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Making the Business Case

Why Do I Need An Integrated Approach to Safety and Health?

An integrated approach to worker safety and health could have significant, long-term impact on your bottom line and the nation’s workforce. An emerging body of evidence now supports what many safety and health professionals, as well as workers themselves, have long suspected—that risk factors in the workplace can contribute to health problems previously considered unrelated to work. For example, there are work-related risk factors for sleep disorders1, cardiovascular disease2, depression3,4,5, obesity6,7 and other health conditions.

In recognition of these relationships, the TWH approach focuses on how the workplace environment can eliminate or lessen risks and enhance overall worker health, beyond traditional safety and health concerns. The TWH approach integrates workplace protections with activities that advance the overall well-being of workers. Establishing policies, programs, and practices in the workplace that focus on advancing the safety, health, and well-being of the workforce may be helpful for individuals, their families, communities, employers, and the economy as a whole.

An integrated approach can...

  • ... Improve effectiveness of worksite programs to improve worker health.
    In a study of tobacco use cessation for blue-collar hourly workers, the smoking quit rates of workers in integrated interventions were more than double that of workers who had participated only in worksite health promotion programs.8

    ... Increase participation in worksite programs to improve worker health.
    Workers who reported that their employers had taken action to reduce workplace risks are more likely to participate in a worksite health promotion program.9

    ... Enhance a culture of trust.
    Reductions in job risks may increase credibility of workplaces and help workers feel that their employers are contributing toward a safe and healthy workplace.10

    ... Address synergistic risks.
    An integrated approach is important to jointly address work-related hazards and other risks.10

    ... Reduce sickness absence and improve worker well-being.
    One study in a manufacturing plant found that integrated interventions created greater reductions in sickness absence and key health risks, including ergonomic and cardiovascular risks and job stressors. 11

How Can It Help My Business or Workplace?

Safe and healthy employees are less likely to be injured while on the job and are more likely to be more vibrant and engaged.

Employees with Better Well-Being…

  • ... Create a happier, less stressful, and better work environment.
    According to a survey by Aon Hewitt, the National Business Group on Health, and the Futures Company, employees who reported having a strong culture of health at work were more likely to report being happy, less likely to report that stress has a negative impact on their work, and less likely to cite the work environment as an obstacle to health.13

    ... Enjoy their jobs more, stay in their jobs longer.
    Employees who feel supported by their employers are more likely to want to keep their jobs and will help attract and retain the best employees. A study by the World Economic Forum found that 64% of employees who reported that their workplaces were active promoters of health intended to stay with their companies at least five years.14

    ... Are good for business.
    Companies that have exemplary safety, health, and environmental programs outperformed the S&P 500 by between 3% and 5%.15

    ... Are more engaged.
    Employers that have high employee engagement performed better than employers with low employee engagement in profitability, customer ratings, turnover, safety incidents, productivity, and quality.16 Engagement includes feeling like someone at work cares about the employee as a person and having the materials needed to do work right.

Future Steps

Perhaps the most valuable action employers can take is to give workers more flexibility and control over their working conditions and schedules whenever it is possible. For many workers, greater flexibility is more important than having more vacation days. Great companies also provide onsite opportunities for healthier food, physical activity, stress management, health education, and health screenings. Designing policies that promote safe and healthy work spaces, fostering low-stress working conditions, and creating built environments that promote safety and health should all be top priorities if organizations want safer, healthier, happier workers.


  1. Caruso, C. 2013. Negative Impacts of Shiftwork and Long Work Hours. Rehabilitation Nursing 39(1): 16-25
  2. Luckhaupt, S, Calvert G. 2014. Prevalence of Coronary Heart Disease or Stroke Among Workers Aged <55 Years—United States, 2008-2012. MMWR 63(30);645-649.
  3. Rayens, M, Reed, D. 2013. Predictors of Depressive Symptoms in Older Rural Couples: The Impact of Work, Stress and Health. Journal of Rural Health 30(1);59-68.
  4. Wulsin L, Alterman T, Bushnell T, et al. 2014. Prevalence rates for depression by industry: a claims database analysis. Social Psychiatry and Psychiatric Epidemiology 49(11);1805-1821.
  5. Arcury T, Gryzwacz J, Chen H, et al. 2013. Work Organization and Health Among Immigrant Women: Manual Workers in North Carolina. American Journal of Public Health 104(12):2455-2452.
  6. Luckhaupt S, Cohen M, Li J, et al. 2014. Prevalence of Obesity Among U.S. Workers and Associations with Occupational Factors. Am J Preventive Medicine 46(3):237-248.
  7. Nobrega S, Champagne N, Abreu M, et al. 2015. Obesity/Overweight and the Role of Working conditions: A Qualitative, Participatory Investigation. Health Promot Pract 2015 Sept 2.
  1. Sorensen G, Stoddard AM, LaMontagne AD, et. al. 2002. A comprehensive worksite cancer prevention intervention: behavior change results from a randomized controlled trial (United States). Cancer Causes and Control 13: 493–502.
  2. Sorensen G, Stoddard AM, Ockene JK, et. al. 1996. Worker participation in an integrated health promotion/health protection program: Results from the WellWorks project. Health Educ Quart 23(2):191-203.
  3. NIOSH. 2012. Research Compendium: The NIOSH Total Worker Health® Program: Seminal Research Papers. Washington, DC: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2012-146, 2012.
  4. Maes S, Verhoeven C, Kittel F, Scholten H. 1998. Effects of a Dutch Work-Site Wellness-Health Program: The Brabantia Project. American Journal of Public Health 88(7):1037-1041.
  5. Porter, Michael E., and Mark R. Kramer. 2011. Creating Shared Value. Harvard Business Review 89(1-2).
  6. Aon Hewitt, the National Business Group on Health, and the Futures Company. 2014. The Consumer Health Mindset.
  7. World Economic Forum. 2010. The Wellness Imperative: Creating More Effective Organizations. Geneva: World Economic Forum.
  8. Fabius R, Thayer R, Dixon BA, et al. 2013. The Link Between Workforce Health and Safety and the Health of the Bottom Line: Tracking Market Performance of Companies That Nurture a “Culture of Health.” JOEM 55(9):993-1000.
  9. Gallup. 2013. The Relationship between Engagement at Work and Organizational Outcomes.
  • Page last reviewed: November 6, 2015
  • Page last updated: December 21, 2015
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    TOTAL WORKER HEALTH ® is a registered trademark of the US Department of Health and Human Services