At a glance
Key accomplishments from the six Centers of Excellence for Total Worker Health® in fiscal year 2020. This includes recognition from the U.S. Surgeon General, adoption of TWH interventions, and the launch of a campaign, toolkit, and other resources.
Introduction
NIOSH funded six Centers of Excellence for Total Worker Heath (TWH) in FY 2020. Located throughout the United States, the Centers explore and research TWH-related concepts. NIOSH defines TWH as policies, programs, and practices that integrate protection from work-related safety and health hazards with the promotion of injury and illness prevention efforts to advance worker well-being. TWH principles aim to broadly integrate workplace systems to control hazards and exposures, organization of work, compensation and benefits, work-life balance, and organizational change management. Their approach works toward a hazard-free workplace for all workers.
You can find this information and more in NIOSH Extramural Research and Training Program: Annual Report of Fiscal Year 2020.
U.S. Surgeon General highlights NIOSH TWH approach
In an article in Public Health Reports, the U.S. Surgeon General, Vice Admiral Jerome Adams highlighted the Centers of Excellence for TWH. The NIOSH Office of TWH and NIOSH TWH affiliates were also spotlighted.
The article focused on the important relationship between employment and health. The U.S. Surgeon General recommended that employers and companies ensure that worker well-being programs are implemented more broadly and meet the needs of workers. This approach can lead to better health and business outcomes. He mentioned successful research and practice for worker well-being from the NIOSH Office of TWH and the Centers of Excellence for TWH. One center project he mentioned included the Health Improvement Through Training & Employee Control Program from the Center for the Promotion of Health in the New England Workplace (CPH-NEW).
However, while the article acknowledged the centers' work and NIOSH, it noted that more research is needed on workplace well-being interventions across varied settings that shows the positive impacts on multiple health, human capital, and financial outcomes. Through partnerships among public health leaders, academia, employers, and other interested parties—like the one between NIOSH and the Centers of Excellence for TWH—the U.S. Surgeon General believes we can help workers achieve their highest potential.
Details: The Value of Worker Well-being
Connecticut Dept of Corrections adopts TWH-oriented training
Based on past studies, CPH-NEW found that correctional officers developed high risks factors for chronic disease within the first five years of working. They often experienced obesity, hypertension, physical inactivity, and high levels of depression, along with poor sleep and nutritional habits. To address this issue, CPH-NEW researchers conducted a study focused on peer health mentoring for new cadet correctional officers known as "Health Improvement through Training & Employee Control (HITEC II)." HITEC II researchers and the Connecticut Department of Corrections developed design teams combining a Kaizen design approach and CPH-NEW's IDEAS process. Correctional officers and supervisors on the teams created TWH interventions for workplace safety and health concerns. The teams created intervention programs, including educational trainings on mental health, prevention of substance use and misuse, and nutrition.
The supervisors involved are also a part of the Correction Supervisors Unit (NP-8) of the Service Employees International Union, Local 2001. In FY 2020, the Connecticut Department of Corrections started permanently funding and offering the trainings to employees as part of a union collective bargaining agreement. Employees now have formal training days to participate in the programs, but their involvement is voluntary. So far, more than 40% of all corrections supervisors have participated in the trainings.
Details: History of Health Improvement Through Training & Employee Control (HITEC) I & II
Suicide prevention campaign for construction industry
In the United States, suicide is the 10th leading cause of death, claiming the lives of nearly 48,000 people in 2019, according to the National Institute of Mental Health. More so, the construction industry has one of the highest suicide rates compared with other industries.
To address this issue, the Association of General Contractors (AGC), a construction industry trade association, developed a suicide prevention campaign with the Healthier Workforce Center of the Midwest. Before the campaign, the center worked with the AGC chapter in Missouri and center-funded researchers at Washington University at St. Louis on projects to improve the safety, health, and well-being of construction apprentices. The collaboration led national AGC leadership to recruit this group to work on its suicide prevention campaign for construction workers. They joined a small team of union safety professionals and representatives from large contractors for the project.
The suicide prevention campaign called "You OK?" launched in September 2019 during National Suicide Prevention Week. This ongoing campaign includes freely accessible materials including medallions, hard hat stickers, posters, and toolbox talk handouts. Throughout FY 2020, 185 individuals requested campaign materials and several large Missouri construction companies have shared this information with hundreds of employees during Safety Stand-Down events. The Healthier Workforce Center of the Midwest now has plans to nationally expand the campaign.
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Oregon Healthy Workforce Center Dissemination Workgroup
The Dissemination Workgroup at the Oregon Healthy Workforce Center focuses on the center's use of best practices for disseminating, or sharing, its intervention research. The Workgroup developed multiple products including the Health Impacts Safety toolbox and safety meeting guides, which are given out at conferences and available online. In FY 2020, more than 400 people downloaded the Health Impacts Safety materials online. The workgroup also created a webpage, YourWorkpath.com, to share all the center's toolkits and TWH-related resources in one space. In FY 2020, 1,264 individuals visited the page.
Two organizations, the State Accident Insurance Fund Corporation (SAIF) in Oregon and Eskenazi Health in Indiana, developed partnerships with the center after their staff visited the page. Eskenazi has plans to roll out the SHIP the center's Safety and Health Improvement Program (SHIP) throughout its hospital system. SAIF will include SHIP in its series of manager-focused training programs, called "Leadership Project."
The Dissemination Workgroup also built a collaboration between the Center and a community college in the Midwest, focused on the Promoting U through Safety & Health toolkit. The college plans to first distribute the toolkit to workers and students from ages 18 through 45 years on two of its four campuses. After this, it will eventually roll out the toolkit to more than 3,000 individuals across all four of its campuses and satellite locations.
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Study identifies policy recommendations and gaps
The Center for Work, Health, and Well-being has conducted the first literature review of TWH research articles, focused on identifying policy implications. The center's researchers analyzed its peer-reviewed publications over 7.5 years that focused on links between work conditions and health outcomes. They looked at the literature for scientific findings addressing organizational or public policies and identified common themes or topics.
The scientists reviewed 32 of 57 peer-reviewed articles published from 2011 through mid-2019 that fit the study's inclusion criteria and found 12 cross-cutting or broad themes focused on policies. These included (1) ergonomic practices, (2) harassment and abuse, (3) safety practices, (4) social support, (5) staffing levels, (6) work-family conflict, (7) work schedules, (8) work stress, job demands and decision-making, (9) injuries and injury reporting, (10) mental health, (11) physical activity, and (12) sleep deficiency. The themes were grouped and reported in two categories—working conditions and related health outcomes—categories that researchers report influence each other. This finding supports a core component of the TWH concept that multiple working conditions can interact and influence one another and health outcomes.
Beyond being the first of its kind, this study is significant because policies are key to the integration of TWH practices in the workplace and its influence on worker well-being. The research identified themes for policy recommendations from TWH research, as well as gaps where future research is needed on policies.
Launch of the Get Outdoors Employer Toolkit
In FY 2020, the Center for Health, Work & Environment created the Get Outdoors Employer Toolkit. It was developed in partnership with the Office of Outdoor Recreation at the Colorado Office of Economic Development and International Trade. The toolkit includes free resources for businesses to support a healthier employee lifestyle. It encourages employers to integrate and promote nature experiences and outdoor recreation into workplace initiatives.
A workplace focused wellness and health survey is included in the toolkit. Employers who complete the assessment receive recommendations on ways their company can improve health and wellness programs through outdoor activities.
Through the assessment and resources, the Center expects to improve the health and well-being of diverse Colorado workforces. The toolkit also aligns with the Colorado Governor's Health Initiative to lower healthcare cost by encouraging state residents to get outside.
The center promoted the toolkit to leading Colorado employers in the manufacturing, healthcare, construction, and retail industries. The media also widely promoted it. In FY 2020, 51 companies of varied sizes and industries completed the assessment and received recommendations. The center launched the first Get Outdoors Healthy Workplace Award in October 2020, recognizing companies based on their assessment results.
Details: Get Outdoors Employer Toolkit
Community interventions for safer and healthier work
Building on data from a past assessment of two Chicago neighborhoods with high levels of unemployment and/or residents in precarious work, the University of Illinois at Chicago (UIC) Center for Healthy Work is developing community interventions. The center is using the assessment results, and a theory of change and strategic road map resulting from it, to create a healthy work culture within the community. The four interventions are a part of the Greater Lawndale Healthy Work (GLHW) Project and focus on community perceptions and strong community infrastructure that support healthy work, along with fair work opportunities within neighborhoods.
Members of the GLHW Council are creating and will pilot test the following interventions within Chicago's Greater Lawndale area:
- An educational campaign that includes an interactive bingo/lotería game, art, and events. These activies are focused on changing beliefs on work and health among community members, workers, employers, and policy makers. Work is highlighted as a human rights and social justice priority.
- Training and outreach materials on workers' rights that will be distributed to temporary staffing agencies. They will then be customized and widely shared by these companies.
- Education and advocacy for policies that increase opportunities to build community wealth and spending. THis is accomplished through more support of local entrepreneurship, small businesses, and cooperative businesses.
- Characterization of COVID-19 impact on communities and related resident needs and use of this information to modify GLHW interventions.