How Healthy is INDIA INC?
As the global downturn fills most people with fear and doubt about the future, doctors send out a health warning. Spiralling stress at the workplace now stalks the power corridors of corporate India.
I f you are a high- pressure executive, beware of your amygdala. That almond- shaped fear centre deep inside your brain gets jittery every time you log 60- plus hours a week, face 24x7 demands, unpredictable work- flows, endless jet lags, flexible global hours, late nights or sleeplessness. It puts your brain on alert and triggers off 1,400 biochemical changes down your body. Adrenal glands pump out stress
hormones, sympathetic nerves go into an overdrive, your heart beats faster, blood pressure rises and your digestive system shuts down. Before you know, your body shifts into a state of perpetual anxiety.
Corporate warriors of the new economy already have plenty on their platter to worry about the amygdala. Yet as the global recession fills most people with fear about the future, scientists send out warnings about the amygdala’s ability to “hijack” the brain and the body: Stress can burn you out, make you sick, or even kill you. With India Inc losing a series of star performers— from CEO Raghu Pillai of Future Group at 54, CEO Ranjan Das of SAP India at 42 to Executive Director R. Ravimohan of Reliance Industries at 52— in the last two years, it is an issue that corporate executives ignore at their own, and their company’s, peril.
Doctors are supposed to become inured to death. But Dr Prathap C. Reddy was devastated when a young patient died of a heart attack way back in 1979. He could have been saved by timely diagnosis. The 1970s was when hospitals in the US had started marketing “executive checks”. Reddy, back in India after a decade- long career as a cardiologist in the US, started planning one. This was even before he set up India’s first corporate hospital chain, Apollo, in 1983. “It led to the first- of- its- kind preventive checkup in India at my hospital,” he says. “Today we have done seven million health checks and we find that although 60 per cent of corporate executives do not show symptoms, for 80 per cent the tests indicate risk factors for serious lifestyle disorders.”
In 2000, when Apollo Hospitals first compiled the health status of corporate India from 15,000 executive checks in the six metros, the findings were dismal. Over 56 per cent were found to be prone to heart attacks, over 30 per cent had cancer risk and 30 per cent were on daily medication. Their latest study, concluded in 2011, covering 250,000 employees from 32 cities and towns, however, shows improvement in overall health:
Degenerative and chronic ailments have come down by 36 per cent over the decade. But stress has zoomed. “Overall stress among corporate executives has gone up from 39 per cent in 2000 to 50 per cent now, while daily pressures are up from 9 to 17 per cent among the same group,” says Dr Adrian Kennedy, head of Lifetime Wellness Rx International, an Apollo Hospitals group company. The immediate impact is behaviour change. No wonder, domestic stress among them is up from 2 to 19 per cent, levels of smoking from 14 to 24 per cent and alcohol consumption from 6 to 16 per cent.
What about CEOs? Power seems to come at a price, as a startling 100 per cent of chief executives seem to suffer from psychosomatic stress ailments: High blood pressure, diabetes, cholesterol to abnormal ECG, frequent headaches, asthma, backaches and allergies. CEOs get 13 per cent more ulcers and 10 per cent less sleep than their executives. The source of all this stress is, however, not the organisation or the home: Only 10 per cent CEOs find their jobs stressful, less than 5 per cent face problems at home, just 33 per cent complain of financial or legal problems as causes of stress. “The major cause of stress, it turns out, is their personality,” says Dr Kennedy. “About 59 per cent of CEOs have a Type- A stress- prone personality. That is, they tend to be highly motivated people who feel compelled to win and are by nature impatient, restless and critical.”
The glass and steel waiting lounge of Medanta- The Medicity in Gurgaon is always packed with people. But if you expect mostly elderly patients being led in and out, you are in for a surprise. Executives in suits or business casuals sip coffee, fidget with their cell phones, check time or walk impatiently up and down the hallway. Most of them are not patients, but waiting their turn for preventive checkups. “Our studies show that most of them are not suffering from any disease, but a third are likely to have high blood pressure, high cholesterol levels and diabetes, brought on by stress,” says Dr Naresh Trehan, cardiac surgeon and chairman of Medicity. “The biggest trouble is that corporate executives are the worst victims of stress yet most are either unaware or unwilling to confront it,” he says.
It’s also trendy to be stressed. The smug view in power corridors is: Competitiveness is a virtue and hence it’s cool to compete even on stress. Dr Samir Parikh, head of psychiatry at Fortis Delhi, explains the new rat race through a case— one of his patients, a 20- something corporate employee. He owns a swanky car and a plush home, all on easy monthly instalments, and a smartphone that he claims is his lifeline. Even during vacation, he answers work- related telephone-calls and checks emails constantly. “You have to be available 24x7, what is the point of technology otherwise,” is his mantra. He smokes about 20 cigarettes a day and pops a sleep medication a few times a week. “It’s everyone’s story, not a big deal,” he shrugs, when Dr Parikh questions the blurring boundaries between work and life.
“He’s a proud member of India Inc, a new breed
of young, working Indians, who have money but no time for themselves,” says Parikh. The rat race has a new finish line: It’s not who gets there first, but who works the hardest and is hence the most hassled. The average workweek has expanded since the 1970s while leisure time has nose- dived by 37 per cent, explains Dr Parikh, and Indians seem to be working extra- hard even on vacations. Twenty- seven per cent Indians work for an average of three hours a day on holidays, 7 per cent above the global average. “Chronic or extreme workplace stress can lead to psychological distress in the form of anxiety, depression or other mental illnesses,” he says. “Workplace challenges like demotivation, absenteeism, a high attrition rate, low productivity, increased healthcare costs have also been associated with stress.”
Scratch below the surface and it’s an unsettling world of long work-hours, strict deadlines, sleep debt, precipitous drop in physical activity, unholy reliance on fat- laden foods of convenience, vicious stress loop at home and work— spiralling into an abyss of chronic lifestyle disorders. At the root of it is obesity. About 36 per cent of corporate employees were found to be overweight and obese in a survey conducted by ASSOCHAM among 2,000 people across India in April 2012. “Obesity is not just a disease of wrong diet but also of negative stress,” says Dr Anoop Misra, director and head, Department of Diabetes and Metabolic Diseases, Fortis Hospitals, Delhi. The body releases a molecule, NPY ( neuropeptide Y), when stressed, which unlocks the fat cells and causes them to grow in both size and number. “Stress also ups cortisol in the body, which is directly linked to fat accumulation.”
At the higher reaches of business, a typical workday stretches well beyond the 10- hour stint in office, over Internet and BlackBerry. But the punishing work pace is not the only stressor: 78 per cent of corporate employees sleep less than six hours, shows the ASSOCHAM survey. Loss of sleep can play havoc with hormones, lead to weight gain, diabetes and compromise immune resistance, leaving one vulnerable to anything from common cold to cancer. The survey shows 54 per cent of executives miss office for simple sicknesses, like common cold and fever. Studies confirm that insomniacs have a hard time holding on to jobs.
Ajay Saxena, 30, an executive with a telecom giant, was gearing up for Diwali launches in 2010 when one morning he felt a twinge in his left arm and uneasiness in his chest. A company dealer got alarmed when Saxena offered him a clammy handshake and forced him to go to a hospital. Saxena blacked out in the OPD: A minor heart attack. “I had never fallen seriously ill, but I was leading life at a frightful pace,” he says. “Work, partying and more work. Eating anything I could grab on the run and smoking 20 cigarettes a day.” He now eats sprouts and greens,
mostly. Spices are out, as are salt and sugar. At 5’ 10”, he was a hefty 86 kg at the time of the incident. Now, he’s down to his high school weight of 74 kg. “I realised it’s, after all, just work. Life is much more than an executive’s daily stressful grind.”
About 52 per cent of corporate employees are afflicted by lifestyle diseases linked to bad eating habits. Dr N. Salgunan, cardiovascular and thoracic surgeon in Chennai, is not surprised. “We Indians are prone to stress, mainly because of the incorrect eating habits we are developing, thanks to the new 24x7 work culture.” There is less time to cook healthy meals at home, with both the husband and wife often in the work force, and it’s easy to eat unwholesome food at fast food outlets dotting city landscapes. New bad eating habits are creeping in: Skipping breakfast and then snacking sporadically through the day, fitting meals into one’s busy schedule, eating too little during the day and then devouring 1,000- calorie dinners. “Unless there is a change in lifestyle and diet style, young corporate executives will be sitting ducks for a range of diseases,” says Salgunan, who does surgery on at least one young victim of corporate lifestyle a day.
Members of the corporate smart set are looking for action plans. And wellness is emerging as an antidote for India Inc’s poor health. Information Technology Enabled Services firms are spending about 11 per cent of non- compensation facilities on wellness: Health food counters, nutritional counselling, psychologist on call, gymnasiums, spa and massage therapies. On the nutrition front, with corporate patronage, the market for functional food— herbs, minerals, vitamins, omega fatty acids, probiotics— is humming. Hospitals are providing a bouquet of services: From healthchecks, weight management modules, stress audits, tobacco clinics, to health tips via SMS, microsites and helplines. Real estate developers are into “wellness homes”: Centrally air- conditioned, sauna, steam, jacuzzi to spas and club facilities, health clubs.
What’s the road ahead if you want to survive and thrive? Eat right, meditate, quit smoking, find time to work out, schedule vacations with family ( and leave the cell phone behind), focus consciously on happy images from the past. They will pacify your amygdala, signal the parasympathetic nervous system to bring down your heart rate, slow down your breathing, and stop stress hormones cortisol and adrenaline from surging up your bloodstream. Over time, regions in your prefrontal cortex, that are responsible for optimism, creativity and well- being, will thicken with grey matter, enough to resist amygdala’s primitive fragile insecurity. Don’t wait until you develop heart disease.