Tobacco

Fat Workers and On-the-Job Injuries

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A new study by researchers at Duke University finds that fat people are more prone to workplace injuries than their svelte co-workers. The researchers divided nearly 12,000 employees of Duke and its health care system into five groups based on body-mass index (weight in kilograms divided by height in meters squared). The fatter the employees were, the more workers' compensation claims they filed, the more the claims cost, and the more days of work they missed. The employees in the highest BMI group (40 or more) filed workers' compensation claims twice as often as the employees in the "recommended weight" group (with BMIs from 18.5 to 24.9); the medical costs for their claims were nearly seven times as high; and they missed 13 times as many workdays. The ratios for the merely "overweight" (with BMIs from 25 to 29.9) were less dramatic: 1.2, 1.8, and 4.2, respectively.

While the associations between BMI and some chronic diseases may be largely due to the poor diet and inadequate exercise that tend to accompany obesity rather than excess weight per se, it seems plausible that extra pounds would make mishaps more likely and injuries more severe. According to the study, "The claims most strongly affected by BMI were related to the following: lower extremity, wrist or hand, and back (body part affected); pain or inflammation, sprain or strain, and contusion or bruise (nature of the illness or injury); and falls or slips, lifting, and exertion (cause of the illness or injury)." An obesity-related lack of agility may contribute to accidents, while the strain that extra weight puts on joints and muscles could make certain types of injuries more likely and more serious.

The researchers think the connection between obesity and workplace injuries bolsters the case for employer-sponsored fitness programs. The A.P. story about the study prominently features an employment attorney's warning that "employers need to be careful not to view this study as a green light to treat obese or overweight workers differently." Michael Siegel sees a double standard:

You don't hear anyone suggesting that to save health care and workers compensation money, employers fire fat people or stop hiring them in the first place. It simply isn't part of the discourse. The suggestion simply does not arise. No public health groups are suggesting—or would suggest—anything of the sort. The response (and an appropriate one) is to recommend fitness or other programs to help employees control their weight.

Not so with an almost identical problem—off-the-job employee smoking. That problem is also costing employers money in terms of health care costs. However, in contrast to the obesity and overweight problem, many anti-smoking groups are supporting the idea of firing smokers or refusing to hire smokers in order for employers to save money.

While Siegel may be right that no one is explicitly recommending that employers avoid hiring fat people, I'm sure obesity often hurts job applicants' prospects, whether for aesthetic reasons or because it's seen as a mark of poor self-discipline or other undesirable traits. (Here's a summary of the research on weight-based employment discrimination.) Are data-based concerns that fat people will cost more to employ a less objectionable reason for turning them away? Is this worse than refusing to hire smokers?

[via The Rest of the Story]

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  1. I’d argue that fitness programs help everyone: The obese and overweight, by slimming them, and the recommended-weight, by keeping them slim. As long as everyone is equally pressured to take part, no one can claim discrimination.

  2. I’m not sure how to react to this story. Clearly, obesity is a major health-related expense for employers. Certainly bigger than illegal drug use (which can lead to firing.) More expensive than smoking (which is coming to sometimes lead to firing.) Kills more than alcoholism (which causes job losses, a.k.a. firing.) Loses more hours than depression and related effects (which leads to workers getting time off, if available and the insurance covers care, or else letting go of workers, sometimes known as firing.) But rather than try to make any important point, I’ll write a shitty poem:

    No one is actually born obese,
    Unlike, say, being gay.
    So go ahead, discriminate!
    (It’s the American way.)

  3. A new study by researchers at Duke University finds that fat people are more prone to workplace injuries than their svelte co-workers.

    We conclude that this is the fault of the white capitalist patriarchy.

  4. I am acquainted with someone that I occasionally refer to as Death Cloud who certainly fits the bill.

  5. My sister is a worker’s comp administrator and the funniest story she ever told was about the fat lady that fell into a manhole on top of an LA DWP worker. Poor sucker’s back will never be the same.

  6. …about the fat lady that fell into a manhole on top of an LA DWP worker

    Wasn’t that from a Chaplin film? Or maybe the Oblongs.

    Can I make a poem, too? How about haiku?

    Fatty McFatfat
    Gonna cost me too much dough
    That human eclipse

  7. “I am acquainted with someone that I occasionally refer to as Death Cloud who certainly fits the bill.”

    he must be quite the charming fellow.

  8. Actually, a local radio host in Seattle was advocating discriminating against fatties just yesterday. He took calls for about an hour and everyone who called agreed with him, including several employers who admitted that they don’t hire fatsos.

    I don’t personally own a company, but I do interview people all the time, and I never recommend hiring fat people. I don’t care about the costs, I just care about what it says about thier personality…

  9. I don’t care about the costs, I just care about what it says about thier personality…

    as opposed to wafer-thin airheads like Nicole Richie?

  10. I wouldn’t hire an airhead either, obviously.

  11. As a person of pudge, I am familiar firsthand with the workplace injuries that are much more likely to happen to heavier people, e.g.:

    – Falling down and scuffing kneecaps when staircase collapses under one’s weight.

    – Stress fractures in bones of hand, fingers, from beating on vending machine in an attempt to make the stuck bag of M&Ms fall.

    – Accidentally putting staples in fingers while stapling papers together because one cannot actually what one is doing over the vast curving horizon of one’s own belly.

    – Rug-burned lips from attempts to hoover-up fallen crumbs of food from office carpet after lunch.

    – Ass-splinters from broken furniture.

    – Getting lashed across the face when elevator cable snaps from the strain.

    – Etc.

  12. Don’t know what field you’re in, but when it comes to software, the innovators (Gates, Wozniak, Torvalds) tend to be the pudgy, pasty dishevelled types. Besides the execs, the only people who look presentable are the marketing and legal departments. And, in my experience, attractive programmers tend to be guys straight out of College who can’t code a damn.

  13. Actually, I work for Bill Gates… I’m not sure why you would decribe him as “pudgy”. He’s not fat at all, and never has been – he was a tall, skinny geek, just like all the other programmers at Microsoft. Linus Torvals is also definitely not fat. Really, I don’t know what the hell you’re talking about.

    Sure, there are a few obese people working here, but they tend to work in IT or testing. Programmers are all skinny dorks.

  14. Could the double-standard arise from the different degrees of impact each type of offender imposes on his immediate social environment? Innocent suffering derived from second-hand fat is easier to avoid than that from second-hand smoke, and thus even addictive overeating more likely to be reflexively culturally/esthetically viewed as a “that’s his problem” condition than polluting the common air. The boundaries of your liberty to swing your lungs intersect with mine more intimately than the boundaries of your liberty to swing your epidermis.

    Add to that the statistically greater prevalence of obesity than tobaccoity, and you at least seem (n.b.: “seem”) to be comparing if not apples and oranges, crab-apples and lady-apples.

  15. I think the important thing is that we’re all agreed that the best programmers are weird looking people.

  16. height in meters squared?

  17. “Innocent suffering derived from second-hand fat is easier to avoid than that from second-hand smoke”

    Have you ever sat in the center seat in coach, between two girthickly challengeds?

    Tell me that’s not suffering from second hand fat.

    CB

  18. I wonder if the line “No Fatties” will start appearing in the employment classified ads now, too.

  19. height in meters squared?

    Go here. It’s easier:

    http://www.nhlbisupport.com/bmi/

  20. No one questions, of course, why the hell employers are required to pay for health insurance for employees in the first place.

  21. No one questions, of course, why the hell employers are required to pay for health insurance for employees in the first place.

    Wow. When did that happen?

  22. cb
    think of them as human airbags, protecting your skinny ass from the damage caused by sudden deceleration syndrome

  23. Steveo
    lets not forget the panting & wheezing that results from the mad dash for the last slice, donut, danish, hard candy, etc.

  24. …why the hell employers are required to pay for health insurance for employees in the first place.

    They are?

  25. I think three possibilities not considered by the poster are:

    1. Many of the injuries described are more likely to happen to people with limited range of motion. It’s not because these people are fat per se, it’s because fat people are more likely to be physically inactive, and are also less likely to know how to prepare their body for activities that require exertion or extension.

    2. Unfortunately, even a small number of malingerers would be enough to skew the data here, and perhaps the sort of person who would be waiting with their fingers crossed for an “injury” that could get them paid disability is more likely to be fat.

    3. This is a reporting issue – physically fit people are less likely to report minor muscle pain as an “injury”, while physically inactive people perceive any back muscle pain to be a horrific injury. [Once again, this wouldn’t have to be true of ALL fat people; just enough to skew the data.]

  26. No one questions, of course, why the hell employers are required to pay for health insurance for employees in the first place.

    It is amazing that on a ‘blog like this it takes 20 comments before the real point comes up.

    During periods of wage controls, employers would add non-cash benefits like this to attract better workers. Over time this became an expectation of everybody in the market place, in the same sense that factory rebates on cars are still somewhat expected even though there is no threat of a price control in the future. The tax code also gives incentives to pay in non-cash benefits too.

    Don’t some States now mandate employer sponsored health care? Or was that just Maryland attacking Wal*Mart?

    So, now we have a situation where many employers are paying a premium for some employees who are more expensive to employ due to the compensation package structure (the fat people and smokers), but smokers are more likely to be overtly told they will not be hired.

    Back to Chucklehead’s point, and one not stated, if the tax code were brought into line with paying workers cash instead of all of these other schemes, then there would be less temptation for the employer to continue emulating a Socialist model of nanny.

  27. Guy,

    If I remember correctly, a lot of this took place in the ’40s during the war as a way to keep ‘the war machine’ cranking along. Since wage and price controls were in place, employers had to offer additional incentives to keep the tanks and aircraft rolling off the assembly line. It was eventually codified into law.

  28. “…Or was that just Maryland attacking Wal*Mart?”

    That was one of the unions attacking Walmart by using their lackeys in the Maryland legislature.

  29. If I remember correctly, a lot of this took place in the ’40s during the war as a way to keep ‘the war machine’ cranking along. Since wage and price controls were in place, employers had to offer additional incentives to keep the tanks and aircraft rolling off the assembly line. It was eventually codified into law.

    That was one of the big ones, but it happened to some extent during all of the other times wage and price controls were in place.

    There was a lot of “re titling” of employees during the Nixon era, plus other non-cash benefits.

    To avoid price controls, manufacturers would call things “new”, “improved” and “new and improved”. IIRC, the feds responded with regulations on what was new or improved. Re-naming products and packaging in different quantities were other methods used by manufacturers to change the price. All were expensive to do, but apparently cheaper than selling products at a loss.

  30. What if fat is correlated with depression (which causes the inactivity and sugar-craving in an attempt to unconsciously self-medicate), which is correlated with more time off, claims of injury/pain, and hypersensitivity?

    Or they’re possibly lazy bastards looking for time off, or maybe they just totter more. Still I’m betting on my first hypothesis.

  31. CB – I feel your pain. Unsolicited flight massage is indeed what comes to mind as an encroachment on Jack Spratt’s civil rights.

    But since most people spend more, uh, gross time in the course of their lives sharing air than sharing hyper-gregarious flesh, I called it only “easier” to avoid.

    Next question: What about dirty looks?

  32. The bigger they are, the harder they fall.

  33. It was eventually codified into law.

    I’m not aware of any law requiring employers to offer health benefits.

    There is a big tax incentive to do so, and a (by this time) immovable market expectation, but no legal requirement. Outside of whatever “Lets Screw Walmart” laws might be in effect.

  34. Only in America would we create an economic system that encourages people to become fat and then complain about how fat people hurt the economic system.

  35. I will admit that I haven’t Ared Tea Eff A, so I don’t know if they’ve corrected for this, but poorer people are much more likely to be obese than wealtheir people, and are also much more likely to be employed at jobs with a higher risk of injury.

  36. It is cheaper to eat badly, lower paid workers do more of the heavy lifting. The study’s authors raise the point that they can’t entirely control for the fact that BMI also tends to coorelate with education and income, and lower paid lower educated workers tend to get the grunt work.

    I’m always suspect of BMI studies. Wouldn’t some very fit employees also rate at least as overweight by BMI? They would if their fitness program included weight training.

  37. Dan T – I’m sure there’s a way to make money off your insight… How about an economic system that encourages resentful people to express their ideas for material gain? Then they can be fat, resentful, and rich all at once!

  38. Re: Obesity – Wouldn’t the poorer folks’ bad diet (eating habits tend to include more inexpensive starches such as potatos and pasta than the more expensive protein items like meat, which trends them towards obesity) be offset by the poorer folks’ equal likelihood to be “confined” (held down by the man) to the more physical (as characterized above) “grunt work”, resulting in a leaner, meaner po’ man?

    CB
    BMI 27.02. I am merely overweight Whoo hoo!

  39. “Only in America would we create an economic system that encourages people to become fat and then complain about how fat people hurt the economic system.”

    The economic system doens’t encourage people to become fat; it allows them the opportunity to become fat. And the economic system isn’t complaining that they are fat. The folks who don’t LIKE that economic system are complaining that some people are fat and that “something must be done”.

    CB
    Going on a diet.

  40. “Sony: cuz Caucasians are just too damn big”

  41. College BMI: 21.8
    Current BMI: 25.8
    Moral: Stay thin. Don’t ever graduate.

  42. “Or maybe the Oblongs.”

    That show is one of the most utterly unfunny television shows to ever be spewed out of the electron gun of a television.

  43. “Okapi – I don’t care about the costs, I just care about what it says about thier personality…”

    Okapi, you are an ass. If you were working for me and hiring based on your superstitions, your career would be toast.

  44. 3. This is a reporting issue – physically fit people are less likely to report minor muscle pain as an “injury”, while physically inactive people perceive any back muscle pain to be a horrific injury.

    This resonated with me. I, of course, not being the other person can only speculate as to the extent of their pain, but I can also imagine how what would otherwise be minor knee pain could be exacerbated by an extra 70lbs of force pushing down on that knee.

    Cracker’s Boy –
    I think it’s fair to say that our economic system encourages people to get fat. Subsidizing farming of cheap calories and subsidizing a car culture are just two ways that we encourage people to get fat. To better phrase it, they have the economic incentive to get fat because, at least in the short run, it appears cheaper to do so. This would not be so much the case if we didn’t subsidize cheap calories, highways, oil, etc.

  45. CB in re Dan T –

    Do not agents of our economic system (generally) permit consumers to reward vendors in direct proportion to sales?

    And therefore are not vendors motivated to produce and sell as much as they can by persuading consumers of the value of the product?

    And, market-share economically trumping altruistic impulses, is the vendor not therefore materially discouraged from expressing on any actual, as opposed to professed, convictions concerning the consumers’ best long-term interest?

    And do not consumers, and/or those sympathetic to consumers perceived as vulnerable to rhetorical victimization by vendors, therefore turn trustingly to state violence and its threat forcibly to impose limits to the ways in which vendors may defraud consumers?

    And does not the difficulty lie in people of good will agreeing on what consititues fraud?

    And do not some persons hold that the monopoly of the state is in the best position to commit the greatest fraud?

    And do not those persons therefore prefer a plurality of interests appealing to and addressing consumers’ liberty, as more trustworthy, due to market checks and balances, than a unitary agent with no competition?

    And don’t those persons call themselves libertarians?

  46. It is easy to accept the subsidized calories part of your argument, but the subsidized roads part I don’t understand.

    Of the road budget, what percentage comes from the general budget and what percentage comes from taxes based upon fuel consumption? While not perfect – low mileage vehicles subsidizing high mileage vehicles – how are road and fuel taxes going to paying for the roads a subsidy to those that pay the road and fuel taxes?

  47. Whoops, my 11:13am comment is in response to this statement:

    “To better phrase it, they have the economic incentive to get fat because, at least in the short run, it appears cheaper to do so. This would not be so much the case if we didn’t subsidize cheap calories, highways, oil, etc.

  48. I saw the other day a Taco Bell commercial where they actually encouraged people to switch from three meals a day to four meals, with the last one being a late-night Taco Bell greasefest.

    But no, our system doesn’t encourage people to become fat. No way.

  49. Reimoose – nothing in capitalism encourages people to get fat. A business in a capitalistic system certainly encourages a consumer to consume more of that business’ product (or raises its price, if the supply is limited – VM “Demand Kurv!”), but consuming more, in that context, doesn’t necessarily mean “get fat”. And capitalism certainly isn’t supporting subsidies. Those subsidies are anti-capitalistic. Part again of “someone must do something”.

    M – Yes

    CB

  50. Exactly when did Taco Bell become “our system”? Was it after they won the Franchise Wars and became the only restaurant?

    **BZZZ** Dan T. you are fined one credit for violating the Verbal Morality Statute. Please remain where you are and await your reprimand.

  51. CB – Thank you. So where do I send my check?

  52. I’m sure there’s a way to make money off your insight… How about an economic system that encourages resentful people to express their ideas for material gain? Then they can be fat, resentful, and rich all at once!

    I believe that field is called “Sports Writing”.

  53. Thus far, Dan T sounds to me like a Hobbesian. I could of course be mistaken about that.

  54. Wow, 2 things to address.

    1. Cracker’s Boy
    I’m confused by your last comment. Please note that what I’m about to say here assumes I understand somewhat reasonably what you’re getting at.
    I think you’re assuming our “system” is Capitalism. Wrong. We have subsidies and market controls… no capitalism here. I could consume 10 lbs of carrots a day and not get fat.. you’re right, consuming more =/= get fat. The system (government) encourages people indirectly to consume products that will make them more prone to fatness by making those products artificially cheaper. I’m not sure where else you were going with your statement. I am against subsidies, if you cannot tell.

    2.MOS (if I may call you that)
    The government is (almost) the only one in the business of building roads. The roads are paid for both through the general budget and gas taxes. While I do not remember the exact figures, from previously looking them up I do recall seeing that gas taxes pay for a large amount of roads. However, this does not counter the fact that the government built the road system in the first place and generated the demand that exists today. Can you guarantee that if we privatized the road system (entirely) that it would be as expansive and all-encompassing as it is today? This isn’t coming out well, so I’ll save it for future comment.

  55. Oh, and private road companies wouldn’t have nearly the use of eminent domain to cheapen their projects as the feds used.

  56. M – You can send it directly to me. I have a paypal account you can use.

    Thanks as always!

    Reinmoose – You sir are, of course, correct. Or system is indeed not capitalism. Sadly. And because it is not so, we end up with these challenging debates over critical life issues. If only it were. I am ineloquently arguing against those who say capitalism made fat folks fat. Life is about choices. Complex, interdependent choices. I yield the floor.

    CB

  57. But no, our system doesn’t encourage people to become fat. No way.

    I think Dan is having a hard time distinguishing between the system and the participants in the system.

  58. Reinmoose,

    The government is (almost) the only one in the business of building roads. The roads are paid for both through the general budget and gas taxes. While I do not remember the exact figures, from previously looking them up I do recall seeing that gas taxes pay for a large amount of roads. However, this does not counter the fact that the government built the road system in the first place and generated the demand that exists today. Can you guarantee that if we privatized the road system (entirely) that it would be as expansive and all-encompassing as it is today? This isn’t coming out well, so I’ll save it for future comment.

    Don’t forget that road construction and maintenance is an enumerated federal power in the Constitution.

    Now, all of this Taco Bell talk is getting me hungry, but I don’t want to hike 8 blocks or so the Pentagon City (the closest TB to me), so I shall pay a couple of bucks more for chicken tacos at Chipotle. I hear they are supposed to be evil too, for some reason. One of those Wal*Mart bashing ‘blogs bashes Chipotle too.

    I find both Taco Bell and Chipotle to be yummy.

  59. Don’t forget that road construction and maintenance is an enumerated federal power in the Constitution.
    This reads as though it’s supposed to be sarcastic…

  60. I find both Taco Bell and Chipotle to be yummy.

    That’s because noone in Virginia knows what mexican food is supposed to be like. Taco Bell & Chipotle (McDonald’s version of Taco Bell) are preferrable to starvation, but just barely.

  61. Death Cloud is a very depressing person, travels around with a cloud of death overhead, sort of like the cloud of dust you see every time Pig Pen makes an appearance in a Peanuts strip.

    …about the fat lady that fell into a manhole on top of an LA DWP worker

    Wasn’t that from a Chaplin film? Or maybe the Oblongs.

    Maybe. this was actually one of those under sidewalk concrete rooms where all the pipes/cables etc come to a junction point. Big enough for one person to move around in, but not when a 340 lb woman has just crushed you like a piano falling out of the window in a Popeye cartoon. Took Rescue 8 about four hours to get the woman out.

  62. CB – Sure. Just let me, and Dan T, know first (politely, please), absent a teeth-bearing and -baring adjudicating Sovereign, what to do with my buyer’s regret.

  63. I mean, should it arise.

  64. per impossibile

  65. They didn’t compare people doing the same jobs. It turns out that most of the fat workers had jobs involving physical labor and heavy lifting and most of the thin workers had jobs without heavy lifting and only light physical labor. The study was poorly designed, so no valid conclusion can be drawn from it. A better study would compare fat and thin workers within the same job category to control for levels of activity.

    http://junkfoodscience.blogspot.com/2007/04/seeing-only-fat.html

  66. That’s because noone in Virginia knows what mexican food is supposed to be like. Taco Bell & Chipotle (McDonald’s version of Taco Bell) are preferrable to starvation, but just barely.

    You sure read funny. Who said they were supposed to be authentic anything except yummy to the writer?

  67. “Don’t forget that road construction and maintenance is an enumerated federal power in the Constitution.”

    This reads as though it’s supposed to be sarcastic…

    Why you find Article I sarcastic is beyond me.

  68. I’m sorry, are you referring to the part about the post office? I’m not terribly good at navigating all of this legal stuff, but as far as Article I is concerned, all I see is a reference to post roads. I don’t see any enumerated power (not to mention, a word implying obligation) referring to highways or expanding roads that are experiencing an increase in citizen car traffic due to a 400 unit housing development being stuck along it…

    Isn’t this post about fat people?
    (though I’ll gladly continue this course of discussion)

  69. “Exactly when did Taco Bell become “our system”? Was it after they won the Franchise Wars and became the only restaurant?”

    Bzzzt! Wake Up, Pete! It’s Mac Tonight!

  70. “You don’t hear anyone suggesting that to save health care and workers compensation money, employers fire fat people or stop hiring them in the first place. It simply isn’t part of the discourse.”
    Michael Siegel needs to do more Googling. Wal-Mart got a lot of bad press for suggesting something very much like that back in 2005.

    http://money.cnn.com/2005/10/26/news/fortune500/walmart/index.htm

  71. Some people are fat for legitimate reasons. I had a coworker who was on steroids for a serious autoimmune illness and gained over 50 pounds. Firing somebody because they’ve got a serious illness is both uncool and illegal. On the other hand, smoking is voluntary and has no protected status.

    Besides, shouldn’t libertarians be celebrating the employer’s right to fire people who smoke? That’s the market in action, baby!

  72. My wife took care of a woman who broke her foot walking; just walking. She was that fat. Fat people are more prone to injury. Fat people have more complications once injured and otherwise take longer to heal from an injury. And fat people have all kinds of bad complication from just being fat; heart disease, diabetes, stroke, and on … oh, let’s not forget the yeast infections in their uncleanable folds.

    Being overweight is very unhealthy, no shit.

    Oh, I also want to point out the irony of that fat tub of goo, Michael Moore, movieing on about the broken US healthcare system, wherein cardiovascular disease is the number one killer. Mostly related to the bad lifestyle choices Moore’s pendulous folds typifies. I hope he ends the film with a bunch of underfed Cubans riding his fat ass to Florida.

  73. Actually, the study in question found that the overweight employees who were the subjects of the study had 5% lower medical claims costs, 30& fewer lost workdays, and 18% lower indemnity claims than the overall rates for employees of the company. But the scary headlines failed to mention that fact because it doesn’t fit in with our desire to hear about how fat people are ruining America and costing us all millions of dollars. I urge you all, including the Reason staffers who write about these issues, to actually read the studies in question before making judgments, rather than just reading press releases and assuming that your biases will be confirmed by the data.

  74. I am completely disgusted by the Reason article which showed nothing but laziness and prejudice. And the ignorant, prejudicial
    commentary on this thread (but for a few who’ve tried unsuccessfully to break through
    the fat phobia and hatred present here) is even more contemptible. Free market most certainly
    doesn’t equal educated, intelligent or compassionate.

  75. Anna and Rene – nothing to eat here, move along.

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