42 MONITOR ON PSYCHOLOGY • SEPTEMBER 2013
Total Worker Health” — illustrated this broader view of
occupational health. In fact, NIOSH coined the term “Total
Worker Health” to advance the idea that factors both inside and
outside the workplace contribute to the health and safety of
today’s workforce.
“Work and health, because they’re such important
components of our lives, cannot be separated,” said L. Casey
Chosewood, MD, senior medical officer at NIOSH, who chaired
a session on Total Worker Health TM. “What happens at work
doesn’t stay at work, and what happens at home doesn’t stay at
home.”
Traditionally, workplace health and safety measures
haven’t been well integrated with general health-promotion
programs. That’s finally changing, Chosewood said. Today’s
companies aren’t just working to make their physical spaces
safe for workers, he said. They’re also encouraging employees to
make healthy choices when they’re off the clock, by providing
opportunities for health education or medical screenings, for
example.
“The workplace is an ideal venue for advancing
health,” Chosewood added. “People come to work with an
understanding that they are going to follow directions, take
instruction, be part of a team and learn new skills. It’s really a
perfect place for health interventions.”
While Total Worker Health was the theme of this year’s
conference, presenters discussed a wide range of topics at the
event. Following are just a few of the many highlights.
Promoting mental health in the workplace
In the opening session plenary presentation, Anthony
LaMontagne, ScD, of the University of Melbourne’s School
of Population and Global Health, discussed an integrated
intervention approach to work and mental health. Anxiety,
depression and other mental health problems are prevalent
in working populations, he said, and some of those problems
are attributable to working conditions. Any intervention to
improve mental health in the workplace needs to combine three
components, he argues.
First, he said, mental health interventions should reduce
work-related risk factors for mental health problems, such as
bullying, job insecurity, long working hours or poor social
support at work.
Second, interventions should promote the positive elements
of work. “Most people derive some meaning or satisfaction from
work,” LaMontagne said. While those elements may be more
obvious in some jobs than in others, people in all sorts of jobs
can draw self-esteem and self-efficacy from their work. “We don’t
do a good enough job trying to build up the positives,” he said.
Finally, LaMontagne said, employers must address mental
health problems among working people, regardless of their
underlying cause. In the end it doesn’t matter whether a person
is depressed because of factors at work or at home, he notes.
Either way, employers must address the issue in the workplace.
Assisting affected employees to seek professional help will
benefit the organization as well as the individual worker.
LaMontagne said that employers have been fairly
accepting of workplace mental health promotion programs,
driven mostly by concerns about absenteeism and
productivity. But they’ve been less successful addressing
job stress issues. “Employers are basically saying, ‘Come in
and fix the workers,’ but aren’t making sure the workplace
is optimal,” he said. While that’s frustrating for people
concerned about mental health, he adds, it’s also an
opportunity. “To some extent, this is an opportunity to ride
on the coattails of mental health promotion, to get job-stress
prevention into the mainstream.”
Job insecurity and accident under-reporting
Tahira Probst, PhD, from Washington State University, studies
both job insecurity and the safety climate of organizations. She
presented results of a recent study investigating the intersection
of those two interests. Three million work-related injuries and
illnesses are reported in the United States each year, Probst
said, but some studies have found more than three-quarters of
workplace injuries go unreported. She hypothesized that when
workers feel their jobs are insecure, they are less likely to report
accidents and injuries.
She surveyed 1,265 workers in 27 organizations from
a variety of sectors, such as hospitality, manufacturing,
construction and health care. She confirmed that as job security
went down, the number of unreported injuries climbed. On
the other hand, organizations with a positive safety climate —
those that reward safe behaviors, enact good safety training
systems and make employees feel comfortable raising issues to
managers, for instance — had lower rates of under-reporting.
Encouragingly, a positive safety climate could overcome the
effect of high job insecurity on under-reporting.
Job security can’t always be improved, Probst said, but
organizations can protect workers by taking steps to improve the
company’s overall commitment to safety. “What goes unreported
goes unfixed,” she said. “The issue of under-reporting is
extremely critical to the health and safety of employees.”
The gap between policy and practice
When it comes to formal policies and management standards,
organizations may say one thing but do another. Companies