What is Total Worker Health™ ?

Total Worker Health™ is a strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to advance health and well-being.

Today, emerging evidence recognizes that both work-related factors and health factors beyond the workplace jointly contribute to many safety and health problems that confront today’s workers and their families. Traditionally, workplace safety and health programs have been compartmentalized. Health protection programs have focused squarely on safety, reducing worker exposures to risk factors arising in the work environment itself. And most workplace health promotion programs have focused exclusively on lifestyle factors off-the-job that place workers at risk. A growing body of science supports the effectiveness of combining these efforts through workplace interventions that integrate health protection and health promotion programs.

In June 2011, NIOSH launched the Total Worker Health™ (TWH™) Program as an evolution of the NIOSH Steps to a Healthier US. Workforce and the NIOSH WorkLife Initiatives, TWH™ is defined as a strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to advance worker health and well-being. The TWH™ Program supports the development and adoption of ground-breaking research and best practices of integrative approaches that address health risk from both the work environment (physical and organizational) and individual behavior. The original scientific rationale for expanding research on the benefits of integrated programs to improve worker health and workplace safety was published last year in a research compendium of three seminal papers on the science and practice of integrating health protection and health promotion, The NIOSH Total Worker Health™ Program: Seminal Research Papers 2012.

The “Issues Relevant to Total Worker Health™” graphic below is an at-a-glance visual of issues relevant to integrating occupational safety and health protection with health promotion. The lists below are not meant to be exhaustive, but, rather they illustrate the breadth of issues related to work that have the potential to impact health and should be considered as strategies are developed for integration of health protection and health promotion activities.

Issues Relevant to Total Worker Health™ *

Conservación de los recursos humanos
Nuevos patrones de empleo:
  • Empleo precario
  • Empleo de tiempo parcial
  • Doble empleadores
  • Cambios demográficos
    • Aumento de la diversidad
    • Envejecimiento de la fuerza laboral
    • Fuerza laboral multigeneracional
  • Fuerza laboral global
Salud y productividad:
  • Compromiso de las autoridades con una cultura de respaldo a la salud
  • Aptitud física para el trabajo
  • Reducción de presentismo
  • Reducción de ausentismo
  • Programas de bienestar en el trabajo
Atención médica y beneficios:
  • Aumento de costos
  • Transferencia de los costos a los trabajadores
  • Ausencia paga por enfermedad
  • Registros médicos electrónicos
  • Ley del Cuidado de Salud a Bajo Precio
  • Ley HIPAA† sobre la privacidad de la información médica
Promoción del bienestar y la salud del trabajador
Bienestar óptimo:
  • Participación del empleado
  • Evaluaciones de la salud y el bienestar
  • Comportamientos más saludables
    • Alimentación
    • Cesación del tabaquismo
    • Actividad física
    • Equilibrio entre el trabajo y la vida personal
  • Envejecimiento productivo
  • Preparación para una jubilación más saludable
  • Apoyo a las políticas y a los entornos urbanos
Trabajadores con riesgos de salud más altos:
  • Trabajadores jóvenes
  • Trabajadores de bajos ingresos
  • Trabajadores migrantes
  • Trabajadores nuevos en trabajos peligrosos
  • Trabajadores con capacidades diferentes
  • Veteranos
Remuneración y discapacidad:
  • Evaluación de la discapacidad
  • Modificaciones razonables
  • Regreso al trabajo
  • Seguro de discapacidad del seguro social
Protección de la salud y seguridad del trabajador
Control de peligros y exposiciones:
  • Sustancias químicas
  • Agentes físicos
  • Agentes biológicos
  • Factores psicosociales
  • Organización del trabajo
Prevención de lesiones, enfermedades y muertes
Promoción del trabajo seguro y saludable:
  • Compromiso de la gerencia
  • Cultura y clima de seguridad
  • Cultura de salud
  • Capacitación para la detección de peligros
  • Empoderamiento del trabajador
Evaluación y control de riesgos:
  • Defensa de la seguridad y la salud
  • Evaluación de todos los riesgos
  • Control de todos los riesgos
  • Análisis de las causas principales
  • Indicadores adelantados e indicadores retrasados
*Issues in these lists are for illustrative purposes and are not meant to be exhaustive

Interventions consistent with TWH™ include but are not limited to:

  • Provision of mandated respiratory protection programs that simultaneously and comprehensively address and provide supports for tobacco cessation.
  • Integrated ergonomic consultations that also discuss joint health and arthritis prevention and management strategies.
  • Regularly scheduled, joint meetings of safety, occupational health and health promotion leadership and staff to include combining the functions of safety, health, and/or sustainability committees into one entity, either intermittently or permanently.
  • Development of stress management efforts that first seek to diminish workplace stressors, and only then work on building worker resiliency.
  • Implementation of training and prevention programs that counter hazards and risks faced by workers both on and off the job. Topics could include falls prevention, motor vehicle safety, first aid, hearing conservation, stretching/ flexibility, back safety/ lifting safety, eye protection, safer work with chemicals, and weight management.
  • Provision of onsite, comprehensive workplace screenings for work and non-work related health risks.
  • Exploration of models that combine occupational health services with workplace primary care.
  • Full integration of: traditional safety programs, occupational health clinics, behavioral health, health promotion programs, coaching, EAP, nutrition, disability and workers compensation through strategic alignment, joint reporting structures or common funding streams.