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  • Writer's pictureJohn Suter

Is Total Worker Health the Same as Employee Wellness?

Updated: Jul 24, 2018

Total Worker Health is an emerging trend in safety. NIOSH is enthusiastically promoting TWH, which is a sure sign that safety professionals should educate themselves on the topic.

But at first glance, Total Worker Health seems similar to employee wellness. Is this just an attempt to repackage and reinvigorate an approach that some have questioned?

I don’t think I was the first person to wonder about this – one of the FAQs on NIOSH’s TWH page asks, “What sets the Total Worker Health approach apart from workplace wellness programs?” NIOSH’s answer, in a nutshell, is that many wellness programs wind up penalizing employees for failing to improve their health. TWH, on the other hand, views work as one of the risk factors that can negatively affect employee health.

This approach reminded me of two concepts of workplace ergonomics – “personal risk factors” and “fitting the job to the worker”. We teach that some ergonomic risk factors are mostly outside the employer’s control. Some of these “personal” risk factors are also outside the employee’s control, such as aging. But others, such as weight, strength and flexibility, are much more controllable by the employee. These health improvements can also lessen the effects of the “uncontrollable” risk factors, for instance by making an older worker less prone to injury and quicker to recover.

NIOSH suggests that wellness programs that encourage employees to lose weight, reduce fatigue and otherwise improve their health are more focused on benefits to the employer. They hope to lower their healthcare and workers’ compensation insurance premiums, reduce absenteeism and increase productivity. These improvements may also benefit employees, but that isn’t their main objective. In fact, employees who have difficulty losing weight, getting adequate sleep or meeting other goals of the wellness program may wind up being discriminated against in NIOSH’s view. They may wind up paying higher healthcare insurance premiums, or be unable to perform more strenuous jobs.

This is where I was reminded of the ergonomic concept of “fitting the job to the worker”. It seems like the TWH approach is to modify the job to fit the personal risk factors of the employee, rather than defaulting to changing the employee. Not that employees shouldn’t be encouraged to improve their health, just not in a manner that may be discriminatory or punitive.

Total Worker Health goes beyond the employee health issues discussed here. It also addresses issues of traditional accident prevention, safety management, workers’ compensation, employee engagement, workplace harassment and many others. But the seeming overlap with employee wellness is an area that has caused some confusion.

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