Just before Ruby Gao, a local Emergency Room Nurse who works night shifts at Beijing United Family Hospital, crossed the finish line of the 2015 Beijing International Marathon, her body was starting to fatigue and she was worried she hadn’t trained hard enough.

“But when I saw [the other runners], I couldn't stop,” she said. “I could feel muscle pain, but I challenged myself. And then, when I crossed the finish line, I thought, wow, oh my God, I did it!"

Today, China’s urbanites are increasingly interested in exercise and living healthy lifestyles. The General Administration of Sport in China predicts that 40 percent of the population will partake in some form of athletics by 2020.

Yet, healthy living can be a struggle. The World Health Organization categorizes obesity as a global health epidemic, and it classified 35.4 percent of the adult population in China as “overweight” in 2014. Family Medicine Physician Dr. David Dai of United Family Hospital points out that individual willingness, like that of Nurse Gao, plays a big role, but issues like air pollution and murky food nutrition guidelines present unique problems for achieving wellness in China.

“Over the past 10 years people have begun paying more attention to their health,” Dai said, “(But) in China there is no primary care or family doctor. You might be on your own and you might not know what evidence-based tests you have to do.”

Companies operating in China are aware of these challenges, and growing numbers of them have created wellness programs to reduce the risks associated with modern living. Company-sponsored wellness initiatives can have substantial returns on investment in an environment where employee retention is challenging.

Bringing wellness in-house

Health programs within companies generally focus on filling information gaps, increasing access to care and incentivizing healthier choices.

Medically based programs are a mixture of services, health education initiatives and discount incentives for medical insurance. “IBM China has developed many health and wellness programs,” said Horst Gallo, Co-Chair of the AmCham China Human Resources Forum and IBM's Vice President of HR. IBM provides health risk assessments, flu vaccinations, medical case management and online health advising. Gallo credits these programs for the fact that IBM’s “medical insurance spending is among the lowest (for a similar benefit design) in the China marketplace.”

Health promotion activities are another way to introduce health as a priority in a company. These are different from medically-based programs in that they augment the company’s overall wellness culture, not just urgent health and safety concerns. Activities may include company-sponsored marathons, nutrition and weight education classes, and stress management seminars.

Companies in China are already coming up with creative ways to encourage employee participation. According to Brian Ridge, Sales Manager for Trek’s Apparel and Gear line, the company’s General Manager leads weekly group bike rides.

“There is a broader movement towards wanting to get out and wanting to do something fun for yourself on the weekend," Ridge said.

Companies are also combining wellness with community impact programs. The United Family Charitable Fund (UFCF), which provides free or low-cost medical services to China’s vulnerable populations in cooperation with United Family Healthcare, launched an annual fundraising campaign four years ago to raise awareness about the foundation’s mission. Employees collected pledges from over 2,500 donors and raised almost RMB 400,000 for the Run for Hope.

“We are very proud of Run for Hope,” said UFH Client Relations Manager Jenifer Sullivan. “Training for the event has gotten company employees engaged in improving their own health while also contributing to a good cause.”

The value of health

A Kaiser Family Foundation study recently reported that 71 percent of firms believe their wellness programs are “very” or “somewhat” effective at reducing healthcare costs. Comprehensive data for wellness programs in China is lacking, but data from the US can offer some insights. PepsiCo’s “Healthy Living Program,” for example, modestly reduced healthcare costs for employees after three years, but after seven years the company successfully reduced costs by a dramatic $360 per person per year.

Some in the field are calling for more comprehensive evaluation and professionalization of wellness programs. The World Economic Forum launched Workplace Wellness Alliance in 2009, now called the Institute of Health and Productivity Management (IHPM), to help businesses harness the fiscal benefits of employee health and productivity. In 2013, they issued a comprehensive report calling for the meticulous evaluation of wellness programs. One of their key recommendations called on companies to run cost-efficiency analyses of proposed wellness interventions before implementation in order to better predict future returns on investment.

Annual reports are another way companies can measure progress. Johnson and Johnson tracks returns on investment, impact and goals in annual reports to company leadership. According to Vice President of Global Health Services, Dr. Fik Isaac, since 2010, 95 percent of Johnson and Johnson's global workforce had completed health risk assessments in 2015, and 53 percent of employees working outside the US had access to wellness programs. Today, 73 percent of the company’s global employee population is considered a “low” health risk, and Isaac hopes to see that number hit 80 percent in 2016.

Isaac said strategic coordination at all levels of management is critical for reaching target returns.

“From our point of view, the key must-have’s for a successful wellness program are strong leadership commitment, employee participation and sustained engagement, evidence-based programs and services, workplace policies and impact measurements,” he said.

Still, the positive influence of small-scale programs should not be overlooked. Ridge noted that Trek’s Beijing office also has a gym for employees, and the company held a contest this winter to see who could lose the most weight.

“We should be looking out for employees’ wellbeing because it's good for business,” Ride said. “Only focusing on the data is kind of missing the point.”

Employees can also take matters into their own hands. Chris Haagen, Business Development Manager at Nielsen, felt he could develop Nielsen’s wellness programs a step further by using his influence as a team manager. Last year, he created a WeChat group where his team shares fitness goals and challenges, and exchanges nutrition advice. Top-down and bottom-up programing is critical, Haagen said, and the strength of influence at the mentor and peer level should not be underestimated.

Growing with demand

Although China’s GDP is no longer experiencing double-digit growth, healthcare remains a bright spot in the future. Clearstate – a division of the Economist Intelligence Unit – predicts that healthcare services in China will grow at a compound annual growth rate of 10.6 percent between 2015 and 2019, and stresses that China will continue occupying the top spot for medical and pharmaceutical growth globally. Notably, much of the expected growth will come from mounting domestic demand.

As more businesses establish wellness programs and robust healthcare offerings, they can play a more critical role in the battle against chronic illness and rising healthcare costs.

“Wellness can be such a powerful and manageable movement,” said Zhou Jun, Director of the US-China Healthcare Cooperation Program. “[Leading a healthy lifestyle] not only helps improve the health of a large population, but also improves productivity, fights chronic disease, and lowers healthcare costs in the long term” – a combination that will help ensure the health of generations to come.

To get involved in AmCham China's US-China Healthcare Cooperation Program, contact Qian Yinan.