Expert: Holistic Approach to Employees' Health Leads to Decreased WC Rates

10 Mar, 2020 Nancy Grover


Boston, MA ( – Work can be terrible for a person’s health; or, it can improve an employee’s wellbeing. Companies that invest in better designed work environments, have employees who are healthier than when they started. And what’s in it for the employer?

“Those same workers, they come back with that increased level of health and that very quickly translates to lower injury risk, lower healthcare spending over time, better engagement,” said L. Casey Chosewood, MD, director of the Office of Total Worker Health at the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health. “That’s the secret sauce. It’s the win-win-win of the TWH approach.”

Speaking during the Workers Compensation Research Institute’s Annual Issues and Research Conference last week, Chosewood said these organizations also have better retention and satisfaction rates from their employees than other companies.

Health Problems

Research has shown that work-associated risk is vastly underestimated, especially for motor vehicle accidents, heat exposure and cancer. Studies have also linked working conditions and certain industries to depression, obesity, heart disease and type 2 diabetes.

“The obesity rate among long-haul truck drivers is not 50 or 60 or 70 percent, it’s closer to 80 percent,” Chosewood said. “What is about these jobs that’s so obesogenic? The need to be constantly vigilant in your work is at play.”

Shift work is another factor associated with higher risks for obesity as well as cancer, heart disease, and diabetes, among others. The combination of shift work, long hours and stress causes obesity among police, firefighters and security guards. They are the professions most likely to be obese.

“The stress of chronic vigilance, the need to go from zero to 100 very quickly,” Chosewood said. “Most firefighters die of stress.”

Up to 20 percent of heart disease may be associated with work, according to studies. “That’s a rallying cry for better work design,” Chosewood said. “We need to take additional steps of saying, ‘how can we influence the common risks of death.’”

Changes to work environments have been shown to make a significant impact on workers’ health, according to NIOSH research. For example, changes in shift work schedules led to a 8 percent decrease in workers’ compensation claim rates, according to one study. Another showed that workers who received flu shots without out-of-pocket costs had 29 percent fewer missed days of work. Additional research revealed weight loss along with lowered blood pressure and cholesterol levels.

“While we cannot get rid of every risk factor, we can decrease the impact by increasing health promotions,” Chosewood said.


“Policies, programs and practices that integrate protection from work‐related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well‐being,” is the definition of TWH, Chosewood explained.

It includes 5 defining elements:

  1. Demonstrate leadership commitment to worker safety and health at all levels of the organization
  2. Design work to eliminate or reduce safety and health hazards and promote worker well-being
  3. Promote and support worker engagement throughout program design and implementation
  4. Ensure confidentiality and privacy of workers
  5. Integrate relevant systems to advance worker well-being

TWH focuses on organization-level interventions that address the job design and workplace conditions, such as workload, leadership and management practices, work schedules, shifts, wages and benefits and employment arrangements. Working conditions are considered important determinants of health, and the approach aims to improve the health and wellbeing of workers as well as their families.  

Interventions include things such as rest, walk-and-stretch breaks, health meeting policies, improved ergonomic designs to work spaces, and work stress interventions.

A healthier work design can help prevent common exposure of stress, a major risk to workers. Included is protecting and expanding employees’ mental health, which must be part of the overall culture.

“It’s not a ‘lunch and learn,’ it has to be built into the design and nature of the work itself,” Chosewood said. “Give managers the skills to recognize those having problems … and helping others.”

Improving and implementing work environments should be done with the full engagement of employees. “Workers need a say in policies, practices and programs – the 3 Ps,” Chosewood said. “Workers need a strong voice.”

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    About The Author

    • Nancy Grover

      Nancy Grover is a freelance writer having recently retired as the Director, Media Services for She comes to our company with more than 35 years as a broadcast journalist and communications consultant. Grover’s specialties include insurance, workers’ compensation, financial services, substance abuse, healthcare and disability. For 12 years she served as the Program Chair of the National Workers’ Compensation and Disability Conference® & Expo. A journalism/speech graduate of Ohio Wesleyan University, Grover also holds an MBA from Palm Beach Atlantic University.

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