Critical illness in the post-COVID era: The critical role of employers in enhancing resilience
6 Dec, 2023

Abdur-Rehman Mangera, Head of Group Benefits at Bryte Life


It’s no secret that South Africans do not always lead the healthiest lifestyles. Smoking, sedentary lifestyles, excessive alcohol intake and unhealthy diets, putting us at risk of a range of serious illnesses. The Heart and Stroke Foundation South Africa reveals that more than a third of South African adults have high blood pressure, which is responsible for one in every two strokes and two in every five heart attacks. Of course, hypertension is caused by a complex set of factors, including genetics, but our national addiction to spicy wings doesn’t help!


Our financial habits aren’t always optimal, either. It’s not always our fault: research shows many of us are working hard, putting in the hours, and still stressing about money and living off credit. Making matters worse, all that stress can be bad for our health, giving us something else to stress about!


Illness as a personal finance priority


Critical Illness poses a massive financial burden on South African households. A recent article in the Journal of Health Economics and Outcomes Research shows that, for most of the population, tobacco use, hypertension, and diabetes were “the risk factors with the highest influence on the odds of a patient suffering a cardiovascular event” and that these risk factors in turn put households at potential of catastrophic financial losses[i]. The risks are exacerbated by relatively low rates of health and Critical Illness assurance  in the country.


Financial challenges in turn lead to worsening of health outcomes. Lack of access to quality primary healthcare can have serious long-term consequences. Consider that a global survey of underdiagnosed chronic obstructive pulmonary disease (COPD) showed an alarmingly high rate of undiagnosed COPD in the South African population compared to other countries (and a high rate of COPD overall) [ii].


These are not new considerations and anxieties, they have taken a particular urgency in the wake of the COVID-19 pandemic, high inflation and low economic growth. While we still don’t fully understand the potential effects of long COVID, particularly on cardiovascular and pulmonary health, we do know lung damage caused by the high prevalence of TB can make post-infection treatment for illness more complex (and expensive)[iii]. Controlling communicable diseases, and helping South Africans live healthier lifestyles, with better access to quality healthcare, is good for our health, good for our personal finances, and good for the economy.


The unique role of the Employers


Health outcomes and financial security are interlinked in complex ways. Effective interventions require input and cooperation from all stakeholders.


Employers, employees and insurers are uniquely placed to glean insights and develop strategies that enhance the health and financial resilience of the workforce and their families.


This requires effective communication and sharing of concerns and objectives to appreciate the challenges and needs of employees when it comes to protecting their physical, mental and financial wellbeing.


Understanding these concerns will help risk managers make more informed decisions in light of the alarmingly high, and potentially increasing, rate of cardiac and lung diseases, and also with consideration to the way these illnesses complicate treatment and worsen outcomes.


Similarly, we need to be adaptive to changing economic conditions, such as another unanticipated inflationary period cause by war, pandemic or some other cause.


Group risk products have an important role to play here, beyond the obvious. Providing employees with Critical Illness cover is an important step in ensuring more people seek quality care when they need it and have the flexibility to ensure that the lifestyle changes can be met with a bit more ease.


Ideally, these approaches should comprise part of broader employee wellbeing strategies, including education to the causes of critical and chronic illnesses whilst providing cover for employees need to improve their lifestyle and health.


Critical Illness cover can be an underappreciated tool in protecting households from debt and distress. South Africans are particularly susceptible to cardiovascular and pulmonary complications, both of which can lead to serious outcomes, including being unable to work for an extended period, or even being left permanently disabled. Beyond basic medical cover, financially vulnerable South Africans also need an effective means of securing their household finances in the event of falling ill.


Critical illness cover should thus not simply be considered a source of useful funds, but as part of a broader intervention to make employees more resilient.





[i] Cardiovascular Disease and Its Implication for Higher Catastrophic Health Expenditures Among Households in Sub-Saharan Africa, J Health Econ Outcomes Res. 2023

[ii] The analysis for SA centred on data from Cape Town. ‘Determinants of Underdiagnosis of COPD in National and International Surveys’, Chest Journal 148:4, 2015

[iii] ‘Post-TB lung disease more common than Covid in SA’, Juta Medical Brief, 21 July 2023


@Abdur-Rehman Mangera
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