Brazilian Perspectives on the Wellness Concept and Movement

It's my pleasure to offer the observations of Alberto Ogata, M.D. and Sâmia Aguiar Brandão Simurro, two Brazilian wellness pioneers well acquainted with trends and opportunities for advancing quality of life in Brazil, America and elsewhere throughout the world.

Don: Thanks for consenting to this interview, Alberto and Samia. My first question is: Do you see merit in making distinctions between wellness and REAL wellness? Do you do so, in any way (e.g., using other terms)?

Samia and Alberto: We think the distinction is important because, especially here in Brazil, the terms wellness and quality of life are applied to nearly everything (buying cars, houses and other good and services). The words are overly familiar and broad - and thus a bit worn out! People in general and even health care and other professionals have difficulty understanding what we mean when we talk about wellness lifestyle. The challenge is to communicate with words that prepare people to recognize a perspective that transcends and thus is so much more important than buying things. Wellness is not about consumerism - it is about a special to live. The REAL wellness concept enables people to understand these differences. It puts the focus on responsibility and commitment as foundation elements that enable vital and meaningful lives.

Don: How long do you suppose the wellness movement will remain stuck in the U.S. model and thus wedded to sickness avoidance, testing and the like, assuming you agree with this characterization?

Samia and Alberto: We do agree with it, but it is hard to say with confidence when a needed change might take place. We hope it's soon. It is not difficult to know why this state of affairs has come about. Governments, entire societies, organizations and health plans designed to serve the people are jeopardized; leaders of all enterprises are amazed at cost increases and flustered about what to do in response to these frightful trends. Health promotion programs are still relatively new in the companies of the world. This is the case with Brazilian companies, as well. Worksite wellness here, as in America, began as a strategy to save medical costs by decreasing health risk factors. Anywhere in the world, an employee with a healthy lifestyle will cost a company less to support than one who lives dangerously in a high risk for illness sense. In the beginning, employers thought that it was all about money. Many still don't see the big picture. We are beginning to realize the need to think more and more about human behavior and change processes. We need approaches that take account of the full person - all his or her needs and possibilities. How might we best deal with a person's difficulties and potentials in every dimension of wellness? Being physically healthy is highly desirable but not a bold enough vision in the context of pursuing true well-being in the fullest sense. Health professionals must be persuaded and guided to go further than the treatment and prevention of diseases, however noble this is. They can and must learn ways to enable people to discover things about themselves and about life that they will deeply value and care most about. The idea in a REAL wellness context is to facilitate responsible choices toward a life full of purpose and meanings. Consistent supports and encouragements are key.

Don: What are your views on worksite wellness in the U.S., Brazil and elsewhere? Are you satisfied with or concerned about the nature and results of this endeavor?

Samia and Alberto: We should go further and rethink how we might best deliver wellness in the worksite. The big challenge is to improve processes, help companies remain competitive, safeguard and enhance total quality - and do all this without compromising employee health and happiness. Although wellness is rapidly advancing around the globe in other ways - especially conceptually, at worksites we are still focused on health benefits, eating patterns, physical activity and lifestyle changes that improve physical health and reduce medical costs. Only when our health practitioners became quality of life educators and practitioners will we advance toward REAL wellness awareness with our employee populations.

Don: What are the most important elements of a wellness philosophy?

Samia and Alberto: The elements of a wellness philosophy are those that affect lifestyle choices. They include consciousness, self-commitment, harmony and joy. All these elements work to improve the individual's capacity for well-being in the sense of living life more fully. Wellness requires individual awareness. A wellness philosophy encourages us to look at ourselves and frame questions that lead to added meaning about existence itself. It encourages a better understanding of needs and aspirations and more willingness to search for both.

This philosophy always begins with you. It is a personal process - it is to live a good life. Thus, it is clearly so much more than good nutrition, physical fitness, stress management and the like. It is a positive attitude towards life.

Don: What are the best performance indicators for companies and for individuals? Do the two complement or are they antithetical?

Sâmia and Alberto: Individual employees and companies are I a truly win/win situation in the context of a wellness enterprise. If the program is consistent and has coherence, it creates a culture and shared vision, as Dr. Judd Allen described in a previous interview with you. Ideally, the workers and the company leadership are united. The companies that have CEOs who are really living wellness lifestyles support and participate in the kind of actions that cover all dimensions of wellness (not only the physical dimension). Such companies design and implement wellness policies that are ethical and transparent. They also create wellness strategies that offer educational opportunities and incentives for healthy lifestyles. Furthermore, they invest the resources needed to render REAL wellness programs viable (i.e., with regard to budgets, staffing equipment and space).

Don: How would you describe key terms and/or the nature of a wellness lifestyle?

Sâmia and Alberto: I'll just address the phrase wellness lifestyle, which is a process that requires a positive attitude to live with enrichment, full satisfaction and balance.

Don: What are best and worst-case scenarios for the wellness concept, by any name, ten years down the road?

Sâmia and Alberto: Actually we have no doubt that lifestyle is related to health outcomes and mortality. We know more and have sufficient evidence that proves risk factors impact both medical costs and productivity.

Don: How much of an influence has resulted from the publication and widespread distribution of your book Quality of Life?

Sâmia and Alberto: Our book, out of necessity, was designed to develop a practical and consistent model to make wellness programs in the workplace possible for Brazilian companies. Some international models do not work in Brazilian culture. We took from those workplace experiences in America and other countries and adjusted them to accommodate different characteristics of Brazilian culture. Our Quality of Life wellness book offers a practical, step-by-step method to implement a wellness program. We believe it has enabled us to improve the nature of the worksite; it has also enabled workers to improve their lifestyles. The book contains intervention strategies suited to the Brazilian workplace. The feedback on the book has been outstanding. It seems to have helped many wellness professionals implement new or improve existing programs. We are delighted to have made many positive contributions to the growth of worksite wellness initiatives in Brazil.