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Advocating for Worker Well-Being

James R. Thornton, CSP, CIH, FASSP, FAIHA, 2023-24 ASSP President and ASSP Foundation Chair
May 01, 2024

Jim Thornton

NIOSH defines Total Worker Health (TWH) “as policies, programs and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness-­prevention efforts to advance worker well-being.” So in addition to traditional safety measures, it considers the physical, mental and social aspects of health and recognizes that these elements affect overall worker safety and productivity.

I first began to advocate for this approach while helping to establish an on-site healthcare facility at Newport News Shipbuilding. The facility makes primary healthcare available to more than 20,000 salaried and hourly employees and their dependents. This is a significant service, especially for the many hourly employees who did not have a primary care physician.

At its core, TWH is about providing a workplace that aims to prevent injuries and illnesses while also promoting worker well-being. The concept recognizes that factors such as job stress, lifestyle and work-life balance can significantly impact a worker’s safety and health. NIOSH has identified five defining elements of TWH:

  • Element 1: Demonstrate leadership commitment to worker safety and health at all levels of the organization.
  • Element 2: Design work to eliminate or reduce safety and health hazards and promote worker well-being.
  • Element 3: Promote and support worker engagement throughout program design and implementation.
  • Element 4: Ensure confidentiality and privacy of workers.
  • Element 5: Integrate relevant systems to advance worker well-being.

Companies that have implemented worker well-being initiatives using TWH principles report benefits such as improved employee productivity and retention, enhanced creativity, and innovation. Other benefits can include lower absenteeism, reduced healthcare costs, and increased employee satisfaction and engagement.

If you are new to TWH or are considering revamping an existing program, I encourage you to follow this sage advice from NIOSH: “Before plunging into the process of modifying existing practices, conduct a preliminary needs analysis. Is there a need to change the existing initiative? What is the organization’s readiness to change?”

Once you have identified your needs, you will need to adopt a comprehensive approach that integrates various strategies. Here are some practical starting steps that I have tried or seen succeed.

  • Promote a culture of safety and health. To develop a workplace culture that values both physical and mental well-being, promote open communication and actively involve employees in designing TWH initiatives.
  • Assess workplace hazards. We are well-acquainted with this process, but we can expand our outlook to be sure we are capturing chemical, biological and ergonomic risks. In particular, reducing repetitive tasks can prevent musculoskeletal disorders while various devices can reduce bending and lifting requirements.
  • Support work-life balance. Work-life balance is a critical factor in maintaining our overall health and well-being. Collaborate with your colleagues to identify where flexible work arrangements can succeed, and encourage workers to use resources such as an employee assistance program.
  • Support mental well-being. Foster a supportive environment where employees feel comfortable discussing mental health concerns without fear of judgment. Encourage them to access counseling services, offer mindfulness training, or share resources for managing stress and anxiety.
  • Create opportunities for social connection. This can include conducting team-building activities, hosting social events with other work groups and supporting networks within the workplace to foster a sense of belonging.

As we do with all initiatives, we should apply Deming’s plan-do-check-act model to regularly evaluate the effectiveness of our TWH initiatives to identify areas for improvement and additional employee engagement. I firmly believe that by applying these core concepts, we will help create safer, healthier and more productive workplaces. It is not a lofty ideal, it is a practical, proven approach that can benefit us all.


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