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Steps To A HealthierUS
Workforce
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December 19, 2003 |
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Ann Brockhaus, M.P.H., Organization Resources Counselors, Inc. (ORC) In the early 1970’s, the Organization Resources Counselors, Inc. (ORC) Health and Safety Networks, [comma added] which were the product of human resources services, focused primarily on regulatory issues. In 2000, the interest of these networks moved to the integrated models for employee health that incorporated both occupational and non-occupational approaches. There are currently 150 large multi-national companies from a wide range of industry sectors that participate in the ORC Health & Safety Networks. The member companies are either part of the OSH Group, which includes the senior managers of Health and Safety; or the Physicians Group, for corporate medical directors and non-physician managers of occupational health programs. The ORC member companies have reported various feedback in terms
of health care costs, competitive pressures, the aging workforce,
the changing nature of work, the increasingly knowledge based workforce,
mental disorders and depression, and other factors that have had
a large impact on health conditions of workers and overall productivity.
Their responses indicate a need for integrated approaches that can
improve both employee health and cost savings to companies. The
interest for these integrated approaches is no longer limited to
occupational health staff but is also intended for health and safety
and benefits managers with engineering and/or safety backgrounds.
Most companies are now in the beginning stages of these integrated
approaches and only a relative handful of companies have demonstrated
success. Lessons have been learned from the actions taken so far
but there are still challenges to be overcome and steps needed for
successful implementation of these initiatives.
Scott Schneider, C.I.H, Director of Occupational Safety and Health, Laborers’ Health and Safety Fund of North America The Laborers’ International Union of North America (LIUNA) represents about 850,000 workers who are mostly construction workers in the U.S. and Canada. Laborers typically have some of the hardest jobs in construction, involving the highest exposures to occupational hazards, and also have high rates of non-occupational risk factors (smoking, drinking, obesity, etc). The compensation system is also inadequate to deal with chronic injuries and illness for construction workers who change employers frequently. Many conditions never get compensated or end up shifting costs to the general health care system or the employer’s health and welfare plan. The rising health care costs in the mid-1980s led the union to create the Laborers’ Health and Safety Fund of North America in 1988. The Fund is a joint Labor-Management non-profit organization that is funded primarily through contributions through the Union Health and Welfare Funds. The mission of the Fund is “to enhance the safety and health of laborers, retirees and their families; strengthen the LIUNA; and improve the competitiveness of LIUNA signatory employers.” The Fund has three divisions: Occupational Safety and Health, Health Promotion, and Research. The Fund provides a variety of services to workers and employers that do not exclusively focus on occupational issues or lifestyle issues. The goal is to reduce occupational injuries and illnesses which will in turn decrease employers’ workers’ compensation costs, and medical/health insurance costs. To tackle some of these issues the Fund developed a Safety and Health Training Program for construction supervisors. The training covers how to create a safe jobsite and the need for health promotion activities in the workplace. Although the Fund has found some success with this program there
are many challenges in merging OSH and Health Promotion in the United
States. One challenge is that job-related health benefits are decreasing
as health care costs rise and employers increasingly drop coverage.
Other barriers include the lack of a U.S. national health system
and inadequate OSH training for a majority of doctors. Aside from
these challenges it is important to illustrate how health promotion
that includes occupational approaches can affect workers’
lives and livelihood. While many of the conditions driving health
care costs are non-occupational, work exposures can be contributing
factors and can affect a worker’s career and retirement. All
these factors must be taken into consideration if the goal is to
improve the lives of workers.
Karen Campbell, Ed.D., Occupational Health Nurse, American Association of Occupational Health Nurses (AAOHN) AAOHN is a 9,000 member professional organization for occupational and environmental health nurses. Their mission is dedicated to advancing and maximizing the health, safety, and productivity of domestic and global workforces by providing education, research, public policy, and practice resources for occupational and environmental health nurses. The mission of AAOHN is to advance the profession of occupational and environmental health nursing through five pillars: education and research, professional practice/ethics, communications, governmental issues, alliances/partnerships. Karen Campbell currently works for the pharmaceutical company Glaxosmithkline, which has 24,000 employees in the U.S. and 104,000 worldwide. Throughout the last couple of years Glaxosmithkline merged with a number of other companies that already had integrated health promotion initiatives. Glaxosmithkline tried to replicate some of the integrated approaches in the new company but found a lack of participation (only 10 % participated), and difficulty in tracking, evaluating, and structuring comprehensive health care strategies that would impact the current healthcare system. One program that the company replicated was entitled ‘Contract for Health.’ This program encouraged employees to participate in healthy behaviors. The original program spanned six years with a $5.5 million return on company investment. Another program implemented was “Step Up Your Health”, which had 5,000 participants and encouraged employees to walk a certain amount each day. The difficulty in implementing these integrated approaches is that
health awareness does not always drive behavior change, and behavior
change is not permanent. Additionally, the threat of a chronic condition
or actual disease does not always motivate behavior change. In order
to make integrated approaches successful there needs to be a linkage
made between health and productivity. It is essential to illustrate
the impact these initiatives will have on employers, their dependents,
and retirees, on reducing healthcare costs, and on chronic condition
management. For continued funding and focus on integrated approaches
it is also essential to illustrate the return on investment
Dr. Franklin Mirer, Ph.D., Director, Health and Safety Department, United Auto Workers International Union (UAW) In the United States, workers spend 40% or more of their waking
hours at work. A percentage of the reasons for absenteeism are due
to occupational and non-occupational factors. The highest percent
of disability claims are received for production and services workers
and are the result of occupational injuries. When one subtracts
injury and musculoskeletal disorders as the reasons for disability
retirement and disability illness claims, mental disorders become
the leading factor. With this information at hand it is important
to ponder the following questions: Is health risk behavior an outcome
of job related psychosocial stress? Is working in pain a psychosocial
stressor? Whatever happened to worksite based hypertension screening
and intervention? To have successful integrated approaches it is
essential to address psychological factors, work stress factors,
and the changing nature of work, especially for blue collar workers.
These approaches need to include collaboration with health insurance
companies and those at the organizational and managerial levels.
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