5 Critical Components to Establishing Total Worker Health

The National Institute of Occupational Safety and Health (NIOSH) was created by the Occupational Safety and Health Act of 1970, which mandated, “To assure so far as possible every man and woman in the nation safe and healthful working conditions and to preserve our human resources.” Keeping workers safe is the foundation upon which NIOSH’s Total Worker Health (TWH) is achieved.

“TWH is a holistic model for improving employee safety, health and well-being, involving an integrated approach that prioritizes safety, while simultaneously engaging in other workplace efforts to advance the overall well-being of employees,” said Sara Gibson, Senior Risk Services Manager at Safety National. “It integrates and acknowledges that employees are humans and there are other factors that are involved in safety, including mental health, stress, interactions with co-workers, wages, and access to paid leave.”

These are the five main elements that are critical to establishing TWH.

1. Leadership’s commitment to worker safety and health at all levels of the organization.

Effective programs thrive in organizations that promote respect for all employees and encourage employee participation at all levels. Examples include:

• Top leaders clearly communicate their commitment to the program and the value of their employees.
• Leadership Openly supports and participates in program initiatives.
• Include safety and health in performance evaluations.
• Provide adequate resources, including training and time.
• Establish a mechanism and budget to act on recommendations.
• Recognize and discuss the competitive advantage of TWH on recruitment, retention, employee satisfaction, community engagement, reputation, and workforce sustainability.

2. Design work to eliminate or reduce safety and health hazards and promote worker wellbeing.

TWH prioritizes a hazard-free work environment with a prevention approach consistent with safety and NIOSH’s traditional inverted triangle Hierarchy of Controls Model as follows:

• Eliminate workplace conditions that threaten safety, health, and wellbeing.
• Substitute health-enhancing policies, programs, and practices.
• Redesign the work environment for safety, health, and wellbeing.
• Educate for safety and health.
• Encourage personal change.

3. Promote and support worker engagement throughout program design and implementation.

Identify safety and health issues that are most important to frontline employees. Identify potential barriers to program use and effectiveness. Improve the long-term sustainability of initiatives and increase employee buy-in and participation. It is recommended to have a Healthy Workplace Participatory Program (HWPP) with a two-committee structure:

• Steering Committee consists of management for strategic decisions, resources, and policy implementation.
• Design Team consists of frontline employees for identifying issues, designing solutions, and developing a business case to present to the Steering Committee.

4. Ensure the confidentiality and privacy of workers.

For any sensitive information collected, confidentiality must be maintained. Some privacy precautions may include:

• Rigorous de-identification of data.
• Destruction of personally identifiable information as appropriate.
• Hiring a third party to handle certain aspects of the program to reduce employee fears.
• Using group or population data rather than individual data.

5. Integrate relevant systems to advance worker wellbeing.

Conduct an initial assessment of relevant existing workplace policies and programs. Identify areas of overlap with existing efforts and where there are opportunities for coordination. Purposely and regularly bring together leaders and teams with overlapping or complementary responsibilities for planning and priority setting. Ask questions such as:

• Is input on the design of benefits regularly received?
• What influences worker safety and health beyond the workplace?
• How do our efforts feed into the community at large?

NIOSH laid out a detailed TWH implementation guide on its website. Additionally, they have funded five Centers of Excellence to provide ideas and innovative approaches to TWH. The Center for the Promotion of Health in the New England Workplace includes training on how to run a collaborative committee, which is an excellent resource for starting all workplace committees.

For more information on this topic, please contact [email protected].