In an age of Apple Watches, Oura Rings and rapidly advancing digital health technologies, one might expect heart health to be improving. Yet the opposite is true. Cardiometabolic diseases, including heart disease, stroke and diabetes, continue to rise globally and are increasingly affecting working-age adults.
Cardiovascular disease remains the world’s leading cause of death, and the burden is no longer something employers can view as outside the workplace. The World Health Organisation (WHO) and International Labour Organisation(ILO) estimate that long working hours were associated with 745,000 deaths from stroke and ischaemic heart disease in 2016. People working 55 or more hours per week was associated with a 35% higher risk of stroke and a 17% higher risk of dying from ischaemic heart disease, compared with those working 35–40 hours per week.
In South Africa, the picture is equally concerning. Cardiovascular disease (CVD) is a major cause of death, and more people die from CVD than from all cancers combined. The World Heart Federation reports 98,605 CVD deaths in 2021, and Stats SA reports that non-communicable disease deaths and CVD mortality have risen over time.
This matters deeply for employers. Within Sanlam Group Risk, workforce health trends have been observed with rising claims related to cardiometabolic disease and mental health, where risks are largely preventable or modifiable if addressed earlier.
As the Heart and Stroke Foundation South Africa calls on employers and employees alike to take heart health more seriously during this year’s Employee Wellness Week, which runs from 1 to 7 July 2026, it is worth pausing and reflecting on heart matters in the workplace and on what meaningful action to shift the trajectory of cardiometabolic health requires from both employers and employees.
With so much health information available, it can be difficult to know where to start. A simple and practical approach, the ABCs of workplace heart health, can help employers and employees move from awareness to meaningful action.
Awareness – A
For employees, awareness starts with knowing your numbers. Blood pressure, cholesterol, blood glucose, weight, waist circumference and other basic health indicators provide important early signals of cardiometabolic risk. Annual health risk assessments support understanding and tracking important health numbers.
For employers, awareness means recognising that data matters. The issue is not necessarily the absence of data, but how it is integrated and used to shift employees into earlier, more focused intervention pathways. Data should not be collected simply for reporting purposes. When used effectively, it can identify risks earlier, target interventions more accurately and ultimately improve health outcomes.
In practical terms, this means asking: What are the key drivers of cardiometabolic risk in our workforce? Are employees being screened? Are high-risk employees being connected to the right clinical pathways? Are interventions reaching those most likely to benefit?
Behaviour – B
Jack Welch, a famous CEO, is widely associated with the phrase, “Change before you have to.” In the context of heart health, it is advice worth taking seriously.
Diet, exercise, weight loss, smoking cessation, stress management and sleep are most effective when managed proactively, not only after a heart attack, stroke, diabetes diagnosis or disability claim. WHO Africa identifies tobacco use, physical inactivity, unhealthy diet, and harmful alcohol use as major behavioural risk factors for cardiovascular disease and says behavioural risk factors account for about 80% of coronary heart disease and stroke. The Heart and Stroke Foundation South Africa similarly say that up to 80% of heart disease and strokes can be prevented.
For individuals, behaviour change does not have to start with a life overhaul. It can start at work: choose a healthier lunch, take the stairs, walk during a break, stand up between meetings, leave work at a reasonable hour, prioritise sleep and schedule exercise before the week runs away. The key is to take the step by making small, consistent and more sustainable changes.
One helpful approach is to use SMART goals that are Specific, Measurable, Achievable, Relevant and Time-bound. Instead of saying, “I need to exercise more,” an employee could say, “I will walk briskly for 20 minutes during lunch on Monday, Wednesday and Friday this week.” Instead of saying, “I must eat better,” the goal could be, “I will bring a healthy lunch to work three days this week.”
For employers, behaviour change requires more than making benefits available. Low uptake should not automatically be interpreted as apathy. It may indicate that programmes are difficult to access, poorly communicated, disconnected from employees’ needs or simply not trusted. If health screening, coaching or intervention is hard to access, poorly communicated, disconnected from clinical care, or not trusted by employees, participation will remain low even when the benefit is valuable.
Clinical care – C
Awareness creates understanding and behaviour reduces risk, but neither replaces the importance of appropriate clinical care. Cardiometabolic conditions such as hypertension, diabetes, dyslipidaemia and established cardiovascular disease require evidence-based diagnosis, treatment and follow-up.
Digital health and AI-enabled care are becoming increasingly important in cardiovascular prevention and management. Recent reviews note that digital health technologies can support more continuous, accessible, and patient-centred care, including physiologic monitoring, early detection, and treatment support, while AI-enabled tools such as wearables and remote monitoring systems may help enable continuous cardiac monitoring and more timely intervention.
Whether care is supported by a clinician, a digital platform or an AI-enabled pathway, the fundamentals remain the same: attend regular check-ups, know your risk factors, follow evidence-based treatment where indicated, and do not ignore symptoms.
Warning signs require urgent action. The Heart and Stroke Foundation South Africa lists sudden chest pain as the most common symptom of a heart attack and notes that symptoms can include shortness of breath, dizziness, abdominal pain, nausea or vomiting, sweating, and pain spreading to the shoulders, arms, neck or jaw. Stroke warning signs can be remembered using FAST: facial drooping, arm weakness, speech difficulty and time to call emergency help.
For employers, it is important to focus on early intervention at scale, and that benefit design needs to shift from treatment funding to early identification, intervention and risk mitigation.
Beyond the ABCs: Gratitude, Happiness and Human Connection
The ABCs provide a practical framework, but heart health is influenced by more than physical risk factors alone.
Sandeep Jauhar, a cardiologist and author of Heart: A History, writes: “For even if the heart is not the seat of the emotions, it is highly responsive to them.”
This is a powerful reminder that heart health is not only biological. It is also shaped by emotional, social and psychological wellbeing. Gratitude, connection, meaning and happiness are not “soft” workplace concepts; they are part of the broader wellbeing environment that shapes how people experience stress, recover from pressure and engage with their health.
The workplace is an important setting for mental health. WHO and ILO estimate that depression and anxiety cause around 12 billion lost workdays each year and cost the global economy nearly US$1 trillion.
South Africa’s well-being context adds further urgency. The World Happiness Report 2026 ranks South Africa 101st out of 147 countries, with a life evaluation score of 5.009 based on survey responses from 2023 to 2025. This does not mean workplace health programmes must solve national happiness, but it does remind us that employee wellbeing is shaped by the broader realities people bring to work each day.
For employees, this means taking responsibility for mental health at work: recognising distress, seeking help early, using available employee assistance or wellness resources, setting boundaries and protecting recovery time.
For employers, it means creating a work environment that actively prevents harm, reduces psychosocial risks and supports people before distress becomes disability.
In the language of the ABCs, happiness is not an optional extra. It is part of the heart health equation.
Conclusion
Christiaan Barnard, the South African surgeon who performed the world’s first human-to-human heart transplant, is widely associated with the phrase “die hart is net ’n pomp” (“the heart is just a pump”).
There is truth in that statement. But the heart is also more than a pump. Heart health influences physical wellbeing, mental health , productivity, financial security and the ability to participate fully in work and life.
As Employee Wellness Week comes and goes, the challenge is to ensure that the ABCs of workplace heart health remain consistent. For employees, that means knowing your numbers, making small but meaningful behaviour changes, seeking clinical care early and prioritising mental wellbeing. For employers, it means using data responsibly, designing benefits around real human behaviour, integrating care pathways and shifting from late-stage funding to early risk mitigation.
Heart health matters in the workplace because people matter in the workplace. And if we are serious about changing the trajectory of cardiometabolic health, the time to act is before we have to.
Author: Dr Blanche Andrews
Senior Medical Advisor: Sanlam Group Risk
References:
WHO/ILO
Heart and Stroke Foundation South Africa
World Heart Federation
Statistics South Africa
WHO Africa
World Happiness Report 2026