Centers of Excellence for Total Worker Health®

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Traditional occupational safety and health protection programs have primarily concentrated on making sure that work is safe and that workers are protected from harms arising from work itself. Today’s workers face not only traditional risks of chemical, physical, and biological hazards, but also increased risks related to the changing nature of work. Evolving employment patterns and shifting workplace environments can contribute to stress, mental health effects, chronic diseases, and other impacts on population health and well-being.

The coronavirus disease 2019 (COVID-19) pandemic has also changed the workplace environment. Workers face increased concerns surrounding economic insecurity and their own personal safety, including their mental health and well-being.  Some faced social isolation and shifts to remote work, while essential workers endured the risks and challenges of working and reintegrating back into a rapidly changing workplace. These and other new challenges among the workplace, families, and communities increase the wear and tear of ongoing, daily stress felt by workers. This increase may affect cognitive reserveexternal icon and resilience, and potentially lead to cognitive decline. Gender, age, and socioeconomic characteristics may affect workers’ sensitivity to these emerging conditions.

NIOSH’s Total Worker Health® Program builds on four decades of scientific knowledge by recognizing that work is a social determinant of health. For example, job-related factors such as wages, hours of work, workload, stress levels, workplace social interactions, and access to paid leave can all have an important impact on the well-being of workers, their families, and communities. Total Worker Health (TWH) is defined 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. This approach prioritizes a hazard-free work environment for all workers and comprehensively integrates workplace systems relevant to the control of hazards and exposures, organization of work, work-life fit, and compensation and benefits. The NIOSH TWH Program supports ground-breaking research and practical applications that address all the implications of today’s changing workplace.


The Centers of Excellence for Total Worker Health are funded by NIOSH via a cooperative agreementexternal icon to advance the overall safety, health, and well-being of the diverse population of workers in our nation. Centers accomplish this through a broad range of multidisciplinary research activities, including intervention-focused research, outreach and education, and evaluation. The Centers are hubs for TWH-related research and practice that build the scientific evidence base necessary to develop new solutions for complex occupational safety and health problems.

Center of Excellence TWH updated 12 2020

Center Descriptions

Fiscal Year (FY) Extramural Research Program Highlights

Program achievements featured in the Extramural Research and Training Program Annual Reports

Funding Opportunity Announcements

All cooperative agreement funding opportunity announcements

Page last reviewed: January 3, 2018