You wouldn’t buy a plane ticket without knowing the real cost. But that’s what many North Carolinians do when it comes to their health care.
We know that navigating the health care system and figuring out what you can expect to pay, is one of the most complex and frustrating issues that many of us face. National studies have shown that North Carolinians pay much more for health care than nearly all other states, currently ranking #50 on certain cost measures. In fact, right here in North Carolina, the cost of a procedure can differ by thousands of dollars even within the same town.
Knowing Where Your Health Care Dollar Goes
In just 10 years, a Blue Cross and Blue Shield of North Carolina (Blue Cross NC) analysis shows that some North Carolinians will spend up to 25 percent of their take-home pay solely on medical expenses. As the largest organization in the state that insures many North Carolinians for most of their lives, we have a responsibility to do what we can to reverse these alarming trends.
And it starts with simplifying the health care process. We want consumers to know they can easily save money on one of their largest household expenses, by giving them the tools they need to make informed health care choices and get the most for their dollar.
In 2012, we introduced HealthNavSM, a tool that lets our members compare the cost and quality of health care procedures. In 2015, we became the first in the country to give everyone the ability to see the costs of over 1,200 common medical procedures through our Cost Transparency Tool.
Now we’re rolling out a new program. One that helps keep more money in customers’ pockets.
Earlier this month, our first group of eligible members gained access to SmartShopper, powered by Vitals.
SmartShopper is a tool that makes it simpler than ever to find low-cost doctors and hospitals. It lets members price shop for over 80 common procedures like colonoscopies and knee replacements. The best part? They can get paid up to $500 per procedure for making cost-effective choices for care they already need.
How does it work?
Using Blue ConnectSM, eligible members can select the SmartShopper option. SmartShopper helps identify quality, in-network doctors who can do the procedure at a lower cost.
Members select the provider they prefer and have their procedure.
SmartShopper mails the shopper a check for up to $500 per procedure.
Watch the video below to see how SmartShopper helps members find the right care for the right price
Vitals SmartShopper - YouTube
The Big Picture
Transparency has become the norm for most industries. The health care field can no longer play by a different set of rules. People can’t be in the dark about costs until bills come in the mail.
Improving access to pricing and quality data can help patients cut their health care costs. It also helps them make informed choices about their care. This is critical if we want to change health care, making it simpler to understand, more affordable and customer-focused.
We’re excited about our range of tools that help simplify the health care experience, especially our new SmartShopper tool. These tools can’t fix the health care system overnight, but we think they’re a step in the right direction.
SmartShopper, powered by Vitals, is a value-added service offered to self-funded large group (250+) employers and additional fees may apply. The program is not part of the member’s policy or benefits and may be changed or discontinued at any time. The program is currently not available for Blue Cross NC fully insured lines of business. Vitals does not offer Blue Cross or Blue Shield products. HealthNAV is a service mark of Blue Cross NC. Blue Connect is a service mark of the Blue Cross and Blue Shield Association.
Genetic testing continues to revolutionize the way oncologists treat breast cancer. New studies have emerged showing that genetic tests can help
determine whether chemotherapy is necessary for individuals in the early stages of breast cancer.
Emily’s family while participating in a Breast Cancer Awareness event.
Armed with this vital information, early detection, and treatment other than chemotherapy may offer revolutionary treatment for women. It can improve their quality of life and their health.
Genetic testing may be helpful for women diagnosed with breast cancer. For me, knowing was better than wondering.
My mom didn’t think about being a carrier of BRCA2. Genetic testing wasn’t something many people thought to do. She was diagnosed with stage four breast cancer at 29, I was only two years old. After reading journal entries from my mom, I realized that I had to take charge of my healthy outcome. It was up to me to fight!
BRCA1 and BRCA 2 Gene Mutations
If you have a family or personal history of ovarian or breast cancer, genetic testing can be done to determine if you are a carrier of the BRCA1 or BRCA2 (Breast Cancer susceptibility) gene mutation. BRCA1 and 2 are tumor suppressors that repair damaged DNA when functioning normally.
Sometimes the suppressor is mutated, which may lead to damaged DNA being incorrectly repaired. This may make the cells susceptible to developing cancer. A recent study found that 72% of BRCA1 and 69% of BRCA 2 carriers will develop breast cancer before they are 80.
A Legacy, My Mothers Bravery
I grew up as an advocate for breast cancer awareness. I watched my mother fight!
I’ve attended Relay for Life, sporting a pink ribbon during the month of October, for as long as I can remember. As an athlete, I’ve always encouraged my teammates to wear pink laces during games.
My mom’s fight was inspiring. She was dedicated to awareness efforts and tirelessly advocated to help find a cure.
In 2009, she passed away after 10 year battle with the disease. For 10 years, she wrote to me in a journal that she filled with wonderful memories. She also wrote about her journey with breast cancer. Her lessons and her words give me courage.
In one entry, she explained that she was a carrier of BRCA2 and that my grandmother and great-grandmother were carriers too. She urged me, and my younger sister, to receive a genetic test as soon as we turned eighteen. Scared and confused, it took awhile for me to realize that it was better to know.
Knowlege is Power
Knowing that I had a 50% chance of being a carrier, I received the testing and the results showed that I was positive for BRCA2. I was in shock, but a wave of relief rushed over me when I remembered what this meant.
Now, I am equipped with the knowledge that allows me to get on a preventive treatment plan. With the goal of detecting breast cancer early, I receive MRI’s annually and find comfort in knowing that if cancer appears in my body, it will be detected and stopped before it can metastasize. That is powerful.
My grandmother once told me that if my mother had known that she carried the genetic mutation BRCA2, she would still be here today.
Just like my mother urged me, I urge anyone with a family history of breast or ovarian cancer to talk to a genetic counselor. Find out if you are a candidate for testing. Knowledge is power and early detection may save your life.
“When that hungry child walks up to you with a tray of food and no money, what are you going to do?”
That’s how Erselle Young explains managing the lunch debt in her school system. “That child has already been through hours of classes and they have to get through the rest of the day. How can we not provide a meal for them?”
Fuel for Learning
Young is director of school nutrition for Rockingham County Schools. She works with the schools in her district to provide healthy food to all students while keeping cafeterias from overspending their budgets.
But recently, school districts in North Carolina and across the country have been facing thousands of dollars in debt from school lunch programs. While the schools are trying to manage what they spend on food, labor, and supplies, many cafeterias end up providing meals for students who don’t pay. Often these students are eligible for the federal free and reduced lunch program, but their parents haven’t applied for the benefit. In other cases, parents forget to send lunch money or add funds to their child’s school lunch account.
When a child doesn’t have lunch money, some schools swap a hot meal for a cheese sandwich or only provide fruits and vegetables. Other cafeterias won’t serve the child at all to avoid the unpaid meal. Doing so leaves a child without a nutritious lunch, sending them back to a classroom on an empty stomach – without fuel to learn. But for schools like Young’s that have a commitment to serving children healthy, warm meals, the unpaid lunches can add up.
“When a child fills their tray and gets to the end of the check-out line with no money, we have an agreement to let that child eat regardless,” said Young. “We work with parents and school administration to avoid denying a student their lunch. We give them a healthy, warm meal for free, and we try to work with the parents to get payment. But that’s how you end up with $15,000 in debt.”
When kids don’t get their lunches at school, they have trouble focusing in class and their performance suffers. According to No Kid Hungry, when students don’t get enough to eat, 80% of teachers see them lose the ability to concentrate, and 62% see behavioral and discipline problems. School meals have a powerful effect on kids’ health, behavior and academic performance – a hungry kid just can’t learn.
A Sigh of Relief
In most cases, a school’s meal budget is separate from other budgets used for salaries and supplies. At Young’s schools, when the lunch debt needs to be paid, that money comes from the school’s general fund. Money that would otherwise go toward things like educational games and science equipment ends up being used to cover the debt.
“Schools really depend on these general funds to purchase educational items that enrich classrooms, but if we use that money to pay for lunches, our teachers have to rely on community donations or fundraisers,” Young said.
“When we got the call about Blue Cross NC’s donation, we all breathed a sigh of relief – it was wonderful,” Young said. “We can try to get parents to apply for federal and reduced lunch, and we can call them about the debt they owe. But at the end of the day, it’s about the children and making sure they can get the food they need to do their best in school.”
You may not know where the Healing Transitions women’s campus is if you weren’t looking for it.
Located near Umstead Park in Raleigh, it’s easy to miss. But for so many in the Triangle, it serves as a safe haven.
Ten Blue Cross NCers recently visited Healing Transitions to get a full tour of the women’s campus and as volunteers to paint bedrooms.
Healing Transitions is a homeless shelter with a peer-run recovery program. Equipped with a detox center, Healing Transitions provides a caring and supportive environment where those suffering from substance abuse can safely detox and begin recovery with a 4-step program.
Blue Cross NC employees want to serve and they want to learn more. More than 50 people put themselves on a waitlist to volunteer.
During the tour, volunteers met a special woman, Shannon.
Shannon has been living at Healing Transitions for the past 22 months through a long and, at times, difficult journey to recovery.
“Before I got here, I didn’t know anything about addiction as a disease,” she said. “I thought addiction was a moral issue, that I was a bad person.”
Participants leave notes about what they like most about themselves while going through recovery.
As alone as she felt in her addiction, once arriving at Healing Transitions, she knew there were others like her. “What got me and these women here might be different, but the pain we share through our addiction is very much the same. We have a strong sisterhood bond here.”
For those going through recovery, it can take several attempts. Shannon had a few setbacks during her journey but says Healing Transitions never turned her away, and at no cost to her.
Because at Healing Transitions, Shannon and her fellow participants receive everything they need: food, shelter, and clothing – for free. “I have no bills. All I have to focus on is how to change me. I’m learning how to live and how to be that functioning member of society.”Participants in the program also receive basic medical care from doctors who volunteer their time twice a week for routine exams.
There’s also an onsite case manager who helps with family reunification throughout the program. Family support is a large component of the program and is echoed throughout the four steps.
Shannon has learned real-life skills through the program. Because of the peer-run nature of the center, all participants have jobs: cleaning, cooking, planning and more.
“I had never worked before,” she said. “I was not used to a 14 hour day on my feet. There were a lot of things that I had never learned how to do: cook, prep food, or wash dishes even. That was all new and scary.”
She’s been sober for eight months – since October 29, 2017.
“I’ve been able to finally accomplish eight months of sobriety because this place never gave up on me, and if it had, I don’t think I would be alive.”
Once Shannon graduates from the program, she aspires to work as a detox monitor at Healing Transitions. She wants to sponsor women going through addiction recovery. “My experiences and my struggles were not for nothing, they now have a purpose now help others.”
Thomas Hogshead, Volunteer Coordinator & Development Associate at Healing Transitions, is nearing 10 years in sustained recovery and has dedicated his career to the place that has changed his life.
“The beauty of Healing Transitions is the fact that it’s a peer-run program. Those seeking recovery are able to interact with new, current and former participants,” he said.
“Support from the outside recovery community provides a foundation for individuals to flourish and grow while embarking on a remarkable journey,” said Thomas.
Over 70 percent of those who graduate the program are still in recovery one year later.
Thomas says the increase in demand for recovery services has skyrocketed with the national opioid epidemic.
“We do whatever it takes, even if that means using mats on the floor to accommodate all those needing services.” They do not turn anyone away. Although the program is free to participants, everything comes with a price tag.
It costs an estimated $37 per person per day to keep the lights on at both the women’s and men’s center. Financial contributions are key to the success of the program. Part of Thomas’ role is working closely with the Development Coordinator completing grant requests seeking funding from private and public sectors.
“Upon completion of the peer-run recovery program, participants are able to return as productive members of society having access to all the services they need,” said Thomas.
Thomas said that participants especially enjoy when members of the outside community support their efforts through volunteer engagements or visiting the campuses for meetings or meals. “People just want to feel valued and know that others care about them. Having a profound sense of hope is key to this organization.”
Thank you to the ten Blue Cross NC volunteers who opened themselves up to learn more about a powerful issue in our state.
The opioid problem won’t be solved overnight. But that doesn’t mean we can’t make significant progress in the short term here in North Carolina.
A research report called “The Opioid Epidemic in America: An Update” from the Blue Cross and Blue Shield Association (BCBSA) published this week shows that the total number of opioid prescriptions in America is falling. And new opioid prescription policies from insurers are helping.
The BCBSA report shows that in our state, opioid prescriptions only fell by 16% from 2013-2017. And that was before Blue Cross and Blue Shield of North Carolina (Blue Cross NC) adopted a new policy on covering first-time opioid prescriptions.
Effective April 1, 2018, we began limiting first-time prescriptions of short-acting opioids to a seven-day maximum supply. After that first prescription, our members can fill future prescriptions for a larger supply if it is appropriate. This is meant to lower the risk of chronic opioid use and limits the number of unused opioids that can wind up being misused, whether intentionally or not.
In the first month under the new policy, Blue Cross NC customers filled 1,800 fewer opioid prescriptions totaling about 70,000 opioid pills. That’s outstanding progress for just four weeks.
Half a Million Years Gone
Lest anyone question the urgency behind these kinds of policies, the Health of America report finds that North Carolina sees an average of 8.2 diagnoses of opioid use disorder per 1,000 Blue Cross NC members, compared with a national average of 5.9.
The gap between 5.9 and 8.2 might not seem very significant, but it actually means our rate of opioid use disorder – a pattern of opioid use that causes significant impairment or distress – is nearly 40% higher than other states.
It’s important to note that there are many people in North Carolina and beyond who truly do benefit from the pain relief opioids can bring. For people dealing with chronic pain, opioids can make life manageable. But there is no denying that too many people are misusing these medicines and too many lives are being destroyed by them.
For example, the Ohio Alliance for Public Health found that misuse of opioids reduced life expectancy in the state by 500,000 years from 2010-2016. That’s a half-a-million years of life taken away from the people of Ohio. How many thousands of years have been stolen from North Carolinians? How many more will be taken?
Blue Cross NC: Taking Action
Beyond the change to our own opioid policies, Blue Cross NC is working on a number of fronts to fight the opioid epidemic in our state. As part of a $50 million series of community investments, we’re devoting $10 million to combat opioid abuse and addiction. TROSA, an abuse recovery program based in Durham, will receive $1 million to expand its service capacity in the Triad and Western North Carolina. The UNC School of Government will use $390,000 to develop community-based resources and programs in 10 communities struggling with opioid addiction.
Despite the state law, about 15 percent of first-time acute opioid prescriptions exceed the maximum limit. That means up to 4,000 prescriptions are being filled each month that are in violation of the law.
The heat is on, and it’s time to shape up for summer. Did you know that as a Blue Cross and Blue Shield of North Carolina member you are eligible for an exclusive, valuable discount program that can help with that, called Blue 365?
As a member and a fitness professional, I was so excited to find out about these great deals. With Blue365, you and your family can get discounts on a wide variety of fitness, health and lifestyle products, and services — including gym memberships!
The Blue365 deals are divided into the following categories:
There’s so much more — from hotel discounts to vision. It’s definitely worth checking out.
Here’s How It Works
It’s easy! Go to Blue Connect to sign up and visit our Blue365 website, where you can review all of the deals available and learn more. As a Certified Personal Trainer and group fitness instructor, I was most excited about the truly valuable benefit of discount gym memberships and fitness trackers!
So I thought I’d highlight this and some of the other healthy lifestyle options currently available to you on Blue365.
It’s easy to sign up and it’s free
This discount program is available to all Blue Cross NC members, but to participate you need to enroll in Blue365 on the website. Joining is easy, and there is no charge to do so. Once you sign up, you’ll have immediate access to all of the deals online.
Note: These were the discounts available at the time of this publication. Offers are subject to change, and new deals are added regularly. Check the Blue365 website for the latest information.
Discounted gym memberships
Fitness Your Way by Tivity Health
Why choose just one gym if you don’t have to? For just $29 a month, Fitness Your Way offers access to nearly 10,000 different gyms! Visit any participating fitness location—anytime, anywhere — as often as you like. That’s ideal if you like to travel.
The monthly fee provides you a basic membership at the facilities. With so many locations, imagine all the group fitness classes you’ll be able to choose from.
You can use the Fitness Your Way gym locator on the web page to find the gyms near you. (I did, and there were six within six miles of me. Impressive!).
Gym Network 360
Get 5% – 20% off gym memberships at thousands of fitness centers and specialty studios nationwide through the GlobalFit gym network.
Participating brands include Gold’s Gym, 24 Hour Fitness, Anytime Fitness, LA Fitness, and Curves, as well as yoga, Pilates, rowing, CrossFit, and more. There is a locator on the web page to find the gyms near you.
They also offer professionally guided health coaching programs including smoking cessation, nutrition, and stress management; and reduced pricing on travel, spa, apparel, restaurants and more.
Snap Fitness You can join Snap Fitness for 50% off their best current enrollment offer, with no processing fees. Plus, you’ll get a 5% discount off monthly dues. Or, you may opt for a 30-day trial membership for a one-time $8.95 fee.
Snap Fitness offers 24/7 access to more than 1,400 locations worldwide. They also offer a money back guarantee: If after becoming a member, you don’t see and feel a difference within 30 days of joining, they’ll give you a full refund.
Fitness trackers for less
Here are some of the trackers available:
Enjoy 18% off and free shipping on Fitbit’s full suite of products including Zip, Flex 2, Alta and Alta HR, Alta SE (Special Edition) and Alta HR SE, Aria 2 Scale, Ace Kid’s Device, Charge 2 and Charge 2 SE, Versa and Versa SE, Ionic and Adidas Ionic.
Healthy eating and weight loss
Jenny Craig Free 3-month membership and $70 of food discounts.
Nutrisystem Save 40% on the Nutrisystem Consecutive 4-week Auto-Delivery Program, plus free shipping.
25% off the Healthy Cooking Essentials Program.
Retrofit 15% off private weight loss coaching programs.
Other health and fitness products and services
Here’s a sampling of what’s available…
Men’s Health, Women’s Health, Bicycling or Runner’s World Magazine for only $10/year.
Reebok Get a 20% discount online or 15% off at outlet stores.
30% off select men’s and women’s styles. (I found a pair of work shoes there for my husband for $49, big savings from the $70 he usually pays for the exact same style. We ordered them immediately!) And they have free shipping and free returns.
Invite Health Save 50% off the retail price of vitamins and non-GMO supplements.
40% off genetic composition testing.
Hope Page Medical 30% off LED safety products for outdoor activities, including LED wearable lights for runners and walkers.
Fitboombah Save $79 on “The BodyBoss 2.0 Home Gym” equipment.
Remember, it’s free but you have to sign up to save
Joining is easy, and once you sign up, you’ll have immediate access to all of the deals online.
So do it right now while you’re thinking about it. And then…hit the gym
Blue365 Health and Wellness Member Discount Program - YouTube
“I thought preventive care was covered at 100%. Why did I get a bill?”
A distraught employee is in your office because they’ve received a bill after their annual physical. You’ve encouraged and incentivized your employees to receive preventive care because you know that these visits can positively impact the onset and severity of chronic diseases. Now, the employee is frustrated and confused and looking to you for an explanation.
If your employee received a bill after a preventive screening, three things could have happened:
They didn’t see an in-network provider
Members can locate an in-network provider by using the Find A Doctor tool.
They talked about a health issue that isn’t considered preventive
The doctor or patient may have asked additional questions that lead to additional testing. What’s included in the benefit? Check out our Summary of Preventative Care resource.
They received a service that wasn’t considered preventive
Learn what services, what age and how often employees should be receiving screenings here.
In truth, the best way to avoid unplanned costs is to equip employees to be savvy health care consumers. This requires proper benefit education and understanding.
These tips will help avoid extra costs during preventive visits
Be clear when scheduling
Ensure the provider knows that you are scheduling a preventive care visit, which is covered at 100% by your plan.
Advocate for transparency
Ask if any tests or treatments done during your appointment might not be considered preventive care.
Don’t get off track
Ask if talking about other health problems that are not considered preventive care during your appointment will lead to extra costs. If so, schedule a follow-up visit.
Know it doesn’t end at this doctor’s office
Ask if lab work can be sent to a Blue Cross NC in-network lab to lower your costs.
* This is representative of ACA-compliant (non-grandfathered) benefit information.
As a Health Promotion Specialist with over 25 years of experience working with organizations, I have routinely heard the same concern from clients, no matter what size. “How can we encourage our staff to get their recommended preventive care screenings in a timely fashion?” Many employers have experienced the rising costs to due to low preventive care adherence rates.
According to the CDC, 7 in 10 American deaths are from chronic diseases like diabetes and heart disease. Many chronic conditions, like these, can be prevented with early detection and proper screenings based on a member’s age and gender.
Motivating staff to get their recommended physicals and change behaviors can be a daunting task. Employees that take advantage of their preventive care screenings are more likely to spot illnesses early and improve their chances of recovery. For employers, early disease detection and prevention amongst their workforce can significantly lower health care costs. Positive preventive care adherence is a win-win for the employee and the employer.
So, the question remains: What can employer groups do to encourage and motivate their workforce to get their recommended preventive care screenings?
Here are three key strategies to consider:
Educate, Educate, Educate
In my own work with members, I have found that many members are unaware that most preventive services are covered at 100% by their insurance plan with no cost to the member. A comprehensive education campaign that teaches employees the right care based on their age/gender and how these services are covered can be very effective in increasing preventive care adherence.
Employees respond to positive stories that are shared by people who they know and trust. Ask employees who have had positive experiences through early detection to share their stories. Include the testimonials from these employees in newsletters, on your company intranet, or during employee meetings. The CEO of a large employer group that I worked with shared with his workers how a routine physical exam uncovered a serious heart condition. Because the issue was discovered in its early stages, he was able to control it with medication that would prevent the condition from progressing to a more serious state. His workforce appreciated his honesty and transparency. He was also told by several of his workers that his story encouraged them to get their yearly physical exam.
Incentives to motivate employees can take many forms. Consider individual rewards such as days off, money or premium differentials, or group rewards such as department recognition. I recommend using incentives after an educational campaign. Employers have found that even when a workforce is educated on a particular topic (ex: benefits of receiving their physical exams in a timely fashion), they still may not be motivated to take action. This is where incentives can be a very effective motivator. While monetary incentives are most effective, days off, casual dress days, or employee recognition can also help encourage employees to change their behavior. The benefit is two-fold. First, employees are rewarded and receive the benefit of a physical exam. Second, the employer can save money in the long term by avoiding costly future medical services that negatively impact their bottom line.
By implementing some of the strategies listed above, employer groups might see an increase in preventive care adherence rates for their population. Preventing disease and early detection are important for living a healthy life. The better the health of your employee population, the more productive and happy they will be while at work.
Did you know an eye exam can do more than measure your eyesight? It can also tell you a lot about your overall health. A comprehensive eye exam with dilation can detect early signs of serious health conditions like diabetes, high blood pressure, high cholesterol and more.1 In fact, more than 30 conditions show symptoms in the eyes2, from sickle cell anemia to colon polyps.3
A couple of years ago, my eye doctor noticed my eyesight had dramatically changed. She stopped the exam and told me to get tested for diabetes before she would continue. Luckily, I didn’t have diabetes, but I was borderline. This allowed me to adjust my diet and exercise more. So far, my blood sugar has stayed in check and I thank my eye exam for originally making me aware of this. I never thought that an eye exam could be life-saving but I look at this more holistically now. I now see there is a connection between my vision needs and my medical needs.
In addition to health issues, there are also a number of vision disorders that are detected during an eye exam. Ask people about the cost of vision loss and they might bring up driving at night or missing out on a good book. They won’t mention what it costs in lost dollars and lost health. The numbers show that vision disorders are among the most costly health conditions in the United States. And that’s just today; The National Association of Vision Care Plans thinks those costs could triple in the next 15 years.4
But there’s good news: When members use vision benefits, companies save in productivity and long-term care.4 That’s not an expense. That’s an investment.
You’ve heard the proverb, “Your eyes are the window to your soul,” but what we can clearly see is an eye exam is truly the window to your overall health. It can help you spot many conditions early on, which helps you get treatment sooner. Early treatment often leads to better outcomes and lower costs in the long run. And who doesn’t want that?
One of the best parts of summer is the opportunity to be active outdoors — whether it’s running, cycling or hiking. It’s also the season for marathons, and when sports teams start practicing for fall. And unfortunately, every year it seems we hear tragic news of a football player losing their life on the field due to heat stroke, or a runner collapsing at a race.
But it’s not just athletes who need to be on the lookout for heat-related illness. Physical exertion in the heat can be dangerous, for all ages.
Anyone who spends time being active in the summer needs to be aware. This includes outside laborers such as roofers and landscapers; families visiting a theme park; and children playing outdoors.
Children have a more difficult time adjusting to the heat than adults and are less effective at regulating body heat. Take extra care with kids.
Why does exercising in hot weather pose a danger?
Exercising under extreme conditions can add significant stress to the cardiovascular system. The danger worsens if people are not adequately hydrated prior to starting exercise, wear heavy clothing, or are overweight or obese.
Heat-induced problems are common in football, where a number of issues combine — the weight of the padding adds to the work the person has to do, the added work increases the amount of heat build-up and increases sweating and dehydration and the padding traps the heat.
A similar condition occurs when people are overweight or obese. The added body fat lies over the muscles and effectively traps the heat from escaping.
Our bodies produce a considerable amount of metabolic heat during exercise. To reduce internal heat, blood is brought to the skin surface to be cooled. When we sweat, evaporation helps cool the underlying blood. With good environmental conditions, these mechanisms will adequately prevent the body temperature from rising more than about 2-3 degrees F, even during heavy exercise. Heat injuries usually occur when the body’s heat loss is compromised.
During exercise in the heat, regulating internal body heat is more difficult, and external heat from the environment may add to the total heat load.
This results in a higher heart rate than normal at any level of exercise.
A hot, humid environment is the most stressful one for exercising. When the air contains a large quantity of water vapor, sweat will not evaporate readily. Since sweat/evaporation is the most efficient mechanism for cooling the body, adequate cooling may not occur when it’s very humid.
Under these conditions, heat exhaustion and heat stroke become dangerous possibilities.
According to the Centers for Disease Control and Prevention, July is the month with the highest number of heat-related deaths reported.
What are the symptoms of heat exhaustion and heat stroke?
Muscle cramping might be the first sign of heat-related illness and may lead to heat exhaustion or stroke. Here’s how you can recognize heat exhaustion and heat stroke and what to do (CDC).
Symptoms of heat exhaustion
Pale, clammy skin
Rapid, weak pulse
Upset stomach or vomiting
What you should do:
Get to a cooler, air-conditioned place.
Lie down and loosen clothing.
Take a cool shower or bath, or apply cool, wet cloths to as much of the body as possible.
Sip cool water.
Get medical attention if symptoms get worse or last longer than one hour.
If vomiting continues, seek medical attention immediately.
Symptoms of heat stroke
High body temperature (above 103°F)
Red, hot and dry skin (no sweating)
Rapid, strong pulse
A throbbing headache
What you should do:
Call 911 immediately — this is a medical emergency!
Move the person to a shady area or indoors.
Reduce the person’s body temperature by sponging with cool water, placing them in a cool bath or shower, or spraying with a garden hose.
Do NOT give fluids.
Continue efforts to cool the person until help arrives or his or her body temperature falls below 102 degrees and stays there.
How to stay safe while exercising in the heat
The American Council on Exercise and the Mayo Clinic offer the following tips for exercising in the heat:
Get acclimated – Begin exercising in the heat gradually. Becoming acclimated to exercising in the heat can take 1-2 weeks. Start by exercising for short periods of time each day. As your body adapts to the heat over time, gradually increase the length and intensity of your workouts.
Think light – Wear light-colored clothing if exercising in the sun, as white reflects heat better than other colors.
Wear breathable clothes – Always wear lightweight, well-ventilated clothing. Never wear impermeable or non-breathable garments.
Stay hydrated – Dehydration is a key factor in heat illness. Help your body sweat and cool down by staying well hydrated with water. Don’t wait until you’re thirsty to drink fluids. Avoid alcoholic drinks because they can actually promote fluid loss.
Know your fitness level – If you’re unfit or new to exercise, be extra cautious when working out in the heat. Your body may have a lower tolerance to the heat. Reduce your exercise intensity and take frequent breaks.
Keep air moving around you – Air movement is critical for adequate cooling and facilitates heat loss. Even in cool conditions, if there is limited air movement (such as exercising indoors on a treadmill or cycle), the air next to the body can become the same temperature as the body and saturated with water vapor from sweat.
Avoid midday sun – Exercise in the morning or evening, when it’s likely to be cooler outdoors. If possible, exercise in shady areas, or do a water workout in a pool. Always stop and come inside whenever you feel overheated. It’s important to teach children to do this as well.
Remember, heat-related illnesses are largely preventable. Take precautions, know the signs, and you and your family can enjoy a safe, fun summer outdoors.