The Perils of Integrating Wellness and Safety and Health and the Possibility of a Worker-Oriented Alternative

Abstract

Integration of workplace wellness with safety and health has gained momentum on the initiative of the state allied with a segment of large employers and some health and safety professionals. Integration has a dual potential: to fundamentally reshape occupational health in ways that profoundly benefit workers, or to serve neoliberal corporate goals. A focus on the workplace and the ways work and health interact broaden the definition of a work-related injury or illness and emphasize and challenge the employer decisions that create hazards and determine risk. However, the implementation of integration is taking place in a context of corporate dominance and the aggressive pursuit of a neoliberal agenda. Consequently, in practice, integration efforts have emphasized individual worker responsibility for health and fail to actually integrate wellness with safety and health in a meaningful way. Can an alternative be envisioned and pursued that realizes the promise of integration for workers?

Integrating worksite health protection and health promotion: A conceptual model for intervention and research

“…Although prior research has examined ways in which the conditions of work influence chronic disease and its behavioral antecedents (Johansson et al, 1991; Marchand, 2008) and risks associated with hazards on the job (Huang et al, 2003; Landsbergis et al, 2014), additional research is needed to examine the synergies and interactions in these relationships, as well as their associations with improved enterprise outcomes. In addition, few studies in this nascent field have successfully modified organizational factors; there is a significant need for systematic research directed at changes in the work organization (Lax, 2016). Responding to recommendations from a recent NIH-NIOSH workshop (Bradley et al, 2016), this model can also guide further development of measures to assess the effects of an integrated approach, inform the design and testing of future integrated approaches to worker health, and offer a framework for increased attention to organizational change, central to the TWH approach yet underrepresented within research findings reported to date (Lax, 2016; McLellan, 2016).…”

“…In addition, few studies in this nascent field have successfully modified organizational factors; there is a significant need for systematic research directed at changes in the work organization (Lax, 2016). Responding to recommendations from a recent NIH-NIOSH workshop (Bradley et al, 2016), this model can also guide further development of measures to assess the effects of an integrated approach, inform the design and testing of future integrated approaches to worker health, and offer a framework for increased attention to organizational change, central to the TWH approach yet underrepresented within research findings reported to date (Lax, 2016; McLellan, 2016). Use of a common conceptual model offers a platform for bridging these diverse perspectives and suggests shared vocabularies for understanding the influences on worker health (Sorensen et al, 2004; Sorensen et al, 2003).…”

“…To ensure accountability, responsibility for an integrated approach can be built into job descriptions and performance metrics; skills for implementing this approach can be incorporated into training and capacity building plans (Kruse, 2009). Benefits and incentives may be instituted that protect and promote worker health and well-being (Blumenthal, 2006; Boden et al, 2012), and include attention to improvements in salary and overall benefits, which may present a barrier for some employers (Lax, 2016). Workplace programs, policies and practices can be monitored and evaluated for both occupational health exposures and health-related behaviors and the relationships of exposures and behaviors to health outcomes (Boden et al, 2012; Institute of Medicine Committee to Assess Worksite Preventive Health Program Needs for NASA Employees, 2005).…”

An Approach to Assess the Burden of Work-Related Injury, Disease, and Distress

“…9 There might, however, be concerns that attention to nonwork factors dilutes precious resources dedicated to traditional occupational safety and health issues and that attention may be shifted from the employer’s responsibility of providing a safe and healthy workplace to an individual worker’s personal risk factors. 37 The consideration of occupational and personal risk factors must be predicated on “the primacy of traditional health protection which prioritizes employer responsibilities for the organization of work over individual health behaviors.” 38(p346) …”

Field tests of a participatory ergonomics toolkit for Total Worker Health

“…A foundational assumption is that engaging front-line workers is essential to identify the full scope of root causes of poor health, unsafe work, or a lack of well-being in an organization. This is a necessary first step for interventions that appropriately address work organization and individual health behavior risks in one integrated approach (Lax, 2016). …”