Presentation on theme: "Heidi Hudson, MPH – Co-Coordinator for Total Worker HealthTM"— Presentation transcript:
1Heidi Hudson, MPH – Co-Coordinator for Total Worker HealthTM NIOSH Total Worker Health™: Innovative Approaches for Healthier EmployeesUSPHS SymposiumJune 20, 2012Heidi Hudson, MPH – Co-Coordinator for Total Worker HealthTMNational Institute for Occupational Safety and HealthCenters for Disease Control and Prevention
2DisclaimersThe findings and conclusions in this presentation have not been formally disseminated by the National Institute for Occupational Safety and Health, and should not be construed to represent any agency determination or policy.The mention of organizations and commercial entities and products in this presentation is for illustrative purposes only and does not represent an endorsement by NIOSH, CDC or the US Department of Health and Human Services.First, there are two disclaimers to bring to your attention:The findings and conclusions in this presentation have not been formally disseminated by the National Institute for Occupational Safety and Health, and should not be construed to represent any agency determination or policy. The mention of organizations and commercial entities and products in this presentation is for illustrative purposes only and does not represent an endorsement by NIOSH, CDC or the US Department of Health and Human Services
3OSH Act of 1970SEC. (2) (b) to assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources . . .(emphasis added)The National Institute for Occupational Safety and Health (NIOSH) is the federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. The mission of NIOSH is to generate new knowledge in the field of occupational safety and health and to transfer that knowledge into practice for the betterment of workers. To accomplish this mission, NIOSH conducts scientific research, develops guidance and authoritative recommendations, disseminates information, and responds to requests for workplace health hazard evaluationsNIOSH (and the Occupational Safety and Health Administration or OSHA) were created by the Occupational Safety and Health Act of 1970 –With the mandate “to assure so far as possible every working man and woman in the Nation safe and healthful working conditions.”The less often quoted portion of the mandate is “ and to preserve our human resources.”We believe this entire mandate provides the directive for a focus on both protecting and promoting the health of the working population.
4OverviewExplain rationale for integrating health protection and health promotionDescribe partnerships in building and promoting integrated programsList resources to launch and improve a Total Worker HealthTM ProgramToday I plan to:Explain rationale for integrating health protection and health promotionDescribe the value of partnerships in building and promoting integrated programsList resources to launch and improve a Total Worker Health ProgramMy hope is that you’ll have a better understanding of why it is important to integrate efforts to protect and promote the TOTAL health of workers so as to improve worker safety, health, and engagement
5Every Day . . .12, new reported cases of nonfatal occupational injuries and illnesses9, workers are treated in emergency departmentsworkers are hospitalizeddeaths from work-related illnessdeaths from work-related injuriesSource: MMWR, Vol. 59, No. 15, April 23, 201040 years after the OSH Act, the burden of work-related injury and illness remains a challenge.Every day there is an average of:12,712 new reported cases of nonfatal occupational injuries and illnesses9,315 workers are treated in emergency departments258 workers are hospitalized134 deaths from work-related illness14 occupational injury deaths
6Work-Related Illness, Injury and Fatalities in the US are costly…. Employers and insurers spent $85 Billion on workers’ compensation in 2007, which isOnly a portion of the costs borne by employers, workers, and societyExcludes costs paid by other insurance systems and most of work-related illness costsIn addition to the human toll, work-related illness, injury and death in the US are costly:Employers and insurers spent $85 Billion on workers’ compensation in 2007, which isOnly a portion of the costs borne by employers, workers, and societyAnd this figureExcludes the costs paid by other insurance systems and most of the work-related illness costs!Source: CDC Morbidity and Mortality Weekly Report. Volume 59, Number 15. April 23, 2010
7Burden of Chronic Health Conditions Cancer553,000 deaths, 1.3M new cases/yr$89B in medical costs, $130B in lost work days & productivityDiabetes>23.6M cases, >200,000 deaths/yr$116B for medical issues,$58B for lost work & productivityCVD80M cases, >870,000 deaths/yr$448B a yearTobacco-Related438,000 deaths$96B in medical costs, $97B in direct costsSource: National Center for Chronic Disease Prevention and Control A major issue that’s relevant to the TWH of any workforce is the prevalence of chronic health conditions.This slide lists 4 of the major diseases that impair health, reduce quality of life, and place extreme economic burden on the healthcare system.In 2006, US healthcare spending was reported to be more than $2 trillion and employers on average pay more than one third of this cost.Chronic health conditions are on the rise across all age gropup in the US, and it is expected that in the near future conditions such as diabetes, heart disease, cancer will add an enormous burden to already high costs of healthcare. Employers will be particularly impacted as they provide medical benefits for employees and absorb the costs of absenteeism and long-term and short-term disability claims.
8The Future of Work Hazards Employment Workforce Persistent Emerging Shortage of WorkersGlobal CompetitionFlexible vs. PrecariousWorkforceAging WorkersHealth-Related IssuesObesityMulti-GenerationalNow , and as we move into the future, we see continuous risks to the safety and health of workers.For example, in terms of Workplace Hazards we see persisting concerns aroundFall from HeightsAmputations from Unguarded MachineryTrench CollapsesMusculoskeletal DisordersWorkplace ViolenceThere are also concerns related to Emerging risks in the areas ofNanotechnologyFood FlavoringsAirborne Transmissible DiseasesGreen JobsAnother challenge is that workplaces are rapidly evolving resulting in changes to how work is organized for example:There has been a shift in the way we produce goods (from manufacturing to service environments)Challenges stemming from global competition and the economic climateDownsizing, corporate restructuringIncreased pressure on remaining workers to do more with less, working longer hours, compressed work weeksShortage of workers. Increasing use of contingent and precarious work arrangements contribute to a sense of instability while at the same time changes in the psychological contract result in job insecurityAnd there are also a number of challenges, workplaces contend with that stem from the changing makeup of the available workforceThe composition of the US workforce is becoming increasingly diverseLimited availability of workers of all agesIncreasing numbers of older workersWe’re seeing health challenges in younger workers (e.g., obesity)A number of our workers are in what is called the “sandwich generation” – caring for young & older workers and thus we’re seeing increasing need for flexibility in work arrangements and scheduling. And ever so slowly, there is an increasing awareness that both on-the-job and off-the-job factors contribute to employees’ health and well-being. Thus, we’re seeing the need to address employees’ TOTAL health from a more comprehensive perspective.
9Traditional Health Protection and Health Promotion Health Protection – Programs that focus on reducing hazards and exposures at workplaces to prevent occupational injury and illnessHealth Promotion - interventions aimed at reducing lifestyle risk factors by promoting healthy behaviors and actionsEmployers have responsibility to provide a safe and hazard-free workplace.Traditionally, Health Protection is conceived as including Programs that focus on reducing hazards and exposures at workplaces to prevent occupational injury and illness. (they promote collective change); control of many hazards is regulated. Often these programs reside in non-health oriented units.On the other hand, TRADITIONALLY, Health Promotion has included Interventions aimed mainly at reducing lifestyle risk factors by promoting healthy behaviors and actions. These itv’s promote individual change. Often these program are a function of human resources or benefits.Historically, there has been a disconnect between those responsible for health protection and those responsible for health promotion in the workplace. Most health protection programs are separated from workplace health promotin programs. Sometimes, when resources are sparse, the programs can even seem to compete for funding. However - - there is an emerging body of evidence that supports efforts to integrate these approaches as a promising practice to protect and promote the total health of workers.
10“Traditional Safety and Health Silos Not Optimal for Workplace Health” ACEOM, 2011 The evidence clearly shoes that the health of workforce is inextricably linked to the productivity of the workforce and the health of the nation’s economy.Few employers have truly integrated programs .
11A Rationale for Integration Workers’ risk of disease is increased by exposure to both occupational hazards and individual risk related behaviorsWorkers at highest risk for exposures to hazardous working conditions are often most likely to engage in risk-related health behaviors and live in higher risk communitiesWorker participation in integrated programs is higher than in single- interventionManufacturing: Greater reduced risks - ergonomic, cardiovascular, job demand and job control risksBlue collar: Smoking quit rates in an integrated program more than doubled relative to a non-integrated programSorensen & Barbeau (2004)
12A Rationale for Integration Sharing resources across departments and functions can be cost efficient and result in a lack of duplication in program offeringCommon set of metrics can be used by all programsReduced competition for senior management attention and scarce resourcesImprovements in employee health will reduce medical care costs AND enhance worker safety, productivity, and organizational competitivenessSuccessful coordinated programs can save MORE money than they cost and achieve significant ROIGoetzel (2005)A growing body of research demonstrates the connection between improved health and functional status.Good physical condition, absence of chronic illness, and good mental health are factors that have been scientifically observed to be associated with low injury rates
13Examples of Integrated Approaches Respiratory protection programs that address tobacco use and smoking cessationErgonomics programs that teach joint health and arthritis managementStress management classes that seek to diminish workplace stressors, personal stressors and build resiliencyIntegrated training and prevention programs (falls, motor vehicle safety, first aid, hearing conservation, stretching, flexibility and lifting programs)Comprehensive screenings for work and non-work risksOccupational health combined with a workplace primary care home modelFull integration of: clinics, behavioral health, traditional safety, health promotion programs, coaching, EAP, nutrition, disability and workers compensation.
1465% of the adult population can be accessed at workplaces (CDC, 2010) Whether or not an illness or injury is work-related, the workplace is an ideal setting for safety, health protection and health promotion activities:There are 143M full- and part-time workers – CDC Estimates that 65% of the adult population can be accessed through worksites.Employees spend more than 1/3 of their day at the workplaceEmployers have a financial interest since they provide health insurance coverageEmployers pay for 36% of the nation’s healthcare expendituresAnd we’ve talked about how chronic health conditions are expensive not only for the healthcare system overall but also impinge upon employees’ abilities to be healthy, productive and engaged at work.[57% of employers with >500 employees offer some sort of wellness program]
15What is Total Worker HealthTM? Total Worker Health™ - A strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to enhance well-being.NIOSH coined the term Total Worker Health in 2011 and defines it as:the strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to enhance worker well-being
16Total Worker Health™ Intramural Program Partnerships Centers of ExcellenceNIOSH has chosen to assume a leadership position in addressing these issues through our Total Worker Health™ program.We see the concept of the TWH™ program as an umbrella for 3 specific components:Our developing intramural research programOur thriving partnerships, e.g, OPM, GSA, DOI federal worksite wellness pilot, VA Wellness is Now programOur Centers of Excellence – 3 maturing (recently refunded) and 1 new in 2011DevelopingThriving3 Maturing1 New
17NIOSH Total Worker Health ProgramTM Value of our partners
18TWHTM Partnerships Federal Worksite Wellness Pilots OPM and OMB Federal Employee Worksite Health & Wellness Initiative (10,000 federal workers)3-5 pilots in the next two years to implement and evaluate optimal interventionsWe have a number of active partnerships with Federal Agencies and have participated in a cross-govt workgroup with the OPM and OMB that is launching the Federal Employee Worksite Health and Wellness Initiative.OSH interventions, evidence-based health promotion strategiesIntegrated health, safety and wellness contentClinical and clinical preventive servicesBuilt environment interventionsHRA’s and chronic disease management strategiesInventory of OSH and health promotion activities throughout the federal workforce nationwideAssistance with vendor and evaluation provider selectionExploring new potential for data collection, claims awareness, EHR’s and incentivesImproved benefits for preventionWe have also been actively involved with helping the Veteran’s Administration design their WIN – Wellness Is Now program. NIOSH has had input into the program’s content, training design and promotion.We have engaged in partnerships to Co sponsor and collaborate on conferencesWe co-sponsored Healthier Federal Workers 2011: A new symposium on the health, safety and wellbeing of the federal workforce. And in response to overwhelming requests for a follow-up, we are hosting another Healthier Feds conference in 2012.We are also working with the American Psychological Association and the Society for Occupational Health Psychology to organize the upcoming WSH conference for which the theme will be “Protecting and Promoting Total Worker Health”
19Wellness Is Now: Veterans Health Administration "Wellness is Now – VA” pilot launched 2 years agoNIOSH engaged with program content, training, and promotionData collection for program effectiveness evaluation including measures of:Employee satisfactionAdministrative dataSick leaveLost time injuriesWorkers' compensation costsVHA is planning a national health promotion survey as part of its periodic work organization surveysLarge network of VA health promotion providers now activeCollaborating on 2011 Health of the Federal Worker Symposium
20NIOSH Centers of Excellence for Total Worker HealthTM University of Iowa Healthier Workforce Center for ExcellenceCenter for the Promotion of Health in the New England WorkplaceAt the University of MassachusettsAt the University of ConnecticutHarvard School of Public Health Center for Work, Health, & Well-BeingOregon Healthy Workforce Center, Oregon Health & Science University (selected in late 2011)This slide lists the 4 NIOSH Centers of Excellence:The University of Iowa Healthier Workforce Center for ExcellenceThe Center for the Promotion of Health in the New England WorkplaceAt the U Mass Lowell andU ConnHarvard School of Public Health Center for Work, Health and Well-beingThe Oregon Healthy Workforce Center at the Oregon Health and Science University – newly funded in 2011These centers are engaged in exciting research that will help us to understand how the integration of health protection and health promotion in the workplace can benefit individual workers, employers, our communities, and our nation.
21Case Studies Examples Promising Practices for tWHTM
22Case Study: NASAExample of an Integrated Program in a Federal Government AgencyIOM Committee Evaluated the Current Program (2005)15 Recommendations for Program Improvement
23Example of Coordination in Practice: NASA Goal: Every employee is healthier than the average worker as a result of work with NASARecommendations:Shift from disease status to health status, treatment to prevention, population-based health model, multiple-risk interventions,Integrated management of health programsMore effective, coordinated, data-driven health program policyJohnson Space CenterExecutive Safety and Health Committee cross-divisionalVP program stimulated broader thinking about health and behaviors at home and in community
25Policies to Support Health Tobacco-free campusFlexible work/schedule policiesLeave, telework, job share, parental/dependent careNutritious foods-at-meetings policyHealthy transportation policiesSmoke-free meetings policyTime during work hours for wellness activitiesTraining or educational opportunities, health fairs, eventsScreenings, health coaching, EAPPhysical Activity
26RESOURCES FOR BUILDING A HEALTHIER AND SAFER WORKFORCE Refer to handout
27Key Total Worker Health™ Reports STEPS to a Healthier WorkforceEssential Elements of Effective Workplace Programs and PoliciesACOEM Guidance on Workplace Health Protection and PromotionThe Whole Worker: Guidelines for Integrating Occupational Health and Safety with Workplace Wellness ProgramsIntegrating Employee Health: A Model Program for NASAHere are a fe key report covering the concept of Total Worker Health. All of these reports a listed and linked to the source on our website.
29Visit our Website: http://www.cdc.gov/niosh/TWH/ This is a screen shot of our TWH™ website, along with the website link.Much of the information I’ve provided today is available on our website, along with lots of great resources for additional information.I encourage you to take a look!
30Upcoming EventsHealthier Federal Workers September 2012 in Washington, DC10th Work Stress and Health Conference May 2013 in Los Angeles
31Designing Healthier Workplaces Can You Become a “Choice Architect”? Choice-making is never neutralDirecting default options toward health can be powerfulSubtle “nudges” toward healthier choices can improve health outcomesPolicy interventions provide a strong basis for better choicesIncentives and spotlights can motivateProviding structure around complex choices helpsThemes from Thaler R, Sunstein, C: Nudge Improving Decisions About Health, Wealth, and Happiness, 2008.
32Workplace’s Built Environment Allow Health to Thrive Safe, hazard-free workplaceWelcoming, user-friendly, ergo-appropriate workspacesCommitment to employee respect, engagement, and inputStairs, walkways, paths, trails that are safe and invitingOnsite food choices that make eating healthier easyTransportation and parking options that enhance healthOnsite or nearby health clinic or access to healthcare providersFitness facilities or opportunities for physical activity
33Heidi L. Hudson email@example.com Thank You!Heidi L. Hudson