NIOSH Centers of Excellence for Total Worker Health®

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The health risks and challenges facing today’s workers and employers are significantly different than when the Occupational Safety and Health Act of 1970 was signed into law. Today’s workers face not only the traditional risks of chemical, physical, and biological hazards but also increased risks related to the changing nature of work, shifting workforce demographics and diversity, evolving employment patterns, and the changing workplace environment.

Building on four decades of scientific knowledge to prevent worker injury and illness and as an active part of the National Occupational Research Agenda (NORA) priority areas, NIOSH’s Total Worker Health®  Program supports ground-breaking research that addresses the implications of today’s changing workplace and responds to demands for information and practical solutions to the health, safety, and well-being challenges that workers face. 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, compensation and benefits, work-life integration/management, and organizational change management.


The purpose is to support Centers of Excellence for Total Worker Health® to advance the overall safety, health, and well-being of the diverse population of workers in our nation. Centers accomplish this through multidisciplinary research, intervention, outreach and education, and evaluation activities.

USA Map of TWH Centers of excellence

Center Descriptions

The Center for Promotion of Health in the New England Workplace (CPH-NEWexternal icon) employs an integrative and comprehensive research approach to reduce workforce hazards and promote worker health, through studying the links between workplace culture and personal high-risk behaviors and examining the effectiveness of designed workplace interventions. CPH-NEW proposes a multi-dimensional productivity/business case approach for engaging employers and workers in the development of healthier workplaces.

The Center for the Promotion of Health in the New England Workplace (CPH-NEW) seeks to evaluate multiple models for integrating worksite health promotion (WHP) with occupational health and safety (OHS) interventions, and on enhancing musculoskeletal, cardiovascular, and mental health. There is a strong emphasis on worker involvement in setting program goals and designing interventions, with an appreciation of both management and labor perspectives.

CPH-NEW has two research projects and one “Education, Translation, Communication and Dissemination” project. A key shared theme is intervening at multiple levels of an organization to improve worker health through an integrated systems approach. The research projects share common investigators and a core of common epidemiologic survey instruments. A “mixed methods”  approach  incorporates  qualitative  analyses  in  participatory  action  research  to generate  hypotheses  and  enhance  interpretation  of  quantitative  data.  A separate interdisciplinary structure, the Cross-Project Methods Teams, enhances internal communication, coordination of research methods, mutual learning from experiences in the field, two-way communication of researchers with employers and practitioners, and evaluation at both the center and project levels.

The Centerexternal icon conducts research to protect and promote the health of workers through effective workplace polices, programs and practices.  This research is currently focused on healthcare, construction and manufacturing.  The Center also facilitates translation of research findings to practice to ensure broad-based application. 

The mission of the Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-being is to improve the health of workers through designing, testing, implementing and disseminating effective and integrated worksite policies, programs and practices that foster a healthy work environment, reduce potential hazardous job exposures and promote safe and healthy behaviors.  NIOSH has funded the Center as part of its Total Worker HealthTM initiative.  The Center currently have three main research projects.  BeWell, Work Well integrates health promotion and health protection strategies to improve the health and safety of health care workers.  All the Right Moves is developing and testing a musculoskeletal disorders and health promotion intervention for commercial construction workers.  In collaboration with a health promotion vendor, SafeWell is exploring the adoption of integrated health promotion and protection strategies by small to medium-sized businesses using The SafeWell Practice Guidelines: An Integrated Approach to Worker Health.

The University of Iowa Healthier Workforce Centerexternal icon (HWC),  is composed of a well-qualified and productive team of investigators dedicated to further developing the science-base for integrated health protection/health promotion programs through peer reviewed publication of its research, real-time translation of evidence-based employee health and safety educational and training tutorials nationally/globally, and outreach to inform state and national stakeholders through Center educational programs and policy papers and advocacy.

The HWC, works to implement, evaluate and compare health protection models and programs, policies and practices to promote health, with the goal of identifying Total Worker Health™ best and promising practices. Through research and outreach activities, the HWC serves as a state and national resource for employee health programs, services, and policies. The Center has a well-qualified leadership team and Internal Advisory Committee, highly qualified investigators, and is advised by its diverse External Advisory Committee. The HWC has demonstrated productive research and electronic translation of its research to practice through implementation and expansion of its outreach efforts and through the efforts of the Small Business Outreach Education and Translation Project. The Small Business Outreach project has developed online resources, including short videos, specifically targeting small- and medium-sized businesses to promote and support employee participation in workplace programs and policies. In addition, a trans-disciplinary research project is currently being conducted in a window manufacturing facility evaluating an integrated safety and health intervention that uses participatory ergonomics in coordination with health coaching to reduce ergonomic stressors, musculoskeletal disease outcomes and their related costs. The Center’s pilot grant program provides guidance and financial resources to engage students, new investigators and community partners in Total Worker Health™ research and initiatives. Through the Healthier Workforce Bulletin, website and social media, the Center shares outcomes and other evidence-based resources and TWH™ best practices to employers, particularly small- and medium-sized employers.

Oregon Healthy Workforce Center (OHWC)external icon is a NIOSH Center of Excellence in Total Worker Health®. Housed within Oregon Health & Science University’s (OHSU) Oregon Institute of Occupational Health Sciences, we are partnered with researchers at OHSU-PSU School of Public Health, Portland State University (Occupational Health Psychology), University of Oregon (Labor Education Research Center), University of Washington (Department of Environmental and Occupational Health Sciences), and Johns Hopkins University (School of Nursing).

At OHWC, we develop and evaluate Total Worker Health (TWH) intervention programs for occupational safety, health, and employee well-being. Specifically, these programs incorporate NIOSH’s TWH approach to jointly address workplace safety and health hazards with employee health and lifestyle as a means to reduce work-related injuries and improve overall worker well-being. Some hallmark targets pertinent to TWH are workplace environment, supervisor support, healthy lifestyles, and job stress.

Located in the Pacific Northwest, OHWC serves as a resource for the western states and complements the other five TWH Centers in New England (two Centers), Iowa, Illinois, and Colorado. We remain the only Center focused on intervention effectiveness, successfully conducting randomized trials of innovative interventions and adding value with a cross-study data repository collected using a set of common measures across projects. Our interventions include a combination of organizational and individual change strategies to bring about knowledge increase, positive behavior change, and improved supervisory practices. These will result in positive outcomes such as hazard reductions, safer work practices, improved lifestyle choices, and better psychological and physical health.

The University of Illinois at Chicago Center for Healthy Workexternal icon seeks to advance the health and well-being of people employed in precarious jobs. Our mission is to “turn unhealthy work into healthy work” by building capacity for action through participatory and collaborative engagement with neighborhoods, communities and organizations at local, state, and national levels. Our collective actions and initiatives are focused on supporting jobs that pay a livable wage, are free from workplace hazards, encourage active participation, offer opportunities for advancement, are free from discrimination, and include benefits such as healthcare, paid sick leave, paid vacation, and retirement savings. The Greater Lawndale Healthy Work project is exploring community-level approaches to understand the nature of work and working conditions in two high-hardship Chicago neighborhoods. These will lead to interventions to expand access to healthy jobs in two different contexts: one community with notably high levels of unemployment resulting from racism and prior incarceration; and one with barriers to employment based on discrimination, language, and documentation status. These contexts result in employment that can be exploitive and precarious in both communities. The Healthy Communities through Healthy Work project involves an assessment of current policies and organizational practices that promote healthy work, to identify organizational perceptions of precarious work across sectors – labor unions and worker centers, educational and healthcare institutions, and advocacy and policy-focused organizations. The project will partner with organizations on current or new initiatives that improve opportunities for healthy work. An Evaluation Team will identify and measure activities and outcomes. The Communications Oversight Team will ensure dissemination of findings and methods through webinars, in-person events, newsletters, toolkits, policy briefs, etc. Our website features a comprehensive set of resources focused on precarious work, a glossary of terms related to precarious and contingent work, and information about upcoming events.

The Center for Health, Work & Environment external iconat the Colorado School of Public Health is one of six Centers of Excellence for Total Worker Health®. Our team includes faculty and staff from the University of Colorado, Colorado State University, and Clemson University. Our mission is to advance worker health, safety, and well-being, using the precepts of Total Worker Health (TWH). ​We educate future leaders, conduct research, and design and implement practical solutions to occupational safety and health challenges with our partners.

We apply a TWH approach in all that we do, by prioritizing safety, first, while striving to promote overall worker health. We engage enterprises of all types and sizes, with a focus on small- and medium-sized organizations and high-risk sectors. By collaborating with organizations across Colorado, Region VIII, and the country, we are able to reach a wide-range of professional, academic, and business audiences to advance worker health, safety, well-being, and productivity. The center works closely with two other NIOSH-supported centers in Colorado: The Mountain and Plains Education and Research Center (MAP ERC) and the High Plains Intermountain Center for Agricultural Health and Safety (HICAHS).

Some of our current TWH projects include Health Links™external icon , the Small + Safe + Well (SSWell) Studyexternal icon , and the Certificate in Total Worker Health® . Through Health Links, we collaborate with employers to build a culture of health and safety in the workplace. The program offers enterprises an evidence-based assessment, one-on-one advising, Healthy Workplace Certification, and a network of like-minded employers and local resources. The SSWell Study examines how small businesses support the health, safety, and well-being of their workforce and how changes to organizational culture impact employee health and safety outcomes. Our Certificate in Total Worker Health is offered through the Colorado School of Public Health. This 15-credit hour academic program is designed to help business professionals, public health practitioners, and students gain the knowledge and skills they need to lead practice-based research and practical interventions, effecting positive change within organizations and communities. Through our Pilot Projects Programexternal icon, we also offer support for research to practice community and academic projects that address regional priorities. This serves as a stimulus for attracting junior investigators and advancing their careers in the field.

Fiscal Year (FY) Extramural Research Program Highlights

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

All cooperative agreement funding opportunity announcements can be found at:

Page last reviewed: January 3, 2018