Tuesday, May 22, 2012

Stop! Weight! I can't hire you!

Now onto a subject that I am not sure how I feel: limiting who a company is willing to hire based on health indicators.  In this specific case, a Texas hospital refuses to hire anyone with a body mass index (essentially a height to weight ratio) greater than 35.  To put that in real terms, a 5'5" tall woman cannot weigh more than 210 pounds, where as a 5'10" man cannot weigh more than 245 pounds.

I see this debate in two chunks:
  1. Whether BMI is a valid indicator of health
  2. The ethics of making hiring decisions based on life choices
From a pragmatic standpoint, the first bullet is making a myopic decision on a limited datapoint.  Using BMI as the only health indicator to determine whether someone is "healthy" (or at least healthy enough to hire) is like calling a Yugo a good car buy because it is small and small cars tend to have good gas mileage.  While there is plenty of data that supports BMI as an indicator for downstream health problems, it is very short-sited to exclude indicators such as body fat percentage and blood pressure (note that 6'1" 250 pound linebacker Ray Lewis has a BMI of 33.0; I dare you to tell him he is fat and out of shape).

Bullet two is more of an ethics question (similar to the smoking ban to which I referred in a past posting): should employers be allowed discriminate (regardless of the side on which you sit, let's call a spade a spade) based on individual choices?  On one side, overweight employees increase an employer's insurance risk pool and increase costs, and in this particular case one could make the argument that the employer is a hospital and has a responsibility to the community to set a healthy example.  This one hits home for me; when I hired into my current employer (a hospital) my BMI was 36.7 and is currently 32.3.

The purpose of this post is not start a political debate but instead to provoke thought.  With that said, we do live in a society that discriminates (again, let's call a spade a spade) for health care based on access to health insurance (often by proxy of income or employment status) and not on behavioral choices (that is, someone who eats food high in cholesterol and sodium still qualifies for employee-provided health plans despite their self-imposed hardening arteries).  Perhaps this is an example of our society becoming more consistent in standards.

At the end of the day, I am not supportive of this policy strictly on the fact the hospital is using only one indicator that happens to be easy to calculate rather than taking the time to see the big picture.  The gray area exists on whether an employer has the right to discriminate based on individual choice, especially one that will directly impact such a large percentage of the American population.

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