Total Worker Health in Action: November 2023

Volume 12, Number 4, November 2023

Director’s Buzz


Employers are uniquely able to impact the lives of their workers, both in and outside of the workplace. Today, the lines between work and life outside work are not as easily drawn. For many workers, this creates new challenges and conflicts. Our newsletter looks at these conflicts, their impact on well-being, and how Total Worker Health (TWH) approaches can help.

Our Promising Practice describes workplace policies employers and organizations can use to prevent work-life conflict. Our TWH Exclusive features exciting new research from the National Safety Council. In the exclusive, we examine TWH as one of the concepts shaping safety in the modern workplace. We also highlight a new Vital Signs article written by NIOSH authors. This article describes alarming new data on the mental health crisis we are seeing in the nation’s health workers. A new NIOSH campaign will provide critical strategies for intervention.

With our partners, we continue to research workplace solutions and share resources to help create positive change. We hope you find these features helpful in your work! We encourage you to connect with us by following @NIOSH_TWH, visiting our website, or emailing us at NIOSH Total Worker Health (CDC)

Total Worker Health Exclusive

The New Value of Safety and Health in a Changing World

To continue keeping people safe in today’s modern workplace, the National Safety Council  partnered on a study to redefine safety in 2023. With funding from Lloyd’s Register Foundation, and assistance from a panel of experts, NSC initiated this project in 2021. The two-year effort resulted in the report The New Value of Safety and Health in a Changing World.

In the report, NSC identifies organizational concepts shaping modern safety programs that include TWH. By definition, TWH is a holistic approach, so it fits perfectly as one of NSC’s three named organizational concepts. These concepts generate broad value and provide a comprehensive approach to safety management.

The organizational concepts are further broken down by theme profiles. Those listed under TWH, for example, include these themes: preventing serious injuries, illnesses, and fatalities; prioritizing mental health; and focusing on psychological safety. They can be understood through their theme profiles. Those involved in business, safety, and policy can use the themes to guide decision-making for best practices, investment decisions, and performance tracking.

The report presents actionable insights and values. It intends to spark conversations, plans, and policy changes. Ultimately, it aims to lead to new safety strategies that improve workplace culture and worker well-being. Find key highlights and recommendations from NSC in the executive summary.

To learn more about the research view the webinar recording or visit the NSC website. If you’re ready to use TWH approaches in your workplace, visit the TWH website to get started.


L. Casey Chosewood, MD, MPH, Executive Editor

Emily Kirby, Managing Editor

Sarah Mitchell, Associate Editor

Jackie Varela, Contributing Editor

Cheryl Hamilton, Copy Editor

Steven Marra, NIOSH Web Developer

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Promising Practice

Family-Friendly Workplace Practices: Early Matters Greater Austin Toolkit

Editor’s Note: This Promising Practices article is part of a series dedicated to work and family well-being. To learn more about this topic or explore solutions to work-life conflict, consider watching webinars from our TWH Webinar Series: Navigating Work-Life Boundaries or Promoting a Sustainable Work-Nonwork Interface.

A family sits at a table while a child works on a written project

Photo by ©Getty Images

Early Matters Greater Austin (EMGA) is a historic coalition of business leaders in the Austin, Texas, metropolitan area. They focus on strengthening early childhood education to support the future workforce and economy. The EMGA Family-Friendly Workplace Toolkit outlines family-friendly workplace options employers can incorporate into policies, programs, and practices. These options can help support the safety and health of workers and their families by preventing or reducing work-life, or work-family, conflict. Promising practices and their benefits described below serve as a “menu” of family-friendly workplace options:

  • Health Benefits: Comprehensive health benefits support workers’ and their families’ physical and financial health, reduces absenteeism, and increases productivity and retention. The toolkit provides details for health insurance, dental and vision, cafeteria plans (or Flexible Spending Accounts), short-term disability insurance, and employee assistance programs.
  • Living Wage: Workers paid a living wage support families’ financial security, improve health outcomes, and reduce turnover. A living wage is defined as pay that covers basic needs like food, housing, healthcare, childcare, education, and transportation.
  • Paid Leave: Paid leave contributes to workers’ and their families’ physical and financial health by making it easier for workers to manage work-life responsibilities. For instance, it allows workers time to attend children’s appointments and functions without the worry of losing income. Examples include paid time off such as sick leave, vacation leave, and other personal leave.
  • Supporting Workers with Caregiving Responsibilities: A significant number of workers care for children, while others have the dual responsibility of caring for both children and adults. Elder care and childcare assistance practices can include on-site facilities, backup or emergency care options, vouchers, and targeted benefit plans. These practices help caregivers meet their responsibilities while maintaining effectiveness at work.
  • Flexibility in Location and Hours: Flexibility around when and where you work, along with supportive managers, promotes work-life harmony. Stable and predictable schedules enable workers to effectively plan for childcare and other life responsibilities.
  • Supportive Services: Family-friendly supportive services described in the toolkit include support for breastfeeding mothers, like a lockable private room with a comfortable chair, sink, and refrigerator. Additionally, expectant and new parents can benefit from dedicated parking spaces and infant-at-work programs.
  • Career Development Opportunities: Organizations can offer return-to-work and reentry support. Other offerings could include education programs and certifications (like tuition reimbursement programs), workplace classes (like English at Work), and transportation benefits to enhance family economic security. Workplace supported recovery programs for people with substance use disorders can also enhance return-to- and stay-at-work efforts.
  • Community Involvement Strategies: Corporate social responsibility involves investing in the community through options like paid volunteer days, workplace giving, philanthropic activities, and donations to organizations that support families’ needs. These efforts may increase social connections among workers and provide a more meaningful work experience.

The toolkit was adapted from the Colorado Family-Friendly Workplace Toolkit and aligns with TWH fundamentals. Discover steps to make family-friendly changes in your workplace on the Early Matters Greater Austin website. Find more tools for planning, evaluation, and assessment on the NIOSH website.

News from NIOSH

CDC Vital Signs Released on Health Workers’ Mental Health Crisis
CDC recently released Vital Signs: Health Worker-Perceived Working Conditions and Symptoms of Poor Mental Health—Quality of Worklife Survey, United States, 2018–2022, written by NIOSH authors. This article provides new data showing health workers reported higher levels of poor mental health days, burnout, turnover, and harassment at work in 2022 compared with 2018. Read the article to learn more about the data and strategies to address this crisis.

Image of a Help Wanted sign

Photo by ©Getty Images

Help Wanted: Union Members and Labor Representatives
Are you a union member or a labor representative who would like to actively participate with the NIOSH TWH program? The TWH Program would like to expand and enhance its partnerships with organized labor to incorporate TWH approaches for advancing worker well-being into activities supported by labor organizations. If you’d like to participate or nominate a union member or representative to participate, contact us at

Recorded Webinars: Continuing Education
Two newly released webinars hosted by the NIOSH TWH Program are now available for on-demand viewing and continuing education credits. In September, we hosted the webinar “Using Participatory Strategies in Healthcare to Improve Support Staff and Security Worker Well-being.” In October, we hosted “SMART Work Design for Healthy and Productive Work.” Access the recordings and learn how to obtain free continuing education on the TWH webinar page.

Reminder: Resources to Support Workers During the Holiday Season
Retail workers are likely to experience more shift work and longer work hours as the holiday season begins. This NIOSH publication and NIOSH Science Blog provide e workplace solutions to address fatigue among retail workers during this time of year. Get into the holiday spirit using these TWH approaches in Santa’s Workshop, as reported in this NIOSH Science Blog.

News From the NIOSH Centers of Excellence for TWH

These are just a few of the updates from the NIOSH Centers of Excellence for TWH. To learn more about each of the Centers, visit their websites.

News From NIOSH TWH Affiliates and Partners

Welcoming New Affiliate, Yolo County Public Health
Yolo County Public Health serves a county of about 220,000 residents. Located between Sacramento and the Bay Area, Yolo County is home to the University of California at Davis. Besides local government and the university, agriculture remains central to the economy of Yolo County. Yolo County Public Health promotes well-being, works to prevent disease and injury, and protects residents and the environment.

Featured Affiliates: Get to Know the NIOSH TWH Affiliates

This feature was created to introduce our readers to current NIOSH TWH Affiliates. See how the NIOSH TWH Affiliates responded when we asked about their work.

Conferences, Webinars, and Training


12 – The UIC Center for Healthy Work will host a 2023–2024 Labor Film Series in partnership with Chicago Jobs with Justice. The film, “Nae Pasaran,” begins at 6 p.m. (CT). For more information about this event and future film screenings, email

12-15 – Join the American Public Health Association’s Annual Meeting to hear about the latest research from the Centers of Excellence.

16 – Register for the Health Links webinar, Health@Work: Supporting Workers with Chronic Conditions, at 1 p.m. (ET). Learn more about how to support workers with chronic conditions at your workplace.

29 – Researchers from the OHWC will present on “TWH Awareness for Safety Committees.” The session is part of the in Portland.


4 – Harvard Center Co-Director Dr. Erika Sabbath will present Work-related Health and Wellbeing of U.S. Obstetrician-gynecologists: Impacts of Post-Dobbs State Abortion Bans at 1 p.m. (ET). Stay tuned to the seminar calendar for more information.

4–5 – Dr. Chosewood will present at the Recovery Ready Workplace New York Symposium.


10 – The Nebraska Safety Council will host Reversing Pre-Diabetes in the Workplace as part of the monthly WorkWell Networking and Training Series.

Looking for more? You can find more events on the NIOSH Conferences, Meetings, Webinars, and Events webpage and the Society for TWH Events page.

Total Worker Health® is a registered trademark of the U.S. Department of Health and Human Services (HHS). Mention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. In addition, citations to websites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these websites. All web addresses referenced in this document were accessible as of the publication date.