesity risk. Shift workers often have irregular eating times, skip main meals, and have a higher consumption of snack meals. They may consume foods high in sugars and fats and lacking in protein, increasing their risk of obesity. Due to exhaustion, they may be more likely to eat whatever is available instead of taking the time to prepare a nutritious meal.

Shift work and exercise

On top of poor sleep and poor nutrition, studies have shown that shift workers are usually less physically active than those who work a standard daytime schedule. It's unsurprising, then, that research has found shift workers are more often obese and more likely to report having diabetes.

Shift work and mental health

People who work shifts face a 22 percent greater chance of developing depression than those who work a regular daytime schedule, according to research published in the journal JAMA Network Open. They also may be drawn to smoking as a coping mechanism, with 32% of shift workers smoking vs. 15% of non-shift workers – which can lead to significant health issues and substance use disorder down the road.


However, these unhealthy habits are far from inevitable. Employers can help shift workers cultivate healthy lifestyles that can slow or prevent the development of chronic conditions and maximize the health of those with existing conditions.

Complex challenge, integrated solution

Acknowledging the realities shift workers face is important when selecting their benefits. Employers should design solutions that can meet their workforce’s unique needs and are convenient, accessible, and affordable. An approach that integrates multiple aspects of holistic well-being and provides tailored support for your unique workforce can help empower shift workers and improve your bottom line.

Good health isn't merely the treatment of illness; it also includes prevention, supportive lifestyle choices, and mental well-being. That's why Cigna Healthcare offers industry-leading integrated care that combines medical, behavioral, and pharmacy management to ensure employees receive a holistic experience, no matter how they connect with us or what they need.

Cigna Total Behavioral Health is our integrated solution that includes inpatient and outpatient case management and a full suite of specialty coaching and support programs focused on specific conditions. It provides comprehensive, personalized support, including navigation assistance and follow-up to ensure every individual's needs are met. Through our highly flexible virtual care programs, employees can meet with their primary care provider (PCP) and have access to licensed therapists and board-certified psychiatrists, with the option to select the same provider for every session.

We also provide a range of programs specific to cardiodiabesity issues, including the following:

  • Diabetes Prevention Program: This program is available through a partnership with Omada, an online app that provides behavioral counseling to people at risk for developing diabetes. The app combines human interaction and technology to help employees achieve and maintain their health goals.
  • Patient Assurance Program: This initiative is for eligible members with chronic conditions such as diabetes who are taking essential medications. It offers out-of-pocket cost caps at $25 for a 30-day supply, providing patients with greater affordability and cost predictability with the goal of improved adherence and better health.
  • GLP-1 Drug Utilization Management: Careful utilization management for GLP-1 drugs, such as Ozempic® and Wegovy®, minimizes the over-prescription of these important diabetes medications. The popularity of these drugs for weight loss has created shortages, negatively impacting access for people with diabetes who need the medication for daily living. Cigna Healthcare uses integrated data to ensure proper stewardship of GLP-1 medications and provides a variety of other ways employees can achieve healthy and sustainable weight loss, including free lifestyle counseling.
  • Cigna Healthcare well-being solution, together with Virgin Pulse: Users get a customized digital experience that promotes social connections and healthy habits for a lifetime.
  • MDLIVE for Cigna Healthcare: Employees with chronic conditions receive access to MDLIVE Health Coaching. The program, which is prescribed by MDLIVE physicians as part of patient treatment plans, provides helpful steps and insights to help support lifestyle changes so patients can better manage their conditions and achieve optimal health and wellness.

Healthy workers during every shift

Providing an integrated, holistic approach to health care – one that encompasses mind and body wellness, life-saving medications, and lasting support for healthy lifestyles – can improve overall health for employees and increase productivity in the workplace during every shift.

Find out how you can support your shift employees while controlling health care costs by contacting a Cigna Healthcare representative or broker today.

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