Coping with cancer in the workplace

HR needs to improve management, accommodation of chronic disease: Experts
By Marcel Vander Wier
|Canadian HR Reporter|Last Updated: 02/27/2019

Cancer is a chronic disease that needs to be increasingly recognized within a healthy workplace strategy.

The disease involving abnormal cell growth has been the leading cause of death in Canada for the last decade, said Chris Bonnett, principal consultant for H3 Consulting in Toronto, speaking at the annual conference of the Human Resources Professionals Association (HRPA) in Toronto on Feb. 1.

Cancer is becoming more common, with nearly 50 per cent of Canadians expected to contract some form of the disease in their lifetime, he said.

“It’s a shocking number… And, unfortunately, that number is actually increasing.”

Cancer is currently the fourth-leading cause of short- and long-term disability in Canada, while drugs to combat the disease are a “massive emerging cost” — with major effects on the workplace, said Bonnett.

“Cancer today is probably where mental health was 10 or 12 years ago,” he said.

“We’re just starting to get it onto the radar.”

The good news is that not all who contract cancer will die of the disease, said Bonnett, noting there are more than 810,000 cancer survivors in Canada.

“Cancer is not just a disease of old age; it’s not just a disease of the public health-care system; it’s not a death sentence,” he said. “That is a change in thinking for most people.”

Impacting employers

A total of 43 per cent of cancer diagnoses occur in working-age Canadians, according to Improving Cancer Management in the Workplace, a 2017 discussion paper published by Bonnett and Allan Smofsky, managing director of Smofsky Strategic Planning in Oakville, Ont.

While many employers support cancer initiatives as part of corporate social responsibility (CSR) programming and through provision of health promotion, many struggle to manage the increasing number of employees diagnosed with cancer who still want to work, said the paper.

There is often a lack of policy and support for affected workers and caregivers, resulting in gaps in processing, navigation and information, it said.

And as cancer incidence climb, the cost and disruption facing employers will only increase, with an aging labour force, poor lifestyle choices and environmental exposures each playing a role, according to Bonnett.

Higher incidence, better outcomes, younger survivors and frequent caregiving means cancer affects employees of all ages, alongside employer health and productivity costs, he said.

That means cancer is not only a public health-care problem, but increasingly a workplace issue, impacting employers through replacement labour and disability management costs, as well as increased strain on the remaining workers, said Bonnett.

Additionally, the prevalence of the disease has meant there are also 800,000 caregivers in Canada, with many taking time away from their jobs, he said.

Cancer treatment will only become more expensive, increasing the urgency to bring it under the same policy umbrella as other chronic disease, said Bonnett.

“We want employers to do what they can to close many of the gaps in care.”

Tying together resources that already exist in terms of wellness management would be a healthy first step for employers, said Smofsky.

“Cancer is a chronic disease that needs to be recognized in a healthy workplace strategy and very principled human resource management.”

Focus on prevention

Cancer has frequent comorbidities, with actions such as smoking, poor dietary choices, lack of exercise and excess time in the sun contributing to one-third of cancer diagnoses, according to Bonnett.

“Prevention is an issue,” he said. “It’s not that you get cancer out of the blue — a lot of it is genetic. And a lot of the causes of cancer are not well-known by scientists. But there is a consensus around (how) over one-third of cancers can be prevented.”

“Stress is well-known to be associated with cancer and other chronic diseases,” said Bonnett.

“So, to the extent you can manage the climate and the culture in your organization — and you can — then that is a positive influence that connects nicely with our efforts to manage how people live their lives, because lifestyle is also an important factor.”

Employers can affect a supportive culture and issues around return-to-work and stay-at-work policies through accommodation, he said, noting the work environment is an important part of the recovery process for affected workers due to its social connections, income and sense of accomplishment.

Of the 60 per cent of cancer survivors who want to come back to work, 40 per cent will need some level of accommodation, said Bonnett.

Accommodation to the point of undue hardship is a legal requirement, but also makes good business sense, he said.

“Why would you lose talent in a time when it’s really hard to find the right people to do the work?”

Advice for HR

Comprehensive employer support can help mitigate significant emotional, physical, occupational and financial distress for patients and caregivers, all of which benefit employers, according to Smofsky.

Regular, candid communication is necessary over the length of the worker’s cancer journey, as survivors are often concerned with risks around privacy and potential job loss, he said.

Human resources can better support employees dealing with cancer by serving as a practical communication conduit to management and by adopting or modifying policy and processes, said Smofsky.

“Employers have a key role to play, and you as HR are the custodians of that,” he said. “You can step up.”

Access to adequate health and disability coverage is an important cornerstone, and HR policy should consider the financial, operational and cultural impacts of cancer as a chronic disease, said Smofsky.

Coverage should be adequate and long-term disability funding should never be terminated, he said.

“It doesn’t have to be perfect. We’re not saying that you have to provide Cadillac plans for individuals that (have) cancer.”

But rather than looking at the disease from a cost perspective, it’s best to contemplate the “downstream impact” of any employer decisions, said Smofsky.

“We do ourselves, our employees and our workplaces a disservice if we just focus on the physical aspects of cancer just like any other condition.”

SIDEBAR

Communicating benefits offerings

Even the very best benefits and wellness programs are only worth as much as employees understand and appreciate them, according to Chris Lee, vice-president of marketing and communications at Accompass in Toronto.

An average benefits plan costs an employer $2,500 annually, he said. So does the typical retirement plan, and together the two result in a substantial investment for larger companies.

Benefits and retirement are “very important pieces of the employee rewards package,” said Lee, speaking at the annual conference of the Human Resources Professionals Association (HRPA) in Toronto on Feb. 1.

Communicating these rewards to employees is a skill HR professionals should practise and perfect, he said.

“There’s lots of things that are really a foreign language for employees… We should be a little bit more aspirational about how we talk to our employees. We’ve got to remember we’re talking to humans here, not resources.”

Often, email correspondence regarding benefits or retirement can feel like “drinking water from a fire hose” for employees, said Lee. “We use a lot of this terminology without even thinking about it.”

Simplification and adhering to marketing principles is a good place for HR to start, he said.

“You’ll want to make sure you’re doing this in concert, and with the blessing of, your legal and compliance teams, so you’re not falling out of step by not communicating enough… (but) we need to be really respectful of the employee experience and thoughtful about how we communicate and interact with them.”

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