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Total Worker Health in Action: July 2012

Volume 1 Number 2 July 2012

Managers’ Buzz


Anita Schill

We recently learned that according to Gallup, the organization that collects information world-wide on what people think, 19% of employees in U.S. workplaces are “actively disengaged” from their jobs, 52% are “not engaged,” and only 29% are “engaged” ( For employers, this means that 71% of employees are either “miserable” or “apathetic”. For far too many employees, this means that time spent at work does not promote overall well-being. This is distressing news for employers, employees, and those of us concerned about Total Worker Health®.

As we reflect on these statistics, we can’t help but wonder whether workplaces with cultures that protect and promote health, safety, and well-being shift the balance between active disengagement and engagement. TWH® in Action! offers ideas for how such cultures can be created and resources to support your efforts. In this issue, you’ll find tips for employers and managers to help employees decrease stress related to conflicting work-family demands. We’re also delighted to present our second report on Promising Practices for Total Worker Health® featuring Erickson Living. Read about the Erickson program to learn how they busted barriers to employee participation and earned an ROI of $4.00 for every $1.00 spent on their program.

Casey Chosewood

Often people ask us about the scientific rationale for the integrated approach to health protection and promotion that we call Total Worker Health®. We are pleased to announce that our newly released Research Compendium, The NIOSH Total Worker Health® Program: Seminal Research Papers 2012, presents three seminal papers on this very topic. Read more in “New Initiatives and Resources.” The four NIOSH-funded Centers of Excellence to Promote a Healthier Workforce are also delivering research findings and products to support the Total Worker Health® approach. To catch up with their most recent activities check out the Center updates. Plus, there are a number of upcoming conferences where the most current research and program practices will be shared. Take a look at the section on “Conferences, Webinars, and Trainings in Support of NIOSH Total Worker Health®” to get the details.

As always we hope you enjoy this newsletter. We’d love to hear your comments and stories about TWH® in Action! Please e-mail us at and look for us on Twitter (#TotalWorkerHealth).

Employer Support for Work and Family Balance Reduces Safety Health Risks


During the summer months, work-family stressors are high for employees caring for school-aged children. With children out of school during the summer, childcare arrangements for families that work can be extremely difficult to juggle. On top of that, the economic crisis has severely limited many families’ ability to pay for adequate care.

Many employers are recognizing employees’ need for quality and flexible childcare and offering family-friendly benefits and programs for their employees. SAS Institute, located in Cary, North Carolina, sets the bar as the top ranked employer for balancing work and personal life by Fortune Magazine’s Best Companies to Work For in 2012. SAS has high-quality child care at $410 a month, 90% coverage of the health insurance premium, unlimited sick days, a medical center staffed by four physicians and 10 nurse practitioners (at no cost to employees), a free 66,000-square-foot fitness center and aquatic center, a lending library, and a summer camp for children.

Recent surveys have found that decreased work-family stress is related to reduced injury risk, and increased safety compliance and safety participation among workers. Further, evidence from the Work, Family, and Health Network suggests that work-family stress is related to worker health and well-being. However, research is just beginning to uncover the significant links to occupational safety and health and work-family stress despite the mounting evidence that work-family stress is related to higher absenteeism, lower performance, and higher job and family stress among workers and their families.

The Oregon Healthy Workforce Center, a NIOSH Center of Excellence, is currently examining several workplace initiatives that integrate health promotion and health protection and their effects on health and safety of corrections officers, construction workers, young workers, and home health workers, all including elements of work-life stress.

Five Tips for Employees to Help Their Teams Achieve Better Work-Family Balance:

1. Train managers and supervisors to be more supportive of work and family. Recent evidence shows that employee support from managers and supervisors for family and work balance leads workers to report better health, improved job satisfaction and lower intentions to leave the company (Hammer et al., 2011).
2. Give workers more control over their work hours. Increased control over when, where, and how work gets done is related to improved health behaviors (Moen et al., 2011).
3. Create a resource guide for employees and their families. For example, work with your Human Resources department to pull together a list of day camps for children of various ages.
4. Be a role model. Take some time off to be with your own family to show your employees you know this should be a priority for them as well, especially if stress is overwhelming them.
5. Encourage and support flexible schedules. Help employees to come up with creative solutions for childcare coverage during the summer, such as working a compressed work week or taking 1-2 days off per week over the summer instead of one large vacation allotment.

Hammer, L. B., Kossek E. E., Anger, W. K., Bodner, T. R. & Zimmerman, K. L. (2011). Clarifying work-family intervention processes: The roles of work-family conflict and family-supportive supervisor behaviors. Journal of Applied Psychology, 96, 134–150.

Moen, P., Kelly, E.L., Tranby, E. & Huang, Q. (2011). Changing work, changing health: Can real work-time flexibility promote health behaviors and well-being? Journal of Health and Social Behavior, 52, 404-429.

Promising Practices for Total Worker Health®

Our TWH® Core Team hit the streets in 2011 to collect real stories from employers who are applying principles of Total Worker Health® in their workplace. In Promising Practices for Total Worker Health® we share with you examples of how employers from across the country and from a wide range of industries are effectively addressing both health promotion and health protection in their workplaces.

If your organization is proactively integrating health protection and health promotion to prevent injury and illness and advance the well-being of your workers, please email us at Your workplace could be featured next!



Patient getting blood pressure checked by nurse

Erikson Living employee getting blood pressure checked at Employee Health and Wellness Center

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 wellness potential, they recently figured out how to provide this same opportunity to their dedicated employees.

Time, cost, education, and access — These are the barriers to receiving health care and participating in wellness activities identified by Erickson Living’s 12,000 employees. In 2008, Erickson Living started to use their Employee Health and Wellness Centers as a resource to remove their employee’s barriers to healthy living. Erikson’s Employee Health and Wellness Centers went beyond addressing standard employee occupational health needs – vaccinations, TB testing, reporting and medical care of injury and infectious exposure, etc. – and started providing convenient, low cost and coordinated services for their employees, such as:

  • Sick care – free or low-cost on-site health services guaranteed to last only 30 minutes;
  • “Health IQ” or “Health Information Quickly” — a 15-minute preventative health screening;
  • Well visits – general health and physical exams guaranteed to last only 45 minutes;
  • Wellness resources – smoking cessation programs including “lung age,” Weight Watchers and “Choose My Plate” classes, exercise facilities, etc.; and,
  • Referrals –a pathway to primary care and behavioral health, providing direct referrals to available primary care providers and their Employee Assistance Program (EAP).

Because they have such a wide range of services available, Erickson Living integrated their assessments of personal risk factors with occupational risk factors for their employees. For example, to reduce back injuries among housekeeping staff, they created a program that confidentially provided each staff member with their personal risk factors. Then, the department began a larger program based on the aggregate data that incorporated core strength training, group walking activities, and individual re-assessments in addition to ergonomic evaluations of specific job tasks.

Many might wonder about the financial investment required to provide such a comprehensive set of services to such a large staff. Certainly there are costs – space, staffing, and equipment. But this seemingly high investment has proven to have an equally high rate of return. The return on investment, including money saved on worker’s compensation costs, is over $4.00 for every $1.00 spent. And according to Dr. Craig Thorne, Vice President and Medical Director of Erickson Employee Health and Wellness, “This is still a conservative estimate. It does not include the value of continued regulatory compliance readiness, stay at work/return to work, increased productivity, employee satisfaction and retention, value of preventative services, cost avoidance due to disease management, etc.”

When asked how Erickson Living has created such a successful program, Dr. Thorne credits two very important factors, both of which have also been identified by NIOSH as Essential Elements Adobe PDF file for Total Worker Health®. The first is support and buy-in of upper management – critical to making long-term change. The second factor, perhaps even more important, is employee involvement. At every step along the way they have solicited the opinions and input of their employees, which contributes to staff enthusiasm and participation in their wellness activities. By figuring out the barriers and needs of their specific worker population, Erickson Living has been able to create a program that contributes to the health and safety of each individual staff member.

Updates from the NIOSH Centers of Excellence to Promote a Healthier Workforce

The Center for the Promotion of Health in the New England Workplace (CPH-NEW)

Under a subcontract with Viridian Health Management through CDC’s National Healthy Worksite Program, the University of Connecticut, CPH-NEW will provide expertise in health protection and safety, specifically training and general use tools for ergonomics, and consultation on worksite organization decisions that impact health protection and promotion. CPH-NEW will also assist with development and analysis of organizational climate and culture surveys and health assessment data to provide aggregate employer reporting and intervention recommendations for employers.

Harvard Center for Work, Health and Wellbeing

New Course! Work, Health, and Wellbeing: Strategic Solutions for Integrating Wellness and Occupational Safety and Health in the Workplace September 17–20, 2012 in Boston, MA. Designed for professionals with direct responsibility for worker health and safety including Consultants, Directors of Occupational Health and Safety, Employee Benefits Managers, Human Resource Directors, Occupational Physicians and Nurses and other professionals from Government, Insurance Companies and Wellness and Health Promotion vendors. Sponsored by Harvard School of Public Health Center for Work, Health, and Wellbeing in partnership with the Center for Continuing Professional Education at the Harvard School of Public Health. A detailed brochure, faculty listing, and registration information can be found online at Continuing Education Credit is offered.

University of Iowa Healthier Workforce Center for Excellence (HWCE)

Join the next Iowa WorkLife Forum! It will be held on Tuesday, September 28, 2012 from 8am – 9am CDT. The Iowa Worklife Forum aims to serve Iowa employers and employees by providing an online venue for engaging discussions about best practices and strategies used to address employee health and wellness. Each forum features speakers from industry or academia on wellness topics related to workplace health promotion and health protection. Open to all employers and interested parties across the state of Iowa at no cost. Contact Matthew Lozier with questions via email ( or by phone at (319) 467–4505.

Oregon Healthy Workforce Center (ORhwc)

New Course! 1st Annual Occupational Health Psychology (OHP) Summer Institute July 16 – 19, 2012 in Portland, Oregon. Featuring renowned regional, national and international occupational health and safety researchers and practitioners speaking on the latest researched-based findings in critical areas of work organization, stress, and safety climate improvement. Sponsored by Portland State University, the Occupational Health Psychology Program at Oregon Health & Science University, CROET Oregon Healthy Workforce Center, and CN Center for Occupational Health and Safety at Saint Mary’s University-Halifax.

News from our Partners

National Healthy Worksite logo

Faced with high health care costs, many employers are turning to workplace health programs to help employees adopt healthier lifestyles and lower their risk of developing costly chronic diseases while improving worker productivity. In October 2011, the Centers for Disease Control and Prevention (CDC) began the National Healthy Worksite Program (NHWP). The NHWP is designed to assist employers in implementing prevention and wellness strategies that will lead to specific, measureable health outcomes to reduce chronic disease rates.

Employers can create healthy work environments that protect employees’ health and make it easier for employers to make healthy choices. Maintaining a healthier workforce can lower direct costs such as insurance premiums and worker’s compensation claims, and positively impact many indirect costs such as absenteeism and worker productivity.

The NHWP will assist up to 100 small, mid-sized and large employers in establishing comprehensive workplace health programs. Each program participant will receive intensive support and expertise over a two year period, putting in place a combination of program, policy and environmental interventions to support physical activity, good nutrition and tobacco cessation. In addition, community participants will receive training and technical assistance as well as mentoring through peer relationships. On-going evaluation of the worksite health promotion programs will track changes in employee knowledge, behavior and productivity, as well as changes in employer health and safety culture. Evaluation efforts will also capture best practices for implementing core workplace health programs, and document unique challenges experienced by employers and strategies to overcome them. Through technical assistance, case studies, success stories and information forums, the information gathered throughout the program will be shared broadly with participating employers, as well as other employers and organizations nationwide interested in creating or expanding their own healthy worksite programs.

Participating employers will be selected from seven communities across the country. The selected counties are:

  • Somerset County, ME (Skowhegan)
  • Shelby County, TN (Memphis)
  • Marion County, IN (Indianapolis)
  • Harris County, TX (Houston)
  • Buchanan County, MO (St. Joseph)
  • Kern County, CA (Bakersfield)
  • Pierce County, WA (Tacoma)

The NIOSH TWH® program is providing consultation to this program and the NIOSH-supported University of Connecticut, CPH-NEW Center of Excellence is participating in this program through a subcontract with Viridian Health Management.

To learn more, visit online at

New Initiatives and Resources

On June 20, 2012, we hosted our second NIOSH National Expert Colloquium on Total Worker Health® in Washington, DC. The first Colloquium was convened in December 2011. We are grateful for the time and commitment all of these national experts made to share their program-related activities, their ideas to advance Total Worker Health®, and recommendations for NIOSH leadership. Additional information about the National Expert Colloquiums will soon be available on /niosh/TWH/.

The National Prevention Council Action Plan, released on June 13, highlights NIOSH Total Worker Health® as an HHS innovative effort for integrating prevention and safety in U.S. workplaces. Read more on page 7 and read the Plan in its entirety at:

New Publication! Research Compendium: The NIOSH Total Worker Health® Program: Seminal Research Papers 2012. The document is a compilation and update of three commissioned papers from a 2004 NIOSH-sponsored conference, Steps to a Healthier U.S. Workforce Symposium. Available electronically on at: /niosh/docs/2012-146/. Comment on the publication on the NIOSH Science Blog at:

New Web Release! United States Department of Veterans Affairs 2011 Employee Health Promotion Disease Prevention Guidebook. This resource includes policies, procedures, and guidelines established to create the Employee Health Promotion Disease Prevention program now web accessible via: Also check out VA’s National Center for Health Promotion and Disease Prevention (NCP)’s WIN with MOVE Employee! Resource Manual now posted on the MOVE! Website:

TWH® Fast Facts

Study confirms workers who believe they work in safe environment have 32% fewer injuries. Read the full article:

Smitt, T. & DeJoy, D. (2012) Occupational Injury in America: An analysis of risk factors using data from the General Social Survey (GSS). Journal of Safety Research, 43(1), 67–74.

Conferences, Webinars and Trainings in Support of NIOSH Total Worker Health®

NHWP Webinar: Is Your Workforce Chronically Gifted? Solutions, Strategies, and Success Stories for an Aging Workforce. Featured speakers: L. Casey Chosewood, MD, Susan Hughes, DSW, and T. Warner Hudson, MD. Hosted by the National Healthy Worksite Program. Thursday, July 19, 1:00pm – 2:00pm EDT. Register today at:

TWH® Speaking Engagement! L. Casey Chosewood, MD speaking on Protecting and Promoting Health and Safety at Work and at Home. August 21, 2012 in Orlando, FL at the Workers’ Compensation Institute 67th Annual Workers’ Compensation Educational and Annual Safety and Health Conference

TWH® Speaking Engagement! L. Casey Chosewood, MD speaking on The Future Workforce. September 14, 2012 in Bloomington, MN at the Central States Occupational and Environmental Association (CSOEMA) Fall 2012 Annual Meeting

New Training Program! Work, Health, and Wellbeing: Strategic Solutions for Integrating Wellness and Occupational Safety and Health in the Workplace. September 17 – 20, 2012 in Boston, MA. Sponsored by Harvard School of Public Health Center for Continuing Professional Education

2012 healthy federal workers - Sept 18-21 2012

Register today for Healthier Federal Workers 2012! Visit It’s back and more exciting than ever! Join over 300 of your colleagues from federal, state and private sectors at the 2nd Healthier Federal Workers Symposium September 18–21, 2012 at the Georgetown Hotel and Conference Center in Washington, DC. Sponsored by NIOSH, the Veterans Health Administration, the US Office of Personnel Management, the Centers for Disease Control and Prevention, Federal Occupational Health, the President’s Council on Fitness, Sports and Nutrition, the US Department of Health and Human Services, the Department of the Army and the Eagleson Institute. Register span6today to bring home best practices for a healthier and more productive workforce!

Call for Proposals! Work, Stress and Health 2013: Protecting and Promoting Total Worker Health® will be held at the Westin Bonaventure Hotel and Suites, Los Angeles, California, on May 16–19, 2013. Deadline for submissions is October 1. To learn more, visit

Please send your comments and suggestions to us at

This newsletter is published quarterly via email by the National Institute for Occupational Safety and Health Total Worker Health® Program to inform members of the public health community as well as interested members of the general public of program-related news, new publications, and updates on existing activities and initiatives.

Disclaimer: The mention of organizations and commercial entities and products in this enewsletter is for illustrative purposes only and does not represent an endorsement by NIOSH, CDC or the US Department of Health and Human Services