THE CASE FOR GETTING ACTIVE AND DRIVING WELL - An analysis of the impact of Vitality Active Rewards for the three year period to August 2018 - hr@uct.
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THE CASE FOR
GETTING ACTIVE AND
DRIVING WELL
An analysis of the impact of Vitality Active Rewards
for the three year period to August 2018
Executive summary
Four behaviours (physical inactivity, poor diet, smoking and excess alcohol intake) lead to four chronic diseases Key findings of the paper
of lifestyle that contribute to an estimated 70% of the deaths among economically active South Africans. Vitality Active Rewards enjoys high levels of take-up and engagement, across a broad range of individuals. The
Another key risk that South Africans are exposed to relates to driving behaviour. Road accident fatalities in South programme has over 5 million members across ten countries, including over 500 000 members in South Africa.
Africa are 45% higher than the global average, with motor vehicle accidents being one of the leading causes of The programme has significantly increased activity levels amongst members. Members exercise, on average, 24%
death among economically active South Africans aged 18 – 29. more frequently after activating Vitality Active Rewards, with a 9% increase in the proportion of high intensity
The majority of these deaths in South Africa are directly or indirectly related to behavioural factors. workout sessions.
Vitality Active Rewards is designed to address these risks.
Vitality Active Rewards uses a combination of goal setting, various incentive structures and peer motivation to
increase activity levels. Micro-rewards such as coffees and smoothies typically result in members increasing the
frequency of physical activity by ~20%, with longer-term, higher-value rewards (e.g. Apple Watch benefit) linked
to increases of 35%. Members with friends have, on average, a 70% higher goal achievement rate than members
The broad appeal of the Vitality Active Rewards programme and its positive impact without friends, highlighting the impact of peer motivation.
on primary health risks and driving behaviour provides an opportunity to extend
The impact of Vitality Active Rewards is greatest amongst members of poorer health. These members stand
Vitality Active Rewards to all South Africans. If achieved at scale, healthy habit
to gain the greatest health benefits from increasing their physical activity levels and engaging in other healthy
formation can have a material impact on society.
lifestyle behaviours. Members with a complex chronic condition, on average, increased their exercise frequency
For every 1 million South Africans that become engaged in getting active by 26% and their exercise intensity by 25%.
and driving well
Higher engagement in physical activity is directly correlated to better health outcomes. Members that start
to exercise experience 14% lower healthcare costs and 69% lower mortality rates than members who remain
unengaged. Engaging in Vitality Active Rewards also triggers other lifestyle behaviour changes such as quitting
352 500 cumulative life years gained 110 road fatalities can be avoided smoking, purchasing healthy food and engaging in preventive screening.
The programme has applicability in modifying other behaviours, such as driving ability. Members engaging
in Vitality Active Rewards and Vitality Drive decrease their harsh events and typically have a higher Driver
Performance Score, resulting in fewer and less severe accidents.
METHODOLOGY
A cohort of members who complete an average of at least 3 Vitality Active Rewards goals per month in the six months post
Vitality Active Rewards are used as the basis of the analysis. The change in their Vitality Age differential from six months prior
Vitality Active Rewards to six months post is used to quantify the life years gained.
The difference in road fatalities per 100,000 motor vehicles between South Africans in general and Discovery members with
short-term insurance has been used to estimate the road fatalities that can be avoided.
2 3Vitality Active Rewards in numbers
> 500 000 Over 80s 1.2 million 69%
members engaging in Vitality Active 36 members older than 80 have total parkruns by members lower mortality rate for members
Rewards in South Africa achieved goal streaks of at least who start exercising
(physical activity and driving) 10 weeks (longest streak was 96-weeks)
457 786
810 billion
50% 28% MoveToGive donations by members
steps by members since
female members members that were smokers activating Vitality Active Rewards
stopped smoking
+35%
7 228 average increase in exercise days
6 993
members have not missed a goal
8.0 million per month for members with the
Apple Watch benefit members who have achieved at
since activating Vitality Active Rewards coffees and smoothies earned least a 52-week goal streak
39 million
+24% > 150 000 gym visits by members since
R7.2 million
average increase in exercise shoes, devices and gym activating Vitality Active Rewards donated to charity through
days per month memberships boosted MoveToGive
51 year old male 7 members (aged between
1st
in Johannesburg
3rd
35 and 53 years, based in 1st Cape Town
Longest goal streak: Bloemfontein, Cape Town,
Fittest City 2nd Johannesburg
149 weeks and counting Johannesburg and Pretoria)
1st
38 year old female with streaks of 148 weeks 3rd Pretoria
in Johannesburg
As of July 2018
4 5The problem
Four behaviours (physical inactivity, poor diet, smoking and excessive The majority of these deaths in South Africa are directly or indirectly related to behavioural factors,
alcohol intake) lead to four chronic diseases of lifestyle (cardiovascular and up to 90% of motor vehicle accidents are due to driver error.
disease, diabetes, chronic lung disease and various cancers) that
contribute to an estimated 70% of the deaths among economically Key contributions to these statistics are:
active South Africans. A similar picture is shown globally, where
non-communicable diseases account for 71% of the 56.9 million global Low levels of awareness around the impact of lifestyle behaviours on health and life expectancy
deaths.
Quality of health and driving are difficult for individuals to track objectively
Another key risk that South Africans are exposed to relates to driving
Overconfidence and bias in assessing one’s own health and driving ability.
behaviour. Road accident fatalities in South Africa are 45% higher
than the global average, with 25.1 road deaths per 100 000 lives.
Motor vehicle accidents are one of the leading causes of death among
Discovery research highlights the impact of optimism and overconfidence.
economically active South Africans aged 18-29.
Causes of death by age
Other
64% 81%
5% Motor vehicle accidents
7%
Endocrine disease Obese members who view their Drivers who believe their
32% health as very good or excellent driving is excellent
Respiratory disease
Cardiovascular disease Vitality is a health programme that encourages and rewards members as they get healthier.
32%
In September 2015, Discovery introduced Vitality Active Rewards, a behavioural change programme
16%
which utilises personalised goal-setting and micro-rewards to create habit formation around physical
Cancer
activity and driving behaviour. This paper summarises the key results of this programme, and discusses
All ages Ages 18 – 29 the applicability of expanding the programme to all South Africans.
7Finding 1:
Vitality Active Rewards enjoys high Vitality Active Rewards members in South Africa
levels of take-up and engagement,
500 000
400 000
across a broad range of individuals
Members
300 000
Since the introduction of Vitality Active Rewards three years ago, the programme has expanded globally
200 000
to over 5 million members across 10 different countries, with members receiving micro-rewards for
engaging in physical activity. 100 000
- The countries with the greatest number of members are China, South Africa and the United Kingdom.
Take-up among Vitality members is higher in younger individuals and individuals of better health status,
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health.
Month
- Take-up is highest in the 30-39 year old age band, with 50% of Vitality members engaging in the benefit.
- Over 20% of members with multiple unstable chronic conditions engage in Vitality Active Rewards and 23%
of members over the age of 50 have joined Vitality Active Rewards.
Take-up rates by age Take-up rates by health status
50%
44%
39% 39% 38%
29%
23% 21%
METHODOLOGY
Members are defined into health risk categories according to the number of chronic conditions they have, as well as the state 18-29 30-39 40-49 50+ Healthy Stable Significant Complex
of the conditions i.e. stable or unstable. chronic chronic chronic
condition condition condition
Take up rates are defined as the number of members in that segment as a proportion of the eligible base.
8 9Finding 2:
Vitality Active Rewards
significantly increases activity
levels among members
A cohort analysis has shown that members’ activity levels increase significantly after activating
Vitality Active Rewards: Exercise days per month Proportion of high
intensity workouts
24% increase in the number of exercise days per month to 7.0 days per month
-
+24%
9% increase in the proportion of high intensity workouts to 40% of all workouts
-
esearch highlights the benefits of higher intensity workouts with Nes et al (American Journal of Medicine,
R
2016) commenting that “fewer sessions, if performed at higher intensities, provide similar or larger health +9%
7,0
benefits compared with frequent, low-intensity activity of longer duration”.
- Vitality incentivises members to perform physical activity at higher levels of intensity by offering
5,6
a greater number of Vitality points for workouts completed at a minimum of 80% of a member’s
40%
maximum heart rate.
37%
After joining Vitality Active Rewards, members with heart-rate devices typically exhibit a steady increase
in the proportion of workouts that are classified as high intensity. This trend typically continues for at
least 24 months after activation, and emphasises the healthy habit formation of the programme, and how
regularly adjusting members’ short term goals can result in continued progress.
Before After Before After
METHODOLOGY Vitality Active Vitality Active Vitality Active Vitality Active
Rewards Rewards Rewards Rewards
Physical activity levels of approximately 250 000 members have been tracked over the past three years to understand the impact
of Vitality Active Rewards. The analysis compared physical activity levels six months before and six months after activating the
Vitality Active Rewards benefit in terms of both frequency and intensity of physical activity:
Frequency refers to the number of gym visits a month, in order to standardise for take-up in wearable devices. Only members
that had activated the gym benefit were considered.
Intensity refers to the proportion of workouts performed at 80% or higher of a member’s maximum heart rate. Approximately
30 000 members had heart rate devices in the six months before and 12 months after Vitality Active Rewards.
10 11Finding 3:
A combination of short and
long-term incentives is most Increase in exercise days per month
effective in changing behaviour +31%
+35%
Vitality Active Rewards uses a combination of communication, feedback and incentive structures to drive
behaviour change. Each of these product characteristics is critical in driving and incentivising engagement.
+20%
The largest behaviour change is seen among individuals with the Apple Watch benefit, where regular goal
achievement over a 24-month period results in the device being fully-funded.
+7%
Product construct Characteristics
Personalised goal setting Activity goals based on health profile and exercise history
Tracking, monitoring and feedback Real time tracking of activity levels in app Goal setting, tracking, Short-term Long-term Apple Watch
monitoring and feedback micro-incentives benefits benefit
Short-term micro-incentives Weekly micro-rewards for completing exercise goals
Long-term benefits Higher value rewards (e.g. cash back on running shoes, devices) based
on number of exercise goals achieved per month
Increase in proportion of high intensity workouts
Shoe, device and gym membership boosters
Apple Watch +21%
•
METHODOLOGY +11%
+7%
+5%
Members have been segmented for this analysis based on the type of incentives that each member regularly engages in. The
frequency analysis considers only members with the gym benefit activated; the intensity analysis considers only members with a
heart-rate device before and after activating the benefit. The cohorts are defined as follows:
Goal-setting, tracking and monitoring feedback: Members who achieve their goals but infrequently selected a reward are used as
the basis for this cohort. App login activity across this cohort has increased from once per month pre-activation to five times per Goal setting, tracking, Short-term Long-term Apple Watch
month post-activation, highlighting that these members are engaged around tracking, but not motivated by the micro-rewards. monitoring and feedback micro-incentives benefits benefit
Long-term benefits: ~80 000 members have at least one long-term benefit linked to their goal achievements.
Apple Watch: ~17 000 members have the Apple Watch benefit activated.
12 13Finding 4:
Features such as social interactions
and donations to charity increase Average number of goals achieved per month
2.7
2.8
2.5
levels of engagement 1.9
1.6
Vitality Active Rewards incorporates social elements into the incentive programme, using peer motivation 1.4
to further encourage members to reach their goals. Members are able to add an unlimited number of friends
to compete against weekly and stay motivated.
embers with friends have, on average, a 70% higher goal achievement rate than members without
M
friends (1.9 goals per month versus 1.1). Adding friends and being able to monitor their progress towards
their goals is seen to further improve the goal achievement rate.
Instead of redeeming weekly rewards for coffees and smoothies, members are able to choose MoveToGive,
0 1 2 3 4 5+
a donation to a person in need. A total of R7.2 million has been donated through MoveToGive rewards.
Number of friends
Members who frequently select philanthropic-based weekly rewards are seen to increase their exercise
frequency by more than the average member.
Increase in exercise frequency
+30%
+20%
METHODOLOGY
This analysis considers all Vitality Active Rewards members over a 12-month period (August 2017 to July 2018) and groups
members according to whether they added at least one friend in the app in the 12 months. The average number of goals
earned per month has been calculated for these two groups over the 12-month period. The period August 2017 to July 2018
has been selected to remove the impact of team rewards on the analysis.
Philanthropic: ~1 300 members regularly choose MoveToGive (donation to a person in need) as their weekly reward, selecting Average Philanthropic
the charity at least once in a month when they meet their goal.
15Finding 5:
The impact on activity levels is Healthy Unhealthy
greatest amongst members most at-risk Exercise days per month
Changes in the frequency and intensity of physical activity are highest amongst members of poorer health
+21% +22% +24% +26%
status. These members stand to gain the greatest health benefits from increasing their physical activity
levels and engaging in other healthy lifestyle behaviours.
For example, members with a complex chronic condition on average increased their exercise frequency 6,8
6,7 6,7 6,7
by 26% and their exercise intensity by 25%. This increases are off a lower base, with the levels of physical 5,6
5,5
activity after activating Vitality Active Rewards comparable across the different health statuses. 5,4
5,3
Condition-specific cohorts demonstrate similar patterns:
– Members classified as overweight or obese experienced the greatest increase in exercise frequency after
activating Vitality Active Rewards. This amounted to an increase of 32% in exercise days per month
Before After Before After Before After Before After
– Members with diabetes experienced a 29% increase in exercise frequency.
Healthy Stable chronic Significant chronic Complex chronic
condition condition condition
Proportion of exercise sessions classified as high intensity
+11% +9% +24% +25%
41% 41%
38%
38% 35%
37%
31%
28%
Before After Before After Before After Before After
Healthy Stable chronic Significant chronic Complex chronic
condition condition condition
16 17Finding 6:
Engaging in Vitality Active Rewards
Impact of Vitality Active Rewards on other lifestyle behaviours among
triggers other lifestyle behaviours members previously unengaged in physical activity
+71%
Members who engage in Vitality Active Rewards tend to adjust their behaviours in other areas of the Vitality
Vitality Active Rewards
programme. Engaging in Vitality Active Rewards is directly correlated with higher prevalence of health
screenings and assessments, and other Vitality benefit activations.
+20%
Overall, the Vitality Active Rewards base experienced the following lifestyle changes after engaging
in the programme:
– 28% decrease in the number of members that are smokers (i.e. ~1 300 members quit smoking)
Inactive Active
– 12% increase in the number of members engaging in the HealthyFood benefit
– 24% increase in the number of members undergoing a Vitality Health Check (VHC).
After activating Vitality Active Rewards, three in four members engaged in HealthyFood and half engaged
-45%
in a VHC. HealthyFood Vitality Health
Smokers activation Checks
he impact is greatest amongst members that were previously unengaged in physical activity but
T
drastically changed their lifestyle, post engaging in Vitality Active Rewards. The following changes were
observed across ~2 200 members:
– 45% decrease in the number of members that are smokers
– 20% increase in the number of members engaging in the HealthyFood benefit METHODOLOGY
– 71% increase in the number of members undergoing a VHC.
The number of smokers is a self-reported result, based on the Vitality Age online assessment.
These behavioural improvements translate directly into a lower relative risk and improved health outcomes:
The number of members with the HealthyFood benefit activated is analysed 12 months prior to activating Vitality Active
– Overweight and obese members experienced a 1.5% and 5.4% reduction in their BMIs respectively Rewards and 12 months thereafter.
The number of Vitality Health Checks is over the period of 12 months prior to activating Vitality Active Rewards compared to 12
– L
ower relative mortality risk, as reflected by the Vitality Age differential decreasing from 3.0 years older
months after.
than their actual age to 1.7 years older than their actual age
A cohort of 2 200 members was analysed where these members increased their physical activity levels from fewer than four
– H
ospital admission rates amongst these members decreased from 22% to 19% in the 12 months after gym workouts per month to an average of at least 16 gym workouts per month after activating Vitality Active Rewards.
activating Vitality Active Rewards. The Vitality Age online assessment collates health and lifestyle behaviours of a member into a risk-adjusted age known as a
Vitality Age. The Vitality Age differential is the difference between Vitality Age and actual age with a positive result relating to a
higher mortality risk and a negative result relating to a lower mortality risk.
18 19Finding 7:
Higher engagement in physical
activity is directly correlated to
better health outcomes
Morbidity and mortality impact Morbidity and mortality impact
Members that increase their levels of physical activity experience materially lower healthcare costs
of members starting to exercise of members already exercising
and mortality rates, irrespective of the member’s historical level of engagement in physical activity.
– I nactive members that start to become physically active experience 14% lower healthcare costs
and 69% lower mortality rates than members who remained unengaged throughout the period. 7% increase in
morbidity rate
– Members that were already physically active and increased their activity levels lowered their
49% increase in
healthcare costs by 22% and their mortality rates by 31%.
mortality rate
Remains inactive Inactive
Remains active
14% reduction in
Inactive morbidity rate Active
69% reduction in
Active mortality rate
22% reduction in
morbidity rate
31% reduction in
Very active mortality rate
METHODOLOGY
A longitudinal study over a five-year period performed across Discovery Health and Vitality members tracked engagement levels
of physical activity across the period. Members were classified based on their levels of physical activity over the initial six-month
period, and the change in activity levels over the subsequent four and a half years. Hospital claims and mortality rates in the final
year were used as the outcome of the analysis.
20 21Finding 8:
Vitality Active Rewards has achieved
similar outcomes in improving driver Relative Driver Performance Score by number of Vitality Active Rewards goals per month
100%
behaviour 87%
95%
Driver Performance Score
77%
70%
Vitality Active Rewards uses a similar structure to incentivise members to drive well, tracking their driving
Relative
behaviour and rewarding them for 100 consecutive event-free kilometres every week. The programme
has 158 000 drivers and has collected over 9.5 billion kilometres of driving data.
Drivers that are engaged in the programme have seen a reduction in the number of harsh events across all
driving trips, relative to their experience before Vitality Active Rewards was introduced. Members achieving three
goals a month decreased their harsh events by 34%, harsh acceleration by 32%, and harsh braking by 24%.
0 1 2 3 4
Engaging in Vitality Drive Active Rewards is correlated with a higher Driver Performance Score.
A higher Driver Performance Score is directly linked with a lower frequency of accidents and Number of goals earned per month
a lower severity of accidents.
Relative severity and frequency of accidents by Driver Performance Score
100 Relative average claim amount
Relative number of car accidents
75
50
25
0
METHODOLOGY
0 - 100 100 - 200 200 - 300 300 - 400 400 - 500 500 - 600 600 - 700 700 - 850
The Vitality Drive Driver Performance Score is calculated based on a driver’s acceleration, braking, cornering, speed, average Driver Performance Score
distance driven and cellphone use.
22 23Discovery Vitality
Contact us 0860 99 88 77 | www.discovery.co.za
Get the latest information about Vitality on:
www.discovery.co.za Discovery Vitality @Discovery_SA @TeamVitalitySA Discovery_SA The Discovery app
Discovery Vitality (Pty) Ltd is an authorised financial services provider. Registration number: 1999/007736/07. Please note all information displayed in this brochure is only a summary of the Vitality benefits. Specific limits, terms and conditions apply to each benefit. Visit www.discovery.co.za to stay updated. Discovery Insure Ltd is an authorised financial
services provider. Registration number 2009/011882/06. Product rules, terms and conditions apply.
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