Years ago, I was on the road a lot for work. As a corporate medical director I attended conferences around the world to stay current on cutting-edge medical trends. That meant a lot of frequent flier miles, and a lot of nights spent away from home.
At first I loved the opportunities to explore a new city. But soon I found myself less enthusiastic about the prospect of flights and hotels. The security lines. The traffic to and from the airport. The “hurry-up-and-wait” lifestyle.
Now, new research on the way business travel affects health may help to explain my ambivalence toward the time away.
It comes from Columbia epidemiologist Andrew Rundle, who analyzed data from 18,328 working people who received annual health assessments from EHE Inc., the New York-based provider of corporate wellness programs. Rundle’s study provides a more nuanced picture of the health of business travellers than we’ve ever had before.
That’s great because until now the picture’s been confusing. Years back, in a newspaper column, I described studies on business travellers as portraying a dichotomy. Some studies, including one from 2010 that I coauthored, showed that business travellers tended to be healthier than workers at large. But a 2011 look at a different EHE data pool established that a lot of travel was bad for people’s health. The study associated lots of time on the road with higher blood pressure as well as higher body weight.
This latest study goes a long way toward explaining the dichotomy. It mentions selection bias as the reason why people who travel for work tend to be healthier than those who don’t travel at all. Because those who are ill tend not to volunteer, or be selected by their bosses, to go away.
To accurately determine the health effects of business travel, this study compares people who go away a lot for work with those who travel only a little.
Compared to occasional travellers, that is, people who logged just one to six nights on the road per month, those who traveled 21 or more nights per month were more likely to smoke, have sleeping trouble, be sedentary and report problems with alcohol, anxiety and depression.
“The odds of being obese were 92% higher for those who traveled 21 or more nights per month compared to those who traveled only one to six nights per month,” writes Rundle in a Harvard Business Review article about the study. They also had higher blood pressure and lower amounts of good cholesterol in their blood.
This isn’t great news. Travel for work is remarkably prevalent. For example, Americans conducted more than 500 million business trips in 2016 alone. Imagine the hubbub if a particular food or drink featured the same health risks as extensive business travel.
So what to do?
One, we need to reassess our general attitude toward business travel, which is regarded as a perk in most workplaces. It’s reasonable to feel jealous that Sally in marketing gets to attend that convention in Hawaii, but we should realize that Jeff, the VP of sales, who spends 150 days a year on the road, is engaging in an activity with its own set of health risks. The road can be a lonely and stressful place when you’re on it for extended periods, leaving one far from friends and family, and at the mercy of unpredictable weather and airline schedules.
Two, occupational medical staff should cooperate with human resources to devise a set of healthy travelling guidelines for the road warriors on company payrolls. Is there a healthy dose of business travel? How much is too much? And how can we get better at predicting those most at risk?
Third, those who travel should try to focus on wellness while on the road. Often, business travelers can fall into cycles of stress followed by indulgence. A hard day of travel sets up the reward of after-dinner dessert and loneliness-busting late nights in the hotel bar.
Instead, travellers should realize that living well requires discipline regardless of where they’re spending the night. When I’m living out of my suitcase for work I take special pains to eat better, to mitigate stress with daily exercise rather than a couple of drinks at the hotel bar, and to stay disciplined on my sleep hygiene. I’d encourage frequent travelers to learn a good hotel-room exercise workout, either from a trainer or by getting up to speed with the many posted on the web. Nothing encourages a healthy frame of mind like physical activity.
Such changes may not be enough to restore the glamour that previously existed around jet flights and departure lounges. But it would improve things a lot for those doing the travelling to at least recognize the health risks.
Dr. James Aw is the chief medical officer of Medcan.