Promising Practices for Total Worker Health highlights real examples of how employers across the country and from a wide range of industries are taking steps to effectively integrate workplace policies, programs, and practices that protect workers’ safety and health and advance their overall well-being. If your organization is proactively exploring opportunities to accomplish these goals by targeting the conditions of work, please email us at Your employer’s practices could be featured as a Promising Practice for Total Worker Health.

Promising Practices from Employers

Under the Hard Hat: Addressing Mental Health in the Construction Industry 

The construction industry experiences some of the highest rates of suicide. One in five adults experience a mental illness in their lifetime, and 57% of construction workers have experienced a mental health issue during their career in the industry. To address this concern, Willis Towers Watson partnered with Suicide Awareness Voices of Education (SAVE) to develop a state-of-the-art mental health education and suicide prevention training program. Read more.

Dartmouth-Hitchcock Health: Helping Employers Navigate New Challenges through the Project ECHO Model

Since 2017, Dartmouth-Hitchcock Health’s Department of Population Health has been working across the health system and with community partners to improve the health of patients, employees, and communities. The organization has consistently been heralded as a leader in health care and was one of the first Total Worker Health Affiliates. In early 2019, Dartmouth-Hitchcock Health (D-HH) Population Health established a Project ECHO hub as a learning infrastructure for clinicians and community organizations to share knowledge and improve clinical and non-clinical determinants of health. Read more.

A Strategic Community-Level Approach to Worker Health: Healthy Workplaces in Madison County, New York

Leaders in public health have recognized the impact of the workforce on a community. For instance, the Surgeon General recently highlighted the value of worker well-being to a community, and both the National Academies of Medicine and Robert Wood Johnson Foundation lead initiatives encouraging business engagement in community health. Recognizing the impact that healthy workforces can have on population health, the Department of Health in Madison County, New York, launched a Healthy Workplaces Initiative. Read more.

Healthy Parks, Healthy Communities, Healthy Nation: The National Park Service

From the lowest point in the United States to the highest point, from remote islands to the nation’s capital, the National Park Service (NPS) has over 400 park areas and regional and program offices, employing more than 22,000 permanent and seasonal workers. To reduce on-the-job injuries and fatalities and to ensure employee satisfaction, the NPS has released the Safety, Health, and Wellness Strategy, which follows the Total Worker Health® approach of embedding worker well-being into the organizational culture. Read More

Award-winning Culture and Support system for Police Well-being

The City of Bend (Oregon) Police Department recognized that law enforcement officers are exposed to many hazards and job stressors, such as night shift, physical work, dangerous work, and traumatic events. These lead to increased risk for mental illness and suicide, as well as heart disease and workplace injuries. With over 100 sworn officers serving a city of more than 90,000 people, the Department developed a comprehensive, multi-pronged initiative that has already started to produce positive outcomes. Read More

Creating Value at Dow Chemical Through Total Worker Health Initiatives

The Dow Chemical Company, a global manufacturer and supplier of raw materials with approximately 54,000 employees in 300 sites in 49 countries, has identified employee safety and health as a strategic priority for the company. As part of this priority, a comprehensive system based on Total Worker Health® (TWH) addresses the complex challenges of advancing the well-being of the company’s employees. According to Thomas John Bender, MD, PhD, Dow’s Occupational Physician and Epidemiologist, the company recognizes that employee health is essential to the company’s sustainability. In fact, the company includes TWH implementation in its 2025 Sustainability Goals and reports regularly on progress in its sustainability reports. Read More

From PPE to ping-pong: How an Oregon workers’ compensation company leads the way to safer, healthier work

When you think about dangerous jobs, you might think about commercial fishermen, loggers, and airline pilots. Insurance company employees or call center workers? Not so much. But just because workers sit at a desk all day, it doesn’t mean they’re not at risk of getting hurt. Read More

Working Toward Healthier Supervision at NIOSH

At NIOSH, protecting and promoting the safety, health, and well-being of diverse worker populations around the globe is a critical part of our work. But if we are really serious about this work, we strongly feel that we must apply the principles that we recommend to other organizations within our own Institute. Importantly, NIOSH workers get the opportunity to regularly provide feedback about their work environment and overall experiences through an annual survey given in all Federal workplaces. This showed that NIOSH employees wanted to see improvements in the way team leaders, managers, and supervisors fulfill their duties. A growing body of research shows that a worker’s direct-line supervisor has significant impact on an employee’s safety, morale, work experiences and performance, and even their overall health—both on and off the job.

In response, NIOSH’s internal TWH-focused program, Healthiest NIOSH, created a customized Healthier Supervision training for all workers in supervisory roles at NIOSH. Read More

A Safety Redesign Jump-Starts Health and Well-Being for L.L.Bean’s Aging Workforce

At L.L.Beanexternal icon, Maine’s quintessential outdoor clothing and equipment company, the workforce is growing older. Although advancing age improves problem-solving and teamwork skills, it also adds risk, especially for older workers with physically demanding tasks. Acknowledging this truth helped L.L.Bean look beyond its established safety and health infrastructure, says Deborah Roy, MPH, RN, COHN-S, CSP, Corporate Director for Health, Safety, and Wellness. The company began taking decisive steps to optimize work processes and prevent injury and illness for all their workers, not only their older ones. Read More

Small Businesses, Big Impact: The Nebraska Safety Council/WorkWell

The Nebraska Safety Council/WorkWell (NeSC) is a not-for-profit 501(c)(3) organization serving all of Nebraska with a mission to “provide leadership and resources to promote a safe and healthy environment in our workplace and community.” With around 35% of its membership represented by small enterprises, NeSC seeks creative ways to meet the needs of their members. Read More

Innovating an Integrated Path Forward at Alcoa

Alcoa, a global leader in lightweight metals technology, engineering, and manufacturing, is making strides in integrating health protection and health promotion. It is incorporating NIOSH’s Essential Elements (Essential Elements of Effective Workplace Programs and Policies for Improving Worker Health and Wellbeing) into several of its initiatives. Read more

The Future of Integrated Practice, Education: Western Kentucky University Curriculum

Recognizing the emerging need for a workforce that can understand the potential synergy between safety, injury prevention, and worker health and well-being efforts, Western Kentucky University (WKU) has begun offering educational programs that encourage students to integrate worker health and well-being into occupational safety and vice versa. Read More

Johnson & Johnson: Keeping Our Business Strong

Johnson & Johnson (J&J) already had a robust culture of safety in 1978 when the company developed a vision to also have the healthiest workforce in the world. Over 30 years later, J&J continues to protect and promote the health of its 128,000 workers in 60 countries. J&J leaders recognize that strong safety performance must be ongoing and requires constant nurturing and support. Similarly, worker health and well-being efforts require reenergizing the population and renewing the motivation of employees and families to participate. Through leadership commitment, integration of safety and health into their strategic framework, and extending workplace injury prevention to the home, J&J has achieved demonstrable impacts on the health and safety of its workforce. Read More

Building Momentum in Kentucky for Integration of Health Protection and Health Promotion

In Kentucky, a multipronged approach to integration is being used. Current efforts in the state range from business outreach to pilot intervention programs in the community, and from joint meetings of safety and health and well-being leaders to instilling principles of integration in future practitioners. The overall vision is to bring worksite safety and health together with injury prevention, connect with the community, and create a statewide plan. Read More

Health, Safety, and Well-Being: Corporate Strategy at Dartmouth-Hitchcock

In 2009, Dartmouth-Hitchcock, an academic medical center in New Hampshire with over 8,000 employees, needed to make a change. Covering over 16,000 in its health plans, health care costs were almost 10% of the medical center’s budget and rising faster than health care inflation rates each year. While collaborative, the employee health and safety departments were in different silos and recognized there were opportunities to create synergies with each other’s initiatives. Another challenge was that the medical center had different locations and clinic sites. The leadership of Dartmouth-Hitchcock decided that it could do better and would aim to have the healthiest workforce possible—a goal which the medical center adopted as the corporate vision to ensure sustainability and engagement at every level. As a result, the strategic priority, Live Well/Work Well (LWWW), was created with a mission to create a culture of health, safety, and well-being. Read more

Totally Engaged in Hearing Loss Prevention

Domtar and 3M were specifically recognized with a Safe-in-Sound Excellence Award® for the comprehensive integration of their hearing loss prevention program beyond the traditional occupational work environment into recreational and community activities enjoyed by their workers, their families, and their neighbors. These plants are leading examples of the effort toward “total worker hearing health” and each is investing in the hearing health of future employees. Both employers recognized the specific non-occupational noise exposures encountered by their workforce and took steps to provide training and hearing protection devices specific to the local sound hazards. read more

State Workers’ Compensation Program Taking a Lead on Workplace Wellness

In 2010, 25 to 29 percent of Ohio’s adult population was considered obese (body mass index equal to or greater than 30) and the largest percent of Ohio’s workforce was between the ages of 45 to 54. While these statistics are comparable to what is occurring nationwide, the Ohio Bureau of Workers’ Compensation (OBWC) is leading the way for Total Worker Health®. Helping employers improve the health and wellness of their workers, OBWC established a Workers’ Compensation Workplace Wellness Grant Program in 2012. The program’s goal is to limit and control the escalating cost of workers’ compensation claims by helping employers develop health and well-being programs for their employees. read more

Erickson Living Extends Care to Employees and Integrates Employee Health and Wellness

Erickson Living is a full spectrum retirement community with 16 campuses in 9 states. These communities offer everything from independent apartment living to complete nursing facility care – and provide special features such as wellness classes, exercise facilities, healthy dining options and access to a personal trainer for their residents. While Erickson Living community had long been known for helping residents reach their health and well-being potential, they recently figured out how to provide this same opportunity to their dedicated employees. Read more

BJC HealthCare, Help for Your Health

BJC HealthCare is a nonprofit health care organization that serves residents in the greater St. Louis, southern Illinois and mid-Missouri regions. Long known for providing excellent healthcare services to their patients, BJC’s leadership recognized a need to commit the same level of attention and care to their own workers’ health and well-being. In 2003, the company launched their “Help for Your Health” program to encourage employees to learn about and improve their health by reducing lifestyle-related risk factors. At the same time, their occupational health and safety team refocused their efforts and took a proactive stance to prioritize the prevention and control of work related injuries and illness. Read more

Healthier Feds

A growing body of scientific evidence indicates that the quality of one’s work environment is a predictor of health behaviors. In support of this notion, the federal government is providing opportunities for advanced health and well-being in its own workforce. The purpose of this section is to spotlight ways in which the federal community is improving the health and safety of federal employees.

NIOSH Walks the Walk!

On April 2, the HealthiestNIOSH Advisory Committee, part of the Total Worker Health Program for NIOSH employees, joined forces with the U.S. Public Health Service’s (USPHS) Junior Officer Advisory Group Working Group for the Office of the Surgeon General’s Every Body Walk! Initiative. NIOSH celebrated National Walking Day by encouraging all NIOSH staff members in all of its locations to participate in at least 30 minutes of walking or other physical activity throughout the work day. Read More

Improving the Health, Safety, and Productivity of Our Federal Employees: Federal Occupational Health

At a time when most federal agencies are being asked to “do more with less,” Federal Occupational Health (FOH) helps by providing services designed to improve the health, safety and productivity of federal employees. A part of the U.S. Department of Health and Human Services (HHS), FOH works in partnership with federal agencies and organizations across government to design and deliver solutions that meet their occupational health needs. Read more

How NASA is Living Total Worker Health

National Aeronautical Space Agency (NASA), an executive Federal Agency dedicated to Space flight, highly values exploration. The Agency’s exploration success depends on employees’ detailed attention to the safety and health of the astronauts and their fellow Earth-bound employees. For decades NASA’s occupational health programs have maximized the opportunities of national health initiatives as well as internal resources. And, they have led the way to improve internal programs for the maintenance of a workforce that operates at its highest level of physical and mental well-being. Read more

Promising and Best Practices in Total Worker Health: Workshop Summary
TWH logo

In 2014, NIOSH and the Institute of Medicine (IOM) convened a public workshop to identify prevalent and best practices in small, medium, and large workplaces. Participants included employers and employees in small, medium, and large workplaces; employer and employee associations; academia; government agencies; and other stakeholder groups. The workshop featured invited presentations and discussions on:

  • Best or promising practices associated with the design, implementation, and evaluation of an integrated approach to worker health, including factors associated with successful implementation;
  • Barriers to implementing programs and ideas for overcoming those barriers, and
  • Measures being used or considered for evaluating program effectiveness.

The workshop report is available for download. For the workshop agenda and link to the report, please visit: icon. You may access the presentations and audio recordings by visiting the meeting site: icon.

Program Descriptions

The following paper provides characteristics of integrated programs. These publications describe program design, frameworks, and implementation and serve as a useful resource for understanding components of effective Total Worker Health programs.

A Conceptual Framework for Integrating Workplace Health Promotion and Occupational Ergonomics Programs
Public Health Reports 2009;124(Suppl 1):16-25.