A Totally Cool New Way to Look at Worker Health

The goal is to convince employers to think of on-the-job health and safety as just one part of an integrated whole that also includes worker wellness and well-being.
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Total Worker Health may be the coolest thing since Nutella. (Chocolate and hazelnut! Spreadable!)

What, you ask, is Total Worker Health?

It's an initiative out of the CDC's National Institute for Occupational Safety and Health--aka, NIOSH. The goal is to convince employers to think of on-the-job health and safety as just one part of an integrated whole that also includes worker wellness and well-being.

Here's how NIOSH puts it on its website:

Traditionally, workplace safety and health programs have been compartmentalized. Health protection programs have focused squarely on safety, reducing worker exposures to risk factors arising in the work environment itself. And most workplace health promotion programs have focused exclusively on lifestyle factors off-the-job that place workers at risk. A growing body of science supports the effectiveness of combining these efforts through workplace interventions that integrate health protection and health promotion programs.

In other words, instead of having one department devoted to worker safety and ergonomics--the sorts of things that fall under the purview of the Occupational Safety and Health Administration (OSHA)-- and another, completely different department devoted to the wellness incentive programs that are currently all the rage, and perhaps yet another department devoted to work-life integration, companies ought to be seeing all aspects of worker health, safety and well-being as the deeply interrelated concerns they are. After all, it all comes down to healthier, less stressed, more engaged workers, does it not?

Wise work-life practitioners have long argued that "work-life balance" is ultimately about allowing employees to bring their whole selves to work --to be themselves, on and off the job. (This, by the way, brings in the whole world of diversity & inclusion, as well.) Now NIOSH is stepping in to say, duh, of course employees bring their whole selves to work, and if we want to keep them alive and healthy and smart and productive, we need to think about their health, safety and well-being as one. (By the way, when I say "now," I mean as of 2011, when NIOSH launched the initiative in its current form.)

To quote NIOSH Director, John Howard, speaking at a recent symposium, "Total Worker Health is more than the sum of its parts--protection and promotion--it is a synthesis of all aspects of health that create worker well-being."

By "Total" They Mean "Total!"

I spoke recently with Casey Chosewood, director of the Office for Total Worker Health, to find out more about this remarkable program. Chosewood pointed out that NIOSH's priority is still on-the-job health and safety--that's the point all employers should be starting from. But he defines such health and safety quite broadly:

"You want work that's high-quality, that's respectful of employees, that doesn't diminish health based on the nature of the work itself. Once a company gets that baseline and can say 'yes, we have a safe, respectful workplace,' then we believe it is time for companies to say, hey, what more can we do to improve outcomes?"

That word "respect"--so unusual in a conversation of this nature--really caught my attention. According to Chosewood, a healthful work environment encompasses the notion that employees have a voice in the decisions that affect their work and their working conditions. And one in which supervisors are trained to understand their employees' work-life needs. And one in which employers treat all employees fairly and provide them with the same access to programs and benefits, regardless of their job status or income-level.

"We know there's a close connection between people's working lives and their home lives," said Chosewood, "and it's artificial not to consider the challenges that both lend or extend to the other."

After assuring this most basic level of safety, respect and control, employers can begin layering in other programs and policies to promote wellness and balance. In keeping with the concept of respect, Chosewood noted that these programs and policies are best implemented based on employee feedback:

"If I can suggest one simple way for employers to get started, it's to pull a group of employees together, find out what their health challenges are and let them create the program. If every employer did that, this initiative would be a tremendous success."

They Walk the (Fifteen-Minute?) Walk

Chosewood knows whereof he speaks. One of his specific responsibilities is bringing employee life at NIOSH into line with what the agency is promoting for other employers.

"We thought it was important early on for us to say that we believe in this concept enough to do it for our own workforce...both from a learning lab perspective--seeing how this works in the real world--and also because we want to speak with integrity."

What does Total Worker Health look like at NIOSH? In addition to having especially strong health benefits and wellness programs (though they prefer the term "wellbeing"), they have "really good policies in place around telework, flexplace and flexible scheduling" and they are always looking for innovative ways to think about health. They're currently piloting both sit-stand workstations (any employee can request an adjustable desk) and walking workstations (these are shared; employees can book time on them in advance). They have a program promoting use of the stairs rather than the elevator and a policy affectionately known as the "no-donut" rule--employees are encouraged to bring only healthy snacks for sharing. (Chosewood, himself, likes to hold team salad bar potlucks, in which each member of his team brings one item for a salad that is assembled and shared over lunch.)

It seems pretty clear that for a Chosewood it's not about a rigid set of programs and policies, but about creative thinking all around. He encourages siloed safety/wellness/work-life/HR departments to share ideas and take part in each other's meetings on a regular basis. He tries to apply a Total Worker Health perspective to every aspect of the job. One of his interventions for NIOSH employees was to build the new, much-anticipated parking lot a good fifteen minute walk away from the office.

Now You Know the What--Here's The Why and the How

Why should employers bother with all this? While he said more definitive research is needed, Chosewood pointed to strong evidence that the value for employers is much like the value of any really strong work-life program: healthier, more committed, productive and engaged workers. (Stand-alone wellness programs, on the other hand, get grief from the experts from being at best, fairly useless and at worst, merely a back-handed way of shifting health care costs.

Unlike OSHA, NIOSH has no power to regulate or enforce policy. (It is, however, seen as a sort of brains-behind-the-brawn, researching and setting goals that may eventually turn into regulations.) But back at the NIOSH website, Total Worker Health is making a lot of promotional noise. There are resources galore, from statistics to activities to research papers to best practice case studies to conferences. And based on those case studies, in particular, a number of companies have taken up the challenge, becoming designated as "TWH Affiliates" to develop programs and conduct research.

All told, it's pretty exciting stuff. Maybe even better than Nutella. Although it's a tough contest, for sure.

Robin Hardman is a writer and work-life expert who works with companies to put together the best possible "great place to work" competition entries and creates compelling, easy-to-read benefits, HR, diversity and general-topic employee communications. Find her at www.robinhardman.com.

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