Total Worker Health® - an integrated approach to a healthier workplace
January 2020
Contributed by Jennifer Cavalari, ScD, CIH, UConn Health and Suzanne Nobrega, MS, University of Massachusetts Lowell
Issue #64
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On average, employed US adults spend more than half of their waking lives working on engaging in related activities (BLS, 2018). Scientific evidence now shows there are occupational risk factors for sleep disorders, cardiovascular disease, depression, obesity, and other common health conditions (NIOSH, 2018). Likewise, our work has a large impact on how we maintain our health. That's why worker well-being is relevant for workers and employers, and why Total Worker Health® can set the stage for worker safety, health and well-being on and off the job.
What is "Total Worker Health®?"
Total Worker Health (TWH) is an emerging program concept that takes occupational safety and health to the next level to include other workforce health concerns such as stress, chronic diseases, and working and living well into older age. TWH is not a wellness program with a new name. Keeping workers safe is the foundation upon which a TWH approach is built. TWH integrates workplace safety efforts with a broad spectrum of opportunities and interventions to improve overall worker health and well-being, as shown in Figure 1.
A TWH approach to workplace well-being focuses on making work organization and the working environment conducive to health. Worker well-being is affected by factors such as the physical and chemical work environment, psychosocial conditions in the workplace, the home and community environment, and personal health behaviors. Therefore, a TWH approach address both the conditions of work and the symptoms of poor health as part of an integrated well-being strategy.
Figure 1: Hierarchy of Controls applied to NIOSH TWH
Examples of an integrated, Total Worker Health Approach to Workplace Safety
| Health & Safety Concern | Total Worker Health Approach |
|---|---|
| Respiratory Illnesses from poor workplace air quality can be more serious for smokers | Improve air quality AND help employees quit smoking |
| Job Stress increases the risk factors for heart diseases such as high blood pressure, smoking, low physical activity, and anxiety/ depression. | Reduce work-related stressors AND Help employees develop skills and habits for exercise, eating well, and managing stress |
| Physically demanding work can lead to feeling too fatigued to exercise or to prepare healthy meals | Provide equipment to reduce bodily forces AND Plan work schedules to allow for rest and recovery |
Simple ways to introduce a Total Worker Health approach
NIOSH outlines essential elements of a Total Worker Health Program (NIOSH, 2017). The examples below outline a few simple steps to begin adopting these elements.
Design for healthier work
- Re-organize work to minimize repetitive motion, excessive force, and awkward postures.
- Plan shift schedules that allow workers to have sufficient sleep quality and quantity.
- Involve employees in assessing work and non-work sources of health concerns.
- Empower employees to identify and solve problems that impact their well-being.
- Get employee feedback on workplace changes before rolling them out.
- Encourage coordinated goal-setting and cooperation between health and safety, wellness, benefits, training, and employee assistance programs.
- US Bureau of Labor Statistics (2018). American Time Use Survey, https://www.bls.gov/charts/american-time-use/activity-by-work.htm
- CDC, NIOSH Total Worker Health (2020) https://www.cdc.gov/niosh/twh/totalhealth.html
- CDC, NIOSH Fundamentals of Total Worker Health Approaches: Essential Elements for Advancing Worker Safety, Health, and Well-being, https://www.cdc.gov/niosh/docs/2017-112/