Total Worker Health Focus Advances Employee Well-Being

October 29, 2019
Total Worker Health Focus Advances Employee Well-Being

​Years before employee experience became a buzz phrase, the National Institute for Occupational Safety and Health (NIOSH) launched a research and advocacy program encouraging employers to redesign their workplaces to improve worker safety, health and well-being.

Since 2011, the agency's Total Worker Health® approach started with the recognition that work directly affects one's health, and that job-related factors such as wages, work hours, workload and stress levels, and interactions with co-workers and supervisors impact the well-being of workers. 

L. Casey Chosewood, the director of the office for Total Worker Health at NIOSH spoke with SHRM Online about the aim of the program, how HR can contribute to employee health and well-being and what concerns need to be addressed.

[SHRM members-only toolkit: Designing and Managing Wellness Programs]

SHRM Online: What are some of the ways that work influences employees' health?

Chosewood: Work has a tremendously powerful, but largely unrecognized, impact on our overall health. In dangerous jobs, this may be obvious. But I think it's true for all workers.

When I speak to an audience, I often ask which single individual in your life has the most influence on your health and well-being? Invariably someone says their personal physician or their spouse or children. But my counter suggestion surprises many. Your supervisor likely has more influence on your day-to-day well-being than any other person. He or she can create calm or chaos for more than a third of your day, when you start and stop work, and maybe even when you go to the restroom. Your supervisor largely influences wages, promotions and time off for illness or vacation. He or she makes the rules around flexibility and workplace culture and sets the tone for all social interactions in the workplace. Because work makes up such a large portion of our day and its influence is constant and pervasive in all parts of our lives, it's a major determinant of our health.

New research is also uncovering more connections to work and the development of chronic diseases, like heart disease, diabetes, depression and obesity. The concept of "fat jobs," those that predispose workers to weight gain, given schedule and activity demands and deficits, is more real than ever before.

SHRM Online: What is the role of employers, HR and people managers in addressing and improving total worker health?

Chosewood: On the policy front, HR's influence on benefits design, especially health care and leave, on promotions and advancement, and on retraining and reskilling can't be overlooked. HR departments often manage occupational health, disability and return-to-work services, and health promotion offerings in many organizations. These all provide tremendous opportunities for both positive and negative outcomes so attention here is critical. If your HR department doesn't have a worker advisory board weighing in on benefits choices and specifics, it's time to change that.

Our research also shows that providing ongoing opportunities for advancement and career development is also critical. The opportunity to gain new skills and experiences can increase employee motivation and job satisfaction and help workers more effectively manage job stress.  Today's labor market is historically tight. Companies that develop the talent they need from within have a strategic advantage. 

In addition, managers and front-line supervisors are culture-makers. Their style, tone and decision-making directly impacts worker satisfaction, retention and productivity. Beyond health care, a significant portion of the "health" spending should be used for developing the listening, problem-solving and soft skills among front line managers. We can train folks to manage with health and well-being outcomes in mind. They need to see the connections between work and nonwork influences on health. They need to learn to be "encouragers-in-chief," to reward and recognize more consistently and to be early to recognize when a co-worker is struggling and needs additional resources to succeed on the job.

A manager's ability to harness the innate human drive to contribute—to be part of something bigger than ourselves—is often overlooked. Yes, this is about inspiring folks to see the meaning in their work, but it's more than that. Increasing employee involvement in decision-making and providing sufficient autonomy and control is perhaps the most important element in maxing out job satisfaction, employee morale and commitment. This element is also essential to acing productivity, reducing turnover and limiting absenteeism. In competitive markets, this one element can be the differentiator when it comes to the quality of services provided or products delivered. 

On the health side, we know that increased worker control, particularly in high-demand work conditions, has been associated with reduced risk of cardiovascular disease, improved mental health, and with a significantly reduced risk of early death.

SHRM Online: What are a few of the most critical areas that need to be addressed right now?

Chosewood: Workplace stress is an extremely important issue in almost all workplaces. It's one of the most common concerns we hear about from employers. And today, it's even more critical that we change this misconception that this discussion doesn't belong in the workplace because mental health challenges and the opioid overdose and suicide epidemics are devastating many in our workforce. Some occupations and industries, like construction, mining and transportation are especially hard hit. 

Mental health conditions are a leading cause of disability and are costly for many employers.  And underlying mental health concerns or diagnoses impact productivity day in and day out and can often slow the return-to-work after workers face other injury and illness, whether work-related or not. The quality of the job and the demands of the work are critical to consider here, not just personal risk factors. We know that fast-paced work, high job demands, job insecurity, and low wages in many work settings may increase risks for poor mental health outcomes. Managers, safety professionals and HR teams should increase their comfort around these issues and be ready to help. Many already have the soft skills critical to help mitigate or address the challenges workers face. 

Crafting workplaces to be more amenable and accepting to workers as they age may also be an opportunity for some employers to compete in tight labor markets. This is more than just special policies for older workers. All workers are aging and all benefit from attention to slip and fall hazards, proper ergonomic design, noise and lighting optimization. Cross-generational mentoring and coaching in both directions is another, often untapped source of creative energy just waiting to emerge. 

SHRM Online: What are some of the proven practices, programs and policies for improving employee health and well-being?

Chosewood: A healthy workplace culture is the result of a comprehensive set of steps employers can take to benefit their employees. It's an ongoing commitment to healthier hiring arrangements and practices, better job design, attention to working demands and conditions, and adequate wages, benefits, recognition and rewards. Good culture supports engagement and retention. It turns a "job" into a fulfilling experience that provides both a living and a life.

A program focused on the health and well-being of workers, must first and foremost look at the components of work itself. Is the work designed to be safe and manageable? Are the demands realistic? Do workers have the resources they need to be able to do their work? Do they have adequate rest breaks? Do they have a voice in workplace program design and in problem solving when difficulty arises? Are they given adequate flexibility to balance work, family and home responsibilities? These are important starting points for any workplace well-being program, and likely far more important than a company gym or a "lunch and learn" on diabetes.



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