Total Worker Health® Research Program

The NIOSH Office for Total Worker Health (TWH) works to advance the safety, health, and well-being of workers by increasing the number of work environments that adopt evidence-based TWH approaches. This is accomplished through both intramural and extramural research programs that effectively advance etiologic, surveillance, and intervention research. As a result, this builds the evidence base for an integrated, holistic approach to worker well-being.

The program has developed an overarching agenda for the nation to help coordinate and prioritize these efforts, the National Occupational Research Agenda/National Total Worker Health Agenda (2016-2026). However, research efforts also remain flexible in order to focus on emerging and fast-breaking threats facing todays’ workers, on the job and away from it. Examples include the TWH program’s leadership at NIOSH on projects like The Future of Work and Response to the Opioid Crisis.

Total Worker Health Agenda

Thumbnail image of the National Agenda to Advance TWH Research

The National Occupational Research Agenda (NORA)/National Total Worker Health® Agenda (2016–2026) is intended to define and prioritize occupational safety and health research, practice, and prevention activities related to Total Worker Health for 2016-2026. This document is built on an earlier draft version entitled, Proposed National Total Worker Health Agenda, released in September 2014 for stakeholder comment. The resulting input, documented/described in NIOSH’s Response to Summarized Stakeholder Commentspdf icon, shaped its continued direction and evolution of the TWH program at NIOSH as a whole.

Visit the National Total Worker Health® Agenda webpage for more information.

NIOSH Future of Work Initiative

Graph for NIOSH Future of Work Initiative

In May 2019, NIOSH launched the NIOSH Future of Work (FOW) Initiative in response to the rapidly changing nature of workplace and work issues experienced by today and tomorrow’s workforce. Forces such as technological innovations, digital transformation, and globalization have an impact on workers and organizations in the United States and around the world. These new realities are driving NIOSH-wide efforts to examine the FOW and broaden the approach to worker safety, health, and well-being.

As part of this collaborative initiative, the Institute is framing FOW based on the multidisciplinary TWH approach. Using the TWH framework, the initiative promotes worker well-being by encouraging collaboration across the spectrum of organizational policies, programs, and practices that influence the safety and health of workers, their families, communities, employers, and society as a whole.

Visit the Future of Work Initiative webpage for more information.

Opioid Crisis Response

Four part chart for opioid crisis

By using TWH principles, NIOSH is developing solutions to help workers and employers facing the opioid crisis in their communities. Visit the NIOSH Opioids in the Workplace webpage for workplace resources and to learn about ways NIOSH is addressing the opioids crisis.

To learn more about ways NIOSH-funded grantees and other partners are working to address the opioid crisis visit Opioids in the Workplace: NIOSH Extramural Research

Intramural Research

NIOSH sponsors intramural research through the NIOSH Program Portfolio. Intramural research on TWH is coordinated through the Research Program Development & Collaboration Team (Research

Program) in the NIOSH Office for TWH. Select examples include:

  • TWH for Small Businesses
  • Fatigue Prevention Training Program for Commercial Pilots in Alaska
  • Promising Practices for Healthy Aging in the Workplace

Visit the Intramural Research webpage for more information.

NIOSH Healthy Work Design and Well-Being (HWD) Program Connection to Total Worker Health Intramural Research 

The TWH program has had a widespread impact on other NIOSH programs through the recognition of well-being as a necessary component of the NIOSH intramural research program structure. The programmatic blend of elements of three separate and independent programs: TWH, Economic Research and Support Office, and Work Organization and Stress-related Disorders is evident in a newly developed program entitled, Healthy Work Design and Well-Being (HWD). HWD is one of seven NORA cross-sector programs in the third decade of NORA.

The mission of the program is to protect and advance worker safety, health, and well-being by improving the design of work, management practices, and the physical and psychosocial work environment. The holistic perspective of HWD focuses on how work affects overall health and well-being, including physical, psychological, social, and economic aspects.

Extramural Research

Centers of Excellence for Total Worker Health

Centers of Excellence for TWH location in the USA Map

NIOSH funds six Centers of Excellence, located throughout the U.S., to explore and research the concepts of TWH. The centers develop and evaluate interventions to improve safety, health, and well-being—TWH approaches—in high-risk industries that can reduce healthcare costs when adopted on a broad scale. The centers enable translation from research to practice, testing the process and feasibility of applying TWH approaches in real-world environments.

Listed below are some of the many ways that the centers are engaged in activities related to TWH:

  • Pilot testing of promising workplace policies and programs
  • Developing and distributing best practices and tool kits
  • Creating strategies to overcome barriers for adoption of work-based interventions to protect and promote health
  • Investigating costs and benefits associated with integrated programs
  • Promoting increased development and application of biological markers of stress, sleep, and depression to protect workers and improve worker health
  • Examining the relationships between workplace policies and practices and worker health outcomes

For more information on the Centers of Excellence, please see the Office of Extramural Programs web page.

Total Worker Health Affiliates

NIOSH TWH Affiliates location in the USA

The mission of the NIOSH Total Worker Health Affiliate Program is to foster an integrated approach to protecting and promoting worker well-being through collaborations with not-for-profit and government organizations, as well as academic and specialty member organization partners.

To learn more about current NIOSH TWH Affiliates and how your organization can become an Affiliate visit the TWH Affiliate Program webpage.

Tools and Resources