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Total Worker Health™ TWH An Integrated Approach to Worker Well-Being A NIOSH Initiative

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Presentation on theme: "Total Worker Health™ TWH An Integrated Approach to Worker Well-Being A NIOSH Initiative"— Presentation transcript:

1 Total Worker Health™ TWH An Integrated Approach to Worker Well-Being A NIOSH Initiative By Sally Bardsley, Ed.D, CIH Montana Tech Safety, Health, and Industrial Hygiene Dept. March 4,

2 * Info from: NIOSH Total Worker Health™: Innovative Approaches for Healthier Employees Heidi Hudson, MPH – Co-Coordinator for Total Worker Health TM National Institute for Occupational Safety and Health Centers for Disease Control and Prevention 2012

3 What We’ll Talk About... Total Worker Health (TWH) TWH & Wellness Research S&H professional’s role re TWH Resources PLEASE share your insights and experience during this presentation. 3

4 TOTAL WORKER HEALTH 4

5 NIOSH’s TWH Initiative A strategy integrating OSH protection with health promotion to Prevent worker injury and illness Enhance and advance well-being How does work (place, practices, etc.) affect life beyond work? How does life beyond work (recreation, home, family) affect work? 5

6 To the Boss, TWH Means... Ensuring optimum well-being for workers through integration of state-of-the-art protection and promotion that has the workers’ best interests as its motivating goal. Promoting worker well-being in all its aspects, including appropriate indemnity and medical care for work injuries and illnesses, adequate paid sick and family leave, maternity and paternity leave, adequate vacation time, living wages, comprehensive health care, social pensions, along with safe and healthful workplace conditions as required by law. John Howard, MD, MPH, JD, LLM, Director, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC) Keynote address at 1st International Symposium to Advance Total Worker Health TM October 6, 2014 | Bethesda, MD 6

7 Traditionally... Awareness of OSH re the worker has been around for decades, but These concepts were largely compartmentalized Health Protection Programs –Focused on reducing hazards and exposures at workplaces to prevent occupational injury and illness Health Promotion Programs –Focused on reducing lifestyle risk factors by promoting healthy behaviors and actions 7

8 Is TWH a New Concept? OSHAct (1970) SEC. (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... Corporate fitness/wellness in the 80s Many companies support employee health and wellness What does your employer do? “Traditional Safety and Health Silos Not Optimal for Workplace Health” ACEOM,

9 Now, Integration is Key TWH Equation TWH = OSH protection + Health promotion Integrate most aspects of the occupational environment and the worker Holistically address the challenges of each both individually and in combination Fit the separate puzzle pieces together into a comprehensive “picture”

10 What changes have you seen? Between OSHA’s inception and now in The workforce The type of work What needs to be changed? 10

11 Issues Relevant to TWH EmploymentWorkplaceWorkers 11

12 Let’s brainstorm all the facets of TWH we can think of re Worker Workplace Employment

13 TWH & Workers Promoting Worker Health & Well-being Optimal Well-Being: Employee Engagement Health & Well-Being Assessments Healthier Behaviors Nutrition Tobacco Use Cessation Physical Activity Work/Life Balance Aging Productively Preparing for Healthier Retirement Policy & Built Environment Supports Workers with Higher Health Risks: Young Workers Low-Income Workers Migrant Workers Workers New to a Hazardous Job Differently-Abled Workers Veterans Compensation & Disability: Disability Evaluation Reasonable Accommodations Return-to-Work Social Security Disability Insurance 13

14 TWH & Employment Preserving Human Resources New Employment Patterns: Precarious Employment Part-time Employment Dual Employers Changing Demographics Increasing Diversity Aging Workforce Multigenerational Workforce Global Workforce Health & Productivity: Leadership Commitment to Health-Supportive Culture Fitness-for-Duty Reducing Presenteeism Reducing Absenteeism Workplace Wellness Programs Healthcare & Benefits: Increasing Costs Cost Shifting to Workers Paid Sick Leave Electronic Health Record Affordable Care Act HIPAA† Health Info Privacy 14

15 TWH & the Workplace TWH & the Workplace Protecting Worker Safety & Health Control of Hazards & Exposures: Chemicals Physical Agents Biological Agents Psychosocial Factors Organization of Work Prevention of Injuries, Illnesses & Fatalities 15 Promoting Safe & Healthy Work: Management Commitment Safety Culture/Climate Culture of Health Hazard Recognition Training Worker Empowerment Risk Assessment & Control: Making the Safety & Health Case Assessing All Risks Controlling All Risks Root Cause Analysis Leading/Lagging Indicators

16 TWH and OSHA Standards Are there any that consider a worker’s general health? Not just focused on prevention of injury or illness https://www.osha.gov/pls/oshaweb/owadisp.show_ document?p_table=STANDARDS&p_id=9783 https://www.osha.gov/pls/oshaweb/owadisp.show_ document?p_table=STANDARDS&p_id=9783 Are there standards that should do so but don’t? When we consider TWH and integration, should it become regulatory? 16

17 *Examples of Integrated Approaches Respiratory protection programs that address tobacco use and smoking cessationRespiratory protection programs that address tobacco use and smoking cessation Ergonomics programs that teach joint health and arthritis managementErgonomics programs that teach joint health and arthritis management Stress management classes that seek to diminish workplace stressors, personal stressors and build resiliencyStress management classes that seek to diminish workplace stressors, personal stressors and build resiliency Integrated training and prevention programs (falls, motor vehicle safety, first aid, hearing conservation, stretching, flexibility and lifting programs) Integrated training and prevention programs (falls, motor vehicle safety, first aid, hearing conservation, stretching, flexibility and lifting programs) Comprehensive screenings for work and non-work risks Comprehensive screenings for work and non-work risks Full integration of: clinics, behavioral health, traditional safety, health promotion programs, coaching, EAP, nutrition, disability and workers compensation. Full integration of: clinics, behavioral health, traditional safety, health promotion programs, coaching, EAP, nutrition, disability and workers compensation.

18 *TWH Advantages Workers’ risk of disease is increased by exposure to both occupational hazards and individual risk related behaviors Workers 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 communities Worker participation in integrated programs is higher than in single-intervention Manufacturing: Greater reduced risks - ergonomic, cardiovascular, job demand and job control risks Blue collar: Smoking quit rates in an integrated program more than doubled relative to a non-integrated program Sharing resources across departments and functions can be cost efficient and result in a lack of duplication in program offering Common set of metrics can be used by all programs Reduced competition for senior management attention and scarce resources Improvements in employee health will reduce medical care costs AND enhance worker safety, productivity, and organizational competitiveness Successful coordinated programs can save MORE money than they cost and achieve significant ROI

19 STATS, RESEARCH 19

20 *Every Day... 12,712 new reported cases of nonfatal occupational injuries and illnesses 9,315 workers are treated in emergency departments 9,315 workers are treated in emergency departments 258workers are hospitalized 258workers are hospitalized 134deaths from work-related illness 134deaths from work-related illness 14deaths from work-related injuries 14deaths from work-related injuries Source: MMWR, Vol. 59, No. 15, April 23,

21 *Costs of Work-Related Incidents and Illnesses Employers and insurers spent $85 Billion on workers’ compensation in 2007, which is –Only a portion of the costs borne by employers, workers, and society, and  Excludes costs paid by other insurance systems and most of work-related illness costs Source: CDC Morbidity and Mortality Weekly Report. Volume 59, Number 15. April 23,

22 *Health Stats 22 Cancer 553,000 deaths, 1.3M new cases/yr553,000 deaths, 1.3M new cases/yr $89B in medical costs, $130B in lost work days & productivity$89B in medical costs, $130B in lost work days & productivityDiabetes >23.6M cases, >200,000 deaths/yr>23.6M cases, >200,000 deaths/yr $116B for medical issues,$58B for lost work & productivity$116B for medical issues,$58B for lost work & productivityCVD 80M cases, >870,000 deaths/yr80M cases, >870,000 deaths/yr $448B a year$448B a yearTobacco-Related 438,000 deaths438,000 deaths $96B in medical costs, $97B in direct costs$96B in medical costs, $97B in direct costs How do you see these Chronic Health Conditions affect your workplace? How do you see these Chronic Health Conditions affect your workplace? Source: National Center for Chronic Disease Prevention and Control [2008]

23 Ten Modifiable Health Risk Factors Are Linked To More Than One-Fifth Of Employer- Employee Health Care Spending Goetzel, et al Goetzel Health Aff November 2012 vol. 31 no Top 7 = Depression, high blood glucose, high blood pressure, obesity, tobacco use, physical inactivity, high stress strongly related to ↑ health care costs Need properly targeted employer- sponsored health promotion programs to produce substantial savings 23

24 Workplace Wellness Programs Can Generate Savings Baicker, et al Baicker Health Aff February 2010 vol. 29 no For every dollar spent on wellness programs: Medical costs fall ~$3.27 Absenteeism costs fall ~$2.73 Such a ROI indicates the financial, health, and productivity benefits of such programs 24

25 Workplace Wellness Programs Cut Healthcare Costs - Survey Of 1,121 wellness program participants surveyed, 1. Over half said they are more productive as a result; 2. 40% said wellness programs encourage them to stay with their company, 3. More than a third said they have missed fewer days of work. BUT while many/most employers offer online wellness information, and educational resources Employees want more hands-on, tangible rewards, like access to nutritionists and onsite fitness facilities 25

26 TWH Research Compendium Research papers –http://www.cdc.gov/niosh/docs/ /pdfs/ pdf 146/pdfs/ pdfhttp://www.cdc.gov/niosh/docs/ /pdfs/ pdf 26

27 The Safety & Health Professional’s Role Re TWH 27

28 OSH Professional’s Role re TWH What is the scope/boundary of our influence and appropriate intervention? Does TWH belong under the umbrella of occupational safety and health? Would/does your employer encourage and promote TWH--workplace WELLNESS as well as occupational safety and health? Would TWH change the educational requirements—would multiple professionals be required? Do you see any downside to TWH?Do you see any downside to TWH? 28

29 Should We Have a Role Re Employee Health beyond the Workplace? Is it part of our professional duty to address the health and fitness of employees? Is it part of our professional duty to address the health and fitness of employees? Or is this beyond the scope of our jobs? We know poor health and fitness affect various work aspects and can affect the safety and health of others The body and mind work together in a synergistic fashion. The body and mind work together in a synergistic fashion. NIOSH and other agencies see thisNIOSH and other agencies see this TWHTWH Occupational Health PsychologyOccupational Health Psychology Even Congress recognizes its importanceEven Congress recognizes its importance Do you think mandates will/should follow? Do you think mandates will/should follow? 29

30 Another Brainstorm! You are a Safety Director that has been asked to develop a workplace TWH program. –How will you proceed? –How could you integrate a wellness/TWH culture into your safety culture? 30

31 RESOURCES 31

32 TWH Centers of Excellence  University of Iowa Healthier Workforce Center for Excellence   Center for the Promotion of Health in the New England Workplace  At the University of Massachusetts  At the University of Connecticut  Harvard School of Public Health Center for Work, Health, & Well- Being   Oregon Healthy Workforce Center, Oregon Health & Science University  healthy-workforce-center/index.cfm healthy-workforce-center/index.cfm healthy-workforce-center/index.cfm 32

33 Facets of TWH Research Perspectives on TWH™ – –http://www.cdc.gov/niosh/twh/perspectives.htmlhttp://www.cdc.gov/niosh/twh/perspectives.html TWH Program Guidelines –http://www.cdc.gov/niosh/twh/reports.html Partnerships –http://www.cdc.gov/niosh/twh/partner.html Newsletter –http://www.cdc.gov/niosh/TWH/newsletter/ 33

34 *Key Total Worker Health™ Reports STEPS to a Healthier Workforce STEPS to a Healthier Workforce Essential Elements of Effective Workplace Programs and Policies Essential Elements of Effective Workplace Programs and Policies ACOEM Guidance on Workplace Health Protection and Promotion ACOEM Guidance on Workplace Health Protection and Promotion The Whole Worker: Guidelines for Integrating Occupational Health and Safety with Workplace Wellness Programs The Whole Worker: Guidelines for Integrating Occupational Health and Safety with Workplace Wellness Programs Integrating Employee Health: A Model Program for NASA Integrating Employee Health: A Model Program for NASA

35 CDC CDC National Healthy Worksite ProgramNational Healthy Worksite Program FAQ FAQ hwp-general-faq.pdfhttp://www.cdc.gov/nationalhealthyworksite/docs/n hwp-general-faq.pdfhttp://www.cdc.gov/nationalhealthyworksite/docs/n hwp-general-faq.pdfhttp://www.cdc.gov/nationalhealthyworksite/docs/n hwp-general-faq.pdf Newsletter Newsletter NHWP_June2012Newsletter_508_ pdfhttp://www.cdc.gov/nationalhealthyworksite/docs/ NHWP_June2012Newsletter_508_ pdfhttp://www.cdc.gov/nationalhealthyworksite/docs/ NHWP_June2012Newsletter_508_ pdfhttp://www.cdc.gov/nationalhealthyworksite/docs/ NHWP_June2012Newsletter_508_ pdf Wellness committees Wellness committees sign/wellness_committees.htmhttp://www.cdc.gov/nccdphp/dnpao/hwi/programde sign/wellness_committees.htmhttp://www.cdc.gov/nccdphp/dnpao/hwi/programde sign/wellness_committees.htmhttp://www.cdc.gov/nccdphp/dnpao/hwi/programde sign/wellness_committees.htm 35

36 Food for Thought; Misc. Alliance with fitness facilities Alliance with fitness facilities Montana Tech OSH and AHSS interns!! Montana Tech OSH and AHSS interns!! NIOSH webinars NIOSH webinars WHO WHO ations/global_plan/en/http://www.who.int/occupational_health/public ations/global_plan/en/http://www.who.int/occupational_health/public ations/global_plan/en/http://www.who.int/occupational_health/public ations/global_plan/en/ 36

37 Thank You Please share your questions, expertise, ideas, and comments. 37


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