PROMISING AND BEST PRACTICES IN TOTAL WORKER HEALTH ™ W O R K S H O P S U M M A R Y Victoria Weisfeld and Tracy A. Lustig, Rapporteurs Board on Health Sciences Policy THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, NW • Washington, DC 20001 NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. This activity was supported by Contract No. 200-2011-38580 between the National Academy of Sciences and the Centers for Disease Control and Prevention. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity. International Standard Book Number-13: 978-0-309-31211-0 International Standard Book Number-10: 0-309-31211-6 Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2014 by the National Academy of Sciences. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin. Note: The trademark symbol (™) follows the phrase “Total Worker Health” on the cover of this report because NIOSH asserts common law trademark rights for this term. Suggested citation: IOM (Institute of Medicine). 2014. Promising and best practices in Total Worker HealthTM: Workshop summary. Washington, DC: The National Academies Press. The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council. www.national-academies.org PLANNING COMMITTEE FOR A WORKSHOP ON TOTAL WORKER HEALTH: BEST PRACTICES IN THE INTEGRATION OF OCCUPATIONAL HEALTH AND SAFETY AND HEALTH PROMOTION IN THE WORKPLACE1 GLORIAN SORENSEN (Chair), Professor, Harvard School of Public Health; and Director, Center for Community-Based Research, Dana- Farber Cancer Institute CHIA-CHIA CHANG, Public Health Analyst, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention RON Z. GOETZEL, Visiting Professor and Director, Institute for Health and Productivity Studies, Johns Hopkins Bloomberg School of Public Health; and Vice President, Consulting and Applied Research, Truven Health Analytics LUANN HEINEN, Director, Institute on Health, Productivity and Human Capital; and Vice President, National Business Group on Health PAMELA ANN HYMEL, Chief Medical Officer, Walt Disney Parks and Resorts NICOLAAS P. PRONK, Vice President for Health Management and Chief Science Officer, HealthPartners, Inc. MARGARET ROBBINS, National Director, Occupational Safety and Health, Coalition of Kaiser Permanente Unions IOM Staff TRACY A. LUSTIG, Forum Director Y. CRYSTI PARK, Senior Program Assistant ANDREW M. POPE, Director, Board on Health Sciences Policy 1Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution. v Reviewers This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary: Marianne Fazen, Dallas-Fort Worth Business Group on Health William H. Kojola, AFL-CIO (retired) Garry Lindsay, Federal Occupational Health James A. Merchant, The University of Iowa Jennifer Sponsler, National Business Group on Health Victoria Weldon, ExxonMobil Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Linda Hawes Clever, California Pacific Medical Center and RENEW. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. vii viii REVIEWERS Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution. Contents 1 INTRODUCTION 1 Background, 3 Organization of the Summary Report, 5 2 TOTAL WORKER HEALTH IN THE REAL WORLD 7 Program Fundamentals, 8 Program Elements and Teams, 9 The Occupational Health–Lifestyle Link, 11 Measuring Results, 13 3 THE VALUE IN PURSUING TOTAL WORKER HEALTH 15 Building Ongoing Support, 16 Defining and Measuring Success, 20 A Labor Perspective on the Value of Total Worker Health, 23 4 TOTAL WORKER HEALTH IN LARGE BUSINESSES 27 The Community Context for Health, 29 A Focus on Safety, 30 Integrating Wellness, 33 Leadership and Impact, 35 Contingent Workers, 36 5 TOTAL WORKER HEALTH FOR SMALL- AND MEDIUM- SIZED BUSINESSES 37 Readiness, 39 Integration Opportunities and Impact, 40 A Focus on Safety, 42 ix