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Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Dr. Elizabeth Rula, principal investigator of Health Outcomes Research at Healthways Inc.

Question: With what factors have health coaches made the largest impact on ROI?

Response: Exercise and diet are huge components. Both are risk factors that can lead to multiple different chronic conditions, primary diabetes and heart disease. Also, there is definitely a link between these risk factors and productivity. It is obvious that as people become thinner as they exercise more and have a healthier diet, they would have a great energy level that would improve their productivity. But to expand upon that, smoking is a risk factor that has a clearly established link to increased costs. Although this might not be an effect at this point — luckily smoking rates are going down to some extent — there is still a huge proportion of the population, especially in certain employer groups, who smoke. This is clearly an area where savings is possible.

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