Preventing Injuries and Building a Culture of Health
Workplace Wellness
How to Address Both Occupational and Lifestyle Issues on the Job was the topic of a roundtable discussion convened by the Commission on Health and Safety and Workers’ Compensation (CHSWC) on July 16, 2008. The purpose of the workshop, which was facilitated by the University of California (UC), Berkeley’s Labor Occupational Health Program (LOHP), was to begin talking about how to combine workplace wellness programs with occupational health and safety in California.
The Relationship between Work, Life, and Health Health is one of the most important and complex issues faced by our country today, and the workplace has a central role to play. Not only is the workplace the source of health insurance for most Americans, but it also has significant influence on worker health, both in terms of (a) how job conditions protect or threaten workers’ health and safety, and (b) how the job promotes or interferes with personal wellness. Although the U.S. is the wealthiest country in the world, and we spend the most money on health care by far, we rank only 24th in overall health, according to the World Health Organization.1 The number of people suffering from chronic disease is increasing. In fact, 78% of all health spending in the U.S. is attributable to chronic illness, much of which is preventable. In addition, the workforce is aging. Employers who can afford group health programs spend more and more each year. Add to this the 5,214 workrelated fatalities and nearly 4 million occupational illnesses and injuries that occur each year.2 The result is $87.6 billion in annual employers’ workers’ compensation costs.3 We are all stakeholders in this matter. In California alone, there were more than 400 work-related fatalities in 2008.4 Each year, there also are about 540,000 to 600,000 non-fatal occupational injuries and illnesses.5 This results in approximately $15 billion in workers’ compensation costs annually for employers in the state.6 Average working American adults spend more than half their waking lives at work (8.7 hours/day).7 Work affects employees and their communities in profound ways, affecting health care options, emotional well-being, and family life.8 In order to fully address health, we have to address both what happens at work and outside of work.
Health care costs are on the rise and many employers are significantly affected. A study of 43 companies analyzed the costs to employers related to health and productivity management (HPM). The sum of median 1998 HPM costs across programs was $9,992 per eligible employee. This amount includes: Group health $4,666 (47%) Turnover $3,693 (37%) Unscheduled absence $810 (8%) Non-occupational disability $513 (5%) Workers’ compensation $310 (3%)11
One of the greatest challenges to creating effective wellness programs is convincing workers to actively participate in them. A common and important concern is that these programs do not address workplace hazards, but instead focus only on individual factors. Evidence suggests that wellness programs that emphasize correcting workplace hazards show greater participation rates than those that focus on individual behavior change alone.10 Therefore, wellness programs may have a greater chance of success if integration with occupational health and safety (OHS) efforts is a priority.
Evidence suggests wellness programs that emphasize correcting workplace hazards show greater participation rates than those that focus on individual behavior change alone.
We may have an excellent opportunity in the workplace to influence overall worker health by addressing not just workplace hazards, but also general health issues.
Examples of ways workplace health can be improved:
Health and safety committees/worker participation (including a wellness planning committee representative)
Injury and Illness Prevention Program (IIPP)
Training on hazards and identification of hazards
Reducing or eliminating hazards
Better regulation of health and safety
Effective rest and recovery time, workers’ compensation, return to work
Job rotation
Adequate breaks
Job analysis and workspace redesign
Examples of ways personal health can be improved:
Exercise
Good nutrition
Medical check-ups
Stress reduction
Mental health services
Tobacco use cessation
Good hygiene
Rest/sleep
Alcohol/drug abuse prevention and recovery
Counseling/support systems
Carpooling options
On-site child care
Wellness fairs/displays with resources
What are the benefits of integration for employers and workers? A healthier, more productive workforce Lower workers’ compensation insurance premiums Less worker turnover Higher employee morale Stronger support for families Less stress More energy Healthier, more positive place to work
Why should program integration be a priority for both labor and management? 15 Many workers are interested in health issues. Workers’ compensation medical expenses are rising again. Current health care costs keep increasing dramatically. Blue-collar workers are at increased risk for chronic health problems (i.e., higher rates of smoking, poor diets). Unions often have the structure for communication, research and organization, and they have the respect of members. In some cases, just having the union stamp of approval has been enough to improve participation. Unions can be a vehicle to reach remote or high-risk workers, such as home care and child care workers and blue-collar workers in construction.
http://www.dir.ca.gov/chswc/Reports/CHSWC_SummaryWorkplaceWellnessRoundtable.pdf. Accessed 1/12/2010.
Every $1 invested in workplace safety results in $3 or more in savings. Safety is an investment, not a cost. Every $1 invested in workplace safety results in $3 or more in savings. Safety is an investment, not a cost (from insurance industry study). Reducing workplace injuries and illnesses can reduce workers’ compensation costs, reduce lost work time and production delays, and eliminate costs of hiring and training others to replace injured workers. —McDonald, Caroline. “Workplace safety pays, survey shows.” National Underwriter; Sep 17, 2001; 105, 38; ABI/INFORM Global pg. 26.
Stretch & Flex Program
An analysis of workers’ compensation claims numbers and costs, data on the health risks from the annual voluntary health screening, and ergonomic evaluations of specific job tasks led to a pilot Stretch & Flex program. Developed by professionals from ergonomics, wellness, recreation and physical therapy, Stretch and Flex is completed on paid time at the start of the work shift. Ergonomics and Wellness Ergonomic and wellness principles are incorporated into the first training week with the goal of promoting safer techniques (e.g., neutral postures; muscular imbalance/body alignment; lifting mechanics; benefits of diaphragmatic breathing). Cultural preferences and sensitivities are addressed in all content and educational materials, and stretching exercises are customized to the work performed. The program opened doors for follow-up to explore equipment recommendations by ergonomic specialists and delivery of other wellness programs. The program evaluation was translated into several languages. —Trish Ratto, UC Berkeley University Health Services
Workers want to protect their privacy, and they worry about losing their jobs if they are found to be in poor health or considered a potential “liability” to the employer.
Evaluate your Program
When designing these programs, make sure to plan for ways to evaluate progress and problems. Evaluation is part of strategic, comprehensive planning. Clearly lay out realistic, measurable objectives and decide on what information you will use to determine success. Your own experience, feedback from participants, and data collection (e.g., participation rates, lost time, etc.) can help paint a picture of what is working and what needs improvement. One challenge to effective evaluation is that there is limited funding for research on wellness programs.27 This makes it more challenging for companies to find proven and effective models that fit their needs. It also makes it more difficult to demonstrate clear cost-benefit analyses or evidence of illness and injury reduction after implementation.
Be sure to set reasonable, measurable goals for both the short term and long-term. Periodically evaluate the outcomes and adjust if needed during the program.
Evaluate both the process and the outcome in order to improve the program in the future. • Share results with eligible population/workers who participated in programs.
Plan to evaluate Return on Investment (ROI) if possible. This can be done by looking for reductions in sick leave use, absenteeism, employer turnover, or health care claims.