Total Worker Health Exclusive

Productive Aging: Safe and Healthy Jobs throughout the Lifespan Benefit Workers, Employers, and Society

Recently the staff of TWH in Action! caught up with Bermang Ortiz, Public Health Advisor, National Center for Productive Aging and Work, NIOSH and Juliann Scholl, PhD, co-director of National Center for Productive Aging and Work, NIOSH to discuss the concept of productive aging in the context of work and to get an updated look at the Center’s current portfolio. 

Q: We’ve been talking about an aging workforce in the US for more than a decade now. Is this still an issue for employers and workers?

A:  Absolutely. The U.S. population continues to age significantly. Today’s workforce is a reflection of that. For example, people 65 years or older accounted for about 15% of the U.S. population in 2015, but that percentage will increase to 22% by 2050.¹ In addition, workers 55 or older are increasing in number, and will account for nearly 25% of the labor force in 2024.² For workers entering the job market now, it will not be uncommon to be working for six decades or more. It’s also important to note that today’s economy is demanding that many of us work longer than we planned. But as folks work longer, they’ll be exposed to both traditional work hazards and newly emerging ones that we have not well-characterized yet. Productive aging provides a useful perspective on how to address the challenges and opportunities presented by a lengthening of the working lifespan and the particular needs of an aging workforce.

Q:  Your NIOSH Center focuses on the concept of “productive aging”.  How did this concept first arise and how do you define it?

A:  In the 1980s, gerontologists advocated for a more balanced discussion about aging, focusing more on the productive abilities of older individuals – not only on the strains they might pose to society’s resources. Out of this effort, the concept of productive aging emerged.³ Since then, productive aging has been defined in different ways, but the common thread for us at NIOSH is that older individuals bring many assets to the workplace, such as greater job knowledge and safer work practices.

Drawing on this perspective, the National Center for Productive Aging and Work (NCPAW) defines productive aging as an approach that emphasizes the positive aspects of growing older. It highlights the ways that workers can make important contributions to their own lives, their communities and organizations, and to society as a whole.  Productive aging also highlights the need for workplaces to provide safe and healthy work environments that make it possible for workers to function optimally and thrive at all ages. Consistent with Total Worker Health®, NCPAW’s concept of productive aging takes a comprehensive, integrated approach to understanding the aging process across the life span, including the physical, mental, and social aspects of a worker’s well-being.

Q:  There’s lots of stereotypes out there about older workers. I understand in NCPAW you are working to shatter some of these old myths.

A:  We are! Productive aging helps us see past the stereotypes of older workers as being unproductive, unadaptable, or unsafe. Although aging can bring losses in physical and cognitive abilities that may affect job performance, older workers possess valuable years of work experience. They have fewer nonfatal injuries, have fewer conflicts with co-workers, and often have advanced skill levels. These positive attributes often more than compensate for declines in other areas. Because of individual variabilities in physical and cognitive losses, age alone is not a sufficient indicator of health and work capacity.

Q:  What guidance can the Center offer organizations and workers?

A:  The NCPAW productive aging perspective offers workers, employers, and occupational safety and health professionals a theoretical framework to follow for workers of every age. By developing and implementing programs and policies that support the changing work capacities of workers over the working lifespan, employers can minimize work-related safety and health hazards. As a result, they will benefit from gains in recruitment, retention, competitiveness and productivity in the long term. Workplaces designed as “age friendly” meet multigenerational workforce needs by minimizing exposures to work-related safety and health hazards. For instance, “age friendly” workplaces are those that prioritize workplace flexibility, matching tasks to abilities, encourage teamwork, and invest in training to build worker skills. These and other practices ensure that younger workers reach later life without injury or illness and older workers maximize their changing abilities by working without injury or illness.

For more information on productive aging and work, visit NCPAW or contact ncpaw@cdc.gov.

1. He W, Goodkind D, Kowal P [2016]. An aging world: 2015. International Population Reports, U.S. Census.

2. Toossi M [2015]. Labor force projections to 2024: the labor force is growing, but slowly. Monthly Labor Review December:1–32.

3. Butler R [1985]. Productive aging: enhancing vitality in later life. Springer Publishing: New York.

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Updates from the NIOSH Office for Total Worker Health

Recent release of the NIH Pathways to Prevention Workshop report

The final report of the National Institutes of Health Pathways to Prevention Workshop “Total Worker Health—What’s Work Got to Do With It?” is now available in the Annals of Internal Medicine. The report, created by an independent expert panel, highlights the current state of the science for TWH and outlines eight recommendations for future TWH research and practice.

World Health Organization Collaboration Document

The NIOSH Office for TWH recently collaborated with the Finnish Institute of Occupational Health, in the report,  Improving Workers’ Health Across the Globe: Advancing the Global Plan of Action for Workers’ Health. This document provides examples of the activities and achievements of the Global Network of World Health Organization Collaborating Centres for Occupational Health, including priorities and case studies from across the globe.

New on the NIOSH TWH Website: Planning, Assessment, and Evaluation Tools

There are many important factors to consider when planning integrated safety, health and well-being programs, policies, and practices. To help organizations create and sustain a culture of TWH, we have created a webpage that provides planning, assessment, and evaluation resources. Visit the webpage to get started with TWH approaches in your workplace.

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Updates from the NIOSH National Center for Productive Aging and Work (NCPAW)

Save the date! On September 27^th, NCPAW is co-hosting a free webinar on the topic of productive aging. This NIOSH TWH Webinar Series installment will feature an expert panel of speakers that will discuss the concept of productive aging, the importance of creating aging-friendly workplaces, and practical employer approaches that can benefit workers of all ages. Registration and additional information on the webinar can be found on the NIOSH TWH Webinar Series page.

On May 5, Juliann Scholl, Co-Director of NCPAW and Health Communication Fellow in NIOSH’s Education and Information Division, gave an invited presentation at the Minnesota Safety Council’s annual conference.   The presentation reviewed the aging workforce landscape, shared NIOSH’s productive aging model, and shared the steps NCPAW is taking to develop and evaluate current aging-related products.

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Promising Practices for Total Worker Health

Promising Practices for Total Worker Health

Chia-Chia Chang, MPH, MBA, NIOSH Office for Total Worker Health
Deborah Roy, MPH, RN, COHN-S, CSP, L.L.Bean

A Safety Redesign Jump-Starts Health and Well-Being for L.L.Bean’s Aging Workforce

At L.L.Bean, Maine’s quintessential outdoor clothing and equipment company, the workforce is growing older. Although advancing age improves problem-solving and teamwork skills, it also adds risk, especially for older workers with physically demanding tasks. Acknowledging this truth helped L.L.Bean look beyond its established safety and health infrastructure, says Deborah Roy, MPH, RN, COHN-S, CSP, Corporate Director for Health, Safety, and Wellness. The company began taking decisive steps to optimize work processes and prevent injury and illness for all their workers, not only their older ones.

Unique Workforce Considerations

When people come to work at L.L.Bean, many become lifelong staff members because they know the company values its workers and embraces active living. However, low turnover means that employees who were hired in their 20s still have physically demanding jobs 25 or 30 years later.  With an average employee age of 50, L.L.Bean’s team shares many of the age-related challenges common in workplaces nationwide. Reduced flexibility of the neck and spine, lower grip and lifting strength, and limits to range of motion all become more likely as workers age. Older workers are also more likely to have one or more chronic diseases such as arthritis, diabetes, and obesity. These issues make a focus on injury and illness prevention an absolute necessity.

Integration of Prevention

Ms. Roy’s team approached the challenge by focusing on one of the highest-risk areas: materials handling in the warehouse. L.L.Bean already had some critical preventive strategies in place: most workers usually were assigned materials-handling activities only twice a week and were rotated to other tasks every couple of hours. Workers were also given three sets of paid 5-minute rest and stretch breaks a day.  Even still, Deborah felt more should be done.

L.L.Bean next turned to a variety of technologies to further reduce the safety and health risks to workers. Solutions for work processes included a mix of robotics, vacuum-driven lift-assist devices, and adjustable pallet lifts.  This approach aligned well with the space, capital, and sustainability needs of the business. Now, for much of the year, a single robot and an operator are sufficient for handling products, but at peak volume the robot along with three workers using vacuum lift-assist devices and pallet lifts can safely do the work. This mix has helped the company to reduce risk while working with existing floor space and meeting changing demands. The vacuum lifts reduce weights to less than 10 pounds, and the pallet positioners allow loads to be at optimal height. Since the system was installed in the summer of 2014, no back injuries have been reported while using this technology. Feedback from workers has been very positive, particularly from those using the vacuum lift-assist devices, which make the work safer but still provide a sense of individual-level control.

Jump-Starting Cardiovascular Fitness

L.L.Bean piloted Jump Start, a voluntary conditioning program to benefit workers on and off the job. It aims to increase cardiovascular fitness and endurance, build muscle mass, and improve flexibility with a 12-week supervised aerobic activity and strength-training program. Sessions are offered three times a week, and workers can participate for 45 minutes of paid company time during their work shift. Besides providing a qualified fitness instructor, L.L.Bean also consults with physical therapy professionals to add customized program components to meet the physical demands of specific jobs.

Early Results: Reduced Injuries, Improved Health and Well-Being

The program’s launch results exceeded expectations. In a 2013 analysis, L.L.Bean found that at the end of the 12 week program, participants showed improvements in muscle strength, endurance, and flexibility, as well as improvements in resting heart rate and cardiovascular endurance. Although weight reduction was not a goal of the program, 29% of the participants lost weight. In addition, 62% of workers reported having more energy and 29% reported less stress. The other focus of the program was to “jump start” employees into their own exercise program or get them interested in existing classes. L.L.Bean found that workers’ compensation cases were reduced from 10 to 2 cases in the same group of workers, with reductions in both compensation costs and medical costs. Adding these cost reductions to the estimated savings from avoided obesity, physical inactivity, and high blood pressure, the company estimates that there was a cost avoidance of $3.15 for every dollar spent (based on the company’s initial costs estimates in 2012).

Leadership Commitment to Program Success

L.L.Bean continues to offer Jump Start, tailoring it to other departments. It constantly improves the program according to results and feedback from participants. Ms. Roy emphasizes that leadership support is critical to the program’s success. “Employees need to feel truly supported by their supervisors when they are going to class every week. Providing paid company time for participation in the program and letting managers and workers plan the session schedule demonstrate the company’s commitment to worker safety and health,” she adds.

L.L.Bean is committed to ongoing organizational interventions to keep workers safe, healthy, and just as vibrant as life itself in the scenic state of Maine.

*Promising Practices features the work of organizations committed to implementing TWH concepts, in whole or in part, to advance the safety, health, and well-being of their workforce.

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Updates from the NIOSH Centers of Excellence for Total Worker Health

Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-being

The Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-being hosted Drs. Stravoula Leka and Aditya Jain from the Centre for Organizational Health and Development from the University of Nottingham in the United Kingdom. Drs. Leka and Jain discussed their innovative research focusing on four major themes:

• Work organization and the management of the psychosocial work environment for business and societal sustainability
• Prevention of work-related stress and promotion of mental health in the workplace
• Development of healthy and sustainable workplaces through responsible business practices
• Policy-level interventions in occupational health and safety

Glorian Sorensen, PhD, and Center collaborator Nico Pronk, PhD, received the 2016 Harvard Chan School’s Excellence in Teaching Award for Executive and Continuing Professional Education (ECPE), for their course entitled “Work, Health, and Well-being: Frameworks, Evidence, and Applications. ” The course aims to provide practitioners with the research and tools necessary to implement integrated approaches to worker safety, health, and well-being. The next course will be held in Boston from February 6-8, 2017.  Registration is open at the course website.

Working together, the Boston Fire Department and Boston Firefighters Union Local 718 approached the Center to build a collaboration to reduce cancer risk among Boston firefighters. Dr. Sorensen’s team has spent the past year trying to identify station-level risk factors like disrupted sleep patterns and high stress levels. Through air sampling and key informant interviews, the researchers are collecting preliminary data that will help inform a future intervention aimed at reducing cancer-related risk factors at the fire station.

University of Iowa Healthier Workforce Center for Excellence (HWCE)

The Healthier Workforce Center is partnering with the Iowa League of Cities to better serve workers in Iowa’s municipalities. The League of Cities includes the Iowa Municipalities Workers’ Compensation Association (IMWCA), which already works closely with its member cities and counties to improve safety and health and to lower their workers’ compensation claims and insurance premiums. This summer, the IMWCA is providing access to exemplary members who have made improvements. Their stories will be included as part of an HWCE video series in a Small Business Outreach Project, which shares best practices of other small employers.

Oregon Healthy Workforce Center (OHWC)

The Oregon Healthy Workforce Center recently hosted its Spring Seminar, with handouts and recordings of the symposium accessible here. OHWC also hosted its 2016 Occupational Health Psychology Summer Institute, which featured an exciting line-up of speakers from the United States and across the world. The upcoming Fall Symposium will take place November 18^th, 2016 and is titled “Diversity and Inclusion in the Workplace: Impact on worker health and well-being.”

Oregon Health & Science University and Portland State University recently created a joint School of Public Health. The new school is embracing TWH in its curriculum. Read more about the new school on the OHSU blog.

Outreach Director, Dede Montgomery, returned from a 10-day visit to Bangkok, Thailand, as part of the OHSU Global Health–SE Asia Initiative, where she taught “Core Elements of Occupational Health: Hazard Identification and Control, Industrial Hygiene, Ergonomics, and Occupational Health Nursing” and blogged about her experiences. Donald Truxillo, co-PI of the Safety & Health Improvement Program intervention (SHIP), conducted a refresher course with supervisors and employees from the study to review the supervisor support and team effectiveness intervention components; supervisors also shared the impact of the SHIP in their daily work practices. Kent Anger, Jason Yano, Diane Rohlman, and Megan Parish presented their Total Worker Health projects at the 2016 Pacific Northwest Apprenticeship Education Conference, which brought together professionals in the construction industry.

The OHWC offers some new videos from their YouTube channel, featuring clips from the Change Maker Series with behavior change experts, Anthony Pratkanis and Aubrey Daniels.

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News from our TWH Affiliates and Partners

The NIOSH Office for Total Worker Health welcomes two new Affiliates: the American College of Preventive Medicine and the Valley Health Alliance.

American College of Preventive Medicine
NIOSH TWH Affiliate

Founded in 1954, the American College of Preventive Medicine (ACPM) is the leader for the specialty of Preventive Medicine and physicians dedicated to prevention. Uniquely trained in both clinical medicine and public health, preventive medicine specialists are equipped to understand and reduce the risks of disease, disability, and death in individuals and in population groups. Utilizing a multi-pronged strategy, ACPM will disseminate the NIOSH TWH resources and programs to its membership, which includes 26 residency programs, and to its coalition partners. ACPM and the American College of Lifestyle Medicine have developed the Lifestyle Medicine Core Competencies Program, a 30-hour online CME opportunity. This curriculum will serve as a foundation for a formal lifestyle medicine training and competence program for physicians and is applicable for nurses, nurse practitioners, physician assistants, dietitians, health coaches, and other allied health professionals.

Valley Health Alliance
NIOSH TWH Affiliate

The Valley Health Alliance (VHA), formed in 2012 by the five largest employers in Pitkin County, Colorado, includes The City of Aspen, Aspen Valley Hospital, Aspen Skiing Company, Pitkin County, and Mountain Family Health Centers. The VHA became a NIOSH TWH Affiliate in April 2016. The VHA, with 4,000 covered lives, is challenged by addressing high blood pressure, hyperlipidemia, and depression as the primary medical risks in the community. Additionally, stress, poor sleep, and weight management are the primary lifestyle risks facing the workforce in the valley. Since the inception of the VHA, metrics related to access to primary care, dental health, and mental health have improved, while evidenced-based practices for population health management have been promoted. VHA and the Total Worker Health Office recently completed a workshop on “Healthier Supervision Strategies” for 50 of VHA’s local managers and team leaders.

National Aeronautics and Space Administration (NASA)
NIOSH TWH Affiliate

NASA’s Occupational Health Program will hold its Annual Meeting June 14-16 at the Kennedy Space Center in Florida. Disciplines participating include medical, nursing, employee assistance, environmental health, health physics, workers’ compensation and fitness. Speakers are experts coming from within the Agency as well as from other federal agencies and industry.

About the NIOSH TWH Affiliate Program

The mission of the NIOSH Total Worker Health Affiliate Program is to foster an integrated approach to protecting and promoting worker well-being through collaborations with academic, labor, nonprofit, and government organizations. Learn more about the NIOSH TWH Affiliate Program here.

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New Publications and Resources

NIH Pathways to Prevention Workshop Report

The NIH Pathways to Prevention Workshop final panel report can be found online in the Annals of Internal Medicine. Also available is the NIOSH Response to the NIH Pathways to Prevention Workshop Recommendations.

Letter to the Editor of New Solutions: A Journal of Environmental and Occupational Health Policy

In response to an article by Michael B. Lax, MD in NEW titled “The perils of integrating wellness and safety and health and the possibility of a worker-oriented alternative,” NIOSH provides updated information about TWH initiatives. Read the letter here.

Frequently Asked Questions about Total Worker Health Now Available in Print-friendly Format

The downloadable PDF is now available on the Frequently Asked Questions webpage.

How to Create and Sustain a Culture of Safety

What does it take to create and sustain a safe workplace culture? This symposium co-sponsored by OHWC and SafeBuild Alliance illustrated the importance, role, and power of leadership, effective supervision, and worker empowerment. Recordings from this engaging symposium are free to the public and can be accessed on the Oregon Healthy Workforce Center’s website.

Promoting U Through Safety and Health (PUSH) Project for Young Workers: Safety Video Series

The Promoting U through Safety and Health (PUSH) Project has launched a series of engaging videos targeted at young workers, ages 14–24. These videos, like the Safety First! Young Worker Safety Rap, were developed with the help of young workers and are available on the OHWC PUSH YouTube page.

Start the Conversation Activities

The Start the Conversation Activities are brief, supervisor-led activities developed and/or adapted from CDC/NIOSH’s Talking Safety: Youth@Work curriculum. These OHWC activities were made to educate young workers about work and non-work factors (safety in the workplace, professional communication, and health) that can impact safety on and off the job.

CPH-NEW Emerging Topics News and Views Issue

Issue #47, Commuting and work: What contributes to employees’ risky commuting safety behaviors, and what can be done about it?

Five New Publications from Centers of Excellence for Total Worker Health

Improving safety climate through a communication and recognition program for construction: a mixed methods study. Researchers at the Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-being implemented and evaluated the efficacy of a safety communication and recognition program designed to encourage improvement of physical working conditions and hazard reduction in construction. The program demonstrated that a simple intervention engaging workers through strong communication infrastructure had a meaningful and positive effect on worksite safety.

Measurement tools for integrated worker health protection and promotion:  Lessons learned from the SafeWell project. This paper from the Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-being presents a conceptual model, measurement tools, data collection processes, feedback reports, and initial test results of a measurement approach assessing health protection and health promotion. The assessment, designed to address knowledge gaps, was fielded in a study called SafeWell.

Participatory action research in corrections: The HITEC 2 program. In this participatory action research program, investigators from CPH-NEW compared intervention programs between two correctional sites utilizing the Intervention Design and Analysis Scorecard (IDEAS) to plan interventions.

Supporting employees’ work-family needs improves health care quality: Longitudinal evidence from long-term care. Investigators at the Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-being analyzed qualitative interviews and quantitative data from supervisors and workers in nursing homes. Results suggest that organizational supportiveness of work-life issues is associated with better quality-of-care outcomes for nursing home residents.

Validation and dimensionality of the Integration of Health Protection and Health Promotion Score: Evidence from the PULSE small business and VA Medical Center surveys. Researchers at the Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-being assessed the validity and dimensionality for the Indicators of Integration Score in two sample groups. Results indicate that Integration Score is a valid metric for assessing the integration of health protection and health promotion within different organizations and may be used as a unified index.

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Conferences, Webinars, and Trainings

September

18^th—CDR Heidi Hudson will present at the annual NIOSH Fatality Assessment and Control Evaluation (FACE) Program meeting held in Morgantown, West Virginia.

15^th—Ms. Chia-Chia Chang, MBA, MPH, will present at the Pan American Health Organization in Washington, DC.

19^th—Ms. Chia-Chia Chang, MBA, MPH, will present at the Nebraska Safety Council Conference in Lincoln, Nebraska.

21^st—Dr. L. Casey Chosewood will give the Keynote Presentation at the Medgate User Group Conference in San Antonio, Texas. Ms. Chia-Chia Chang, MBA, MPH, will also present.

27^th—The NIOSH TWH Webinar Series will host a free, CEU-pending webinar on the topic of Productive Aging. More details and registration can be found on the NIOSH TWH Webinar webpage.

27^th— Members of the Iowa Healthier Workforce Center will hold a workshop at the Iowa League of Cities Annual Conference and Exhibit in Des Moines, Iowa.

October

6^th—Ms. Chia-Chia Chang, MBA, MPH, will speak at the Northeast Association of the American Occupational Health Nurse (NEAOHN) Conference in Portland, Maine.

14^th—CDR Heidi Hudson will speak at the Tri-State Occupational Medicine Association annual conference in Columbus, Ohio.

24^th—Dr. L. Casey Chosewood will give a General Session Presentation at the American Industrial Hygiene Association’s Fall 2016 Conference in San Antonio, Texas.

27^th to 28^th—Dr. L. Casey Chosewood will present at the Labour Relations Conference, in partnership with the Health Sciences Association of Alberta, in Calgary in Alberta, Canada.

November

12^th to 14^th—Ms. Chia-Chia Chang, MBA, MPH, and Dr. Sara Tamers of the NIOSH Office for TWH will present “Fitting the Job to Advance Worker Well-Being” at the 2016 National Ergonomics Conference and Exposition in Las Vegas, Nevada.

2017

Call for Proposals for Work, Stress, and Health 2017

NIOSH and partners invite submissions to the Work, Stress, and Health 2017 international conference. The Call for Proposals is now available for the conference, which will take place June 7–10, 2017, in Minneapolis, Minnesota. Proposal submissions for papers, posters, symposia, and interactive panels are due October 31. For conference updates and upcoming information about registration and hotel accommodations, visit the conference website or the Work, Stress, and Health Conference Facebook page. The conference is co-convened by NIOSH, the American Psychological Association Public Interest Directorate, and the Society for Occupational Health Psychology.

SAVE THE DATE for Understanding Small Enterprises: October 25–27

The Understanding Small Enterprises Conference will take place October 25–27, 2017, in Denver, Colorado. Conference topics include linking worker well-being and business health, contingent and vulnerable workers, and how partners interact with small businesses.

2018

SAVE THE DATE for the 2^nd International Symposium to Advance Total Worker Health®: May 8–11

In spring 2018, the only NIOSH-sponsored conference dedicated solely to advancing Total Worker Health research and practice returns to the campus of the National Institutes of Health in Bethesda, Maryland. Esteemed presenters from nonprofits, government agencies, academic institutions, and the private sector will share the latest perspectives, research findings, and practical applications of Total Worker Health. This triennial conference is not to be missed!