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MarnieDobson,Ph.D.Center for Occupat ional andEnvironmental Health,
Univers ity of Cal i fornia, I rv ine
OHPSummer Inst i tute , OregonHea l th Workforce Center Ju ly 10 , 2018
AdvancingtheHealthyWorkCampaignDisseminatingworkstresseducationandpreventionstrategies.
BACKGROUND:CenterforSocialEpidemiologyCSEisaprivatenon-profitfoundationestablishedin1988…topromotepublicawarenessoftheroleofoccupational/workstressintheetiologyofpsychologicaldisordersandcardiovasculardisease.
à Collaborationwithotherresearchinstitutions/researchersonmajoroccupationalhealthstudies.
àWebsite(unhealthywork.org):translationanddisseminationof40+yearsofscientificevidence(longitudinalstudies,reviews/meta-analyses,interventionstudies)oftherelationshipbetweenworkorganization/psychosocialworkstressorsandchronicillness,healthandwell-beingofworkingpeople.
à “WorkingonEmpty”(workingonempty.org)isinnovativefilmprojectbegunin2016
à Developingthe “HealthyWorkCampaign”(2017-2018)
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Translation/DisseminationandtheHWC
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Characteristicsofthetranslationalframeworkforpublichealthresearch(Oglivie etal2009)
• Redefinestheendpointfromthatofinstitutionalising effectiveinterventionstothatofimprovingpopulationhealth
• Incorporatestheepidemiologicaltraditionsofpopulationhealthsurveillanceandtheidentificationofmodifiableriskfactors
• Reflectsaspectrumofdeterminantsofhealthfromtheindividualtothecollectivelevelandacorrespondingspectrumoflevelsofintervention
Oglivie,D.etal.Atranslationalframeworkforpublichealthresearch.BMCPublicHealth2009;9:116
HealthyWorkCampaign:MISSIONTheHealthyWorkCampaign(HWC)isapublichealthcampaignthataimstopromote
healthywork andreduceunhealthyworkingconditions intheU.S.àand,thereby, preventandreduceinjuries,chronicillnesses,healthinequalities,
andthecoststoworkers,businessesandsociety.
Reduceharmfulworkstressors.Improvejobqualityandhealth.WWW.HEALTHYWORKCAMPAIGN.ORG
4Healthy Work Campaign in partnership with The Center for Social Epidemiology
HWCGOALS1.EDUCATE Americanworkersandorganizationsaboutunhealthywork,howitmakesworkersill,thecoststoallofus,andwhatsolutionsexisttoachievehealthywork.
2.ASSESSwhetherworkishealthyornotbyidentifyingworkstressorsforindividualworkersandfororganizationsutilizingtheonline “HealthyWorkSurvey.”
3.EQUIPAmericanworkersandorganizationswithtools,sothatindividuallyandcollectively,peoplecanhelptobringaboutpositivechangestotheorganizationandcultureofworkinAmerica.
4.ADVOCATE- provide allstakeholderswithopportunitiestosupportortakeactiontopromotehealthyworkforall.
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WHATIS“HEALTHYWORK”?
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NIOSH:TOTALWORKERHEALTH™(2011)Integrating:HealthPromotionwithHealthProtection(OccupationalHealth)
http://www.cdc.gov/niosh/twh/
WHEREISWORKORGANIZATION(2013)?
http://www.cdc.gov/niosh/twh/totalhealth.html
Mechanisms
What is work organization?(adapted from NIOSH model (2002))
LandsbergisP,etal.OccupationalHealthPsychology(pp.1086-1130).InAnnaD(ed.)TheOccupationalEnvironment(3rded.).AmericanIndustrialHygieneAssociation,2011.
EmploymentConditions
Formal/informaleconomy
Forced/childlabor
Precarious/full-timepermanentemployment
Unemploymentrate
Laborregulations
Unionizationofworkforce
OrganizationalFactors
Downsizing,outsourcing,privatizationofpublicservices
Subcontracting/temporarywork
Productionsystems
Safetyculture/climate
Staffinglevels
HRpolicies
Labor-mgmtrelations
Job/Task-SpecificFactors
Physical/chem,biomechanicalhazards
Longhours,shiftwork
Psychosocialstressors:Highdemands+lowcontrolHighefforts+lowrewardsLowsupportJobinsecurityHarassment/discrimination
PhysiologicalSleepInflammatory factorsWork ABP
PsychologicalBurnoutAnxietyDepression
BehavioralSmokingLack of exerciseAlcoholEating behaviors
HealthandCosts
ChronicIllness/Injury
HypertensionCardiovasculardisease
Obesity/DiabetesMusculoskeletaldisorders
Injuries
Productivity/CostsAbsenteeism/SickLeave
PresenteeismDisability
WorkersCompensationHealthCareCosts
Workstressorsplayaroleinchronicillness
• JOBSTRAIN• EFFORT-REWARDIMBALANCE• LONGWORKHOURS• ORGANIZATIONALINJUSTICE• DOWNSIZING• SHIFTWORK
CVD
• JOBSTRAIN• EFFORT-REWARDIMBALANCE• WORK-FAMILYCONFLICT• THREAT-AVOIDANCEVIGILANCE
HYPERTENSION
• JOBSTRAIN• EFFORT-REWARDIMBALANCE• WORK-FAMILYCONFLICT• LONGWORKHOURS• LOWSOCIALSUPPORT• ORGANIZATIONALINJUSTICE• DOWNSIZING
BURNOUT/DEPRESSION
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Schnalletal.IJHS,2016Theorelletal.EurJPubHlth,2016Kivimaki etalLancet2012Kivimaki etalLancet2015Ha&Park.JOH2005
LandsbergisetalAJPH2013Trudel etalOEM2013Gilbert-OuimetJPsychosom Res2011
TheorelletalBMCPubHealth2015SiegristJ.EurArchPsychClinNeurosci 2008
UnhealthyWorkCostsAllofUs
CardiovascularDisease(CVD)remainsthe#1causeofdeathintheUSatnearly801,000deaths/year.
TheAHAstatesthecurrentcostofCVDis$600billionayear.
Andweknowthat10-20%ofannualCVDdeathsarecaused bythewaywework.
(AmericanHeartAssociation,CardiovascularDisease:ACostlyBurdenforAmerica2017;TokyoDeclaration,March2013viathe InternationalJournalofOccupationalMedicineandEnvironmentalHealth,
January 2015, vol. 28)
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CostsofWorkStressors“JobstresscostsUSemployersmorethan$300
billionannually.”
“Morethan120,000deathsperyearareassociatedwithhowU.S.companiesmanageworkers.”- GohandPfefferetal,ManagementScience,
February2016
Infact,differentworkstressorsincludingjobinsecurityandjobcontrol,collectivelyshortenthelivesofAmericans,onaverage,byasmuchasthreeyears.- GohandPfeffer,HealthAffairs,October
2015vol.10
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TheHEALTHYWORKCAMPAIGNandTotalWorkerHealthTM
• NIOSHTotalWorkerHealthnowrecognizesworkasasocialdeterminantofhealth and“acknowledgesriskfactorsrelatedtoworkthatcontributetohealthproblemspreviouslyconsideredunrelatedtowork.”
•TheHWCcouldbeacollaborativepartnertoNIOSH’sTWHprogram– asabroad“publichealth”campaigntoeducateandoutreachtothepublic,industryandlaborunionsabouttheimpactofworkstresscausedbyunhealthyworkorganization,onworkerhealthandwell-being.
•HWCproposesto helpdisseminateTWHCOE’sworkorginterventionresearch,programsandbestpracticestothepublicandotherstakeholders.
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Goal1:HealthyWorkEducationEDUCATE Americanworkersandorganizationsaboutunhealthywork,howitmakesworkersill,thecoststoallofus,andwhatsolutionsexisttoachievehealthywork.HWCuser-friendlyeducationalresourcesinclude:oThePrinciplesofHealthyWorkoHealthyWorkStatistics/InfographicsoWorkingonEmpty filmprojectandMedia
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HealthyWorkCampaignwebsite– UnderConstruction
www.healthyworkcampaign.org
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PrinciplesofHealthyWork
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ØIntendedtoeducatethepublic:ØDefines“HealthyWork”– similartopreviousdefinitions(Karasek’s“GoodJobs,BadJobs,”WHOHealthyWorkplaceFrameworketc.)asthe“opposite”ofcommonworkstressors(demands,control,support,jobsecurityetc.)includingabriefoverviewofpossiblechangestothecultureororganizationofworkthatcouldreduceworkstressors.
Ø TobedesignedasaninteractivegraphiclocatedontheHWCwebsite.
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PrinciplesofHealthyWork– InteractiveGraphic(underconstruction)
Goal1:HealthyWorkEducation,continued
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HealthyWorkStatistics/Infographics
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Goal1:HealthyWorkEducationcontinued…WorkingonEmptyFilmProject&otherMedia
◦ workingonempty.org◦ Cross-platformmedia(videos,Mediumarticles,podcasts)
◦ 11minutevideoteaser◦ Featurelengthdocumentary(inprogress)
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SocialPlatforms
- Facebook- Twitter- Medium.com:“WorkingonEmpty: StoriesfromtheHealthy WorkCampaign"
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HWCGoal2:ASSESSwhetherworkishealthyornotbyidentifyingworkstressorsforindividualworkersandfororganizationsutilizingthe“HealthyWorkSurvey.”
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TheHealthyWorkSurveyØ PURPOSE:toeducateworkersandorganizationsbyidentifyingworkstressorsusingastandardized,validatedonlinesurveyà intendedtosupportworkplacechange.
Ø CurrentlyindevelopmentbytheCenterforSocialEpidemiologyandpartners,Dr.BongKyooChoi(COEH,UniversityofCalifornia,Irvine),Dr.PaulLandsbergis(SchoolofPublicHealth,SUNYDownstate)
Ø Collectinginternationalexamplesofnationalworkplacesurveysà oftenpartofnationalsurveillancesystems/regulationsin:Columbia,Mexico,Taiwan,Korea,Japan(StressCheck),Europeancountries(COPSOQ),Canada(stressassess.ca)àfuturepublication:
vInternationalcomparisonofnationalworkorganizationalriskassessmenttoolsinsevencountries(UnitedKingdom,Canada,SouthKorea,Spain,Mexico,Colombia,andChile)ChoiB,Garcia-RivasJ,LandsbergisP,DobsonM,SchnallP,BakerD,ChangSJ,KoSB,Juarez-GarciaA,Gomez-OrtizV(CollaborationwiththeICOH-WOPSscientificcommittee)PresentedatAdvancesinTWHSymposium,May2018
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StressAssessØCanadianOccupationalHealthClinicsforOntarioWorkers(OHCOW)developedanonlinesurveytoolforindividualsandorganizationsbasedontheCOPSOQØMeasures:demands,control,support,jobinsecurity,work-lifeetc.ØCurrentlyscoresarebeingcomparedtoaDanishpopulation,butcolleaguesaredevelopingaCanadiannationallyrepresentativedataset.ØWewillusethisonourHWCwebsiteuntilaU.S.basedonlinesurveyisdeveloped.
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www.Stressassess.ca
Creatingashort,validquestionnaireforworkorganizationriskassessmentforUSworkers…
� BasedontheNIOSHQWLquestionnairehttps://www.cdc.gov/niosh/topics/stress/qwlquest.htmloEnablingcomparisontonationalstatisticso63itemsfor34scalesaboutjob-levelandorganizationallevelworkingconditions,includingmajorworkstressors(demands,control,support,work-lifeetc.)
� Basedoncommon,coreandvalidQWLquestionso IdentifyingcommoncoreQWLitemsthathavebeenusedacrossallormostGSS-QWL
surveys(2002,2006,2010,2014,and2018)o TestingthevalidityofthecommoncoreQWLitems/scales(constructvalidity,
predictivevalidity,andDIF/DEFanalyses)
� Addingmorekeyitemsformissingdomains� Ashorterquestionnaire:≤35itemsoAcceptabletomanyTWH-basedprojects/businessesoAcceptabletoseveralnationalsurveys,includingNHIS
HWCGoal3:EQUIPAmericanworkersandorganizationswithtools,sothatindividuallyandcollectively,peoplecanbringaboutpositivechangestotheorganizationandcultureofworkinAmerica.
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TheHealthyWorktoolkitPurpose:Todisseminateevidenced-basedinterventionresearchandcaseexamplestoorganizations/individualswhocompletetheHWSorwhoareinterestedinworkorganizationchange.
o ORGANIZATIONS- Onlinetoolkitforbusinesses,unions/workerorganizationsandothersincludingevidenced-basedstrategiesandprograms thatpromotehealthywork,reduceworkstressorstoimprovehealthandproductivity.
oINDIVIDUALS- Onlinetoolkitforworkingpeoplewhichincludes:someresourcesrelatedtomanagingworkstress,butALSOex.ofcollectiveways workergroups(collectives,unions,employeeownedbusinesses)havechallengedstressfulandtoxicworkenvironmentsExamples:
o NationalDomesticWorkersAllianceo WorkersLab– RestaurantWorkersOpportunitiesCentersUnitedo Fightfor$15o UnitedStatesFederationofWorkerCooperativeso WorkplaceBullyingInstituteo AFL-CIO
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HealthyWorktoolkitcont.oHWCToolspageswillincludelinks/summariestovaryingexamplesofsuccessful“interventions”byworkstressorscategories:Improving:
ØWorkload/demandsØEmployeeparticipation/jobcontrolØWork-lifebalanceØSupport/leadershipØJustice/respectanddignity/workclimateØLongworkhours/scheduleØShiftworkØPrecariouswork
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HealthyWorktoolkitcont…CURRENTLY- Usingadatabase tocollect:1. Bestpracticesinprocess-orientedtools(e.g.NIOSHTWH/CPHNEW“Healthy
WorkplaceParticipatoryProgram– providingorganizationslinks,ILOsStressPreventionChecklist)
2. Evidenced-basedinterventionstudies -effectivelyreducedworkstressors,improvedworkorgandhealth.
3. Caseex.ofworkers/NGOs organizingtoimprovework(e.g.reducingon-call-scheduling,collectivebargainingworkloadreductions)
4. Stateandnationallegislativeex - promotehealthywork(e.g.nurse-patientstaffratios,anti-bullyingbills)
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HWCGoal4:AdvocateProvideallstakeholderswithopportunitiestosupportortakeactiontopromotehealthyworkforall.
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AdvocateforHealthyWork Agenda for Healthy Work in America
Ø Spreadthemessagethatifwewanthealthypeople,weneedhealthywork.
Ø Changethecultureofwork inAmerica.
Ø Changetheorganizationofwork inAmerica.
Ø StrengthenAmericanworkers’voice&laborpowertocreatehealthywork.
Ø Supporttheenforcementofexistinghealthandsafetyregulationsandanexpansiontoinclude“healthywork”guidelines.
1. “HealthyWorkAgenda”– outlinesactionstepsforindividualsororganizationstopromote“healthywork”à
2. “ShareYourStory”form– allowsworkingpeopletowriteabouttheir(un)healthyworkexperiences.
3. “JointheMovement”– andreceiveournewsletter.
4. “BecomeaPartner”– allowsorganizationsandotherinterestedgroupstojointhe#healthyworkmovementinvariouscapacities.
5. Buildsupportfordeveloping“HealthyWork/WorkStressPrevention”guidelinesfortheU.S.
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TheHWCTeamPeterSchnallMD,MPH – HWCExecutiveDirector
MarnieDobsonZimmerman,PhD - HWCCo-ExecutiveDirector (Research)
PaulLandsbergis,PhD,MPH- HWCResearchAssociate,PIHealthyWorkSolutionsToolkit
BongKyooChoi,Sc.D.,MPH– HWCResearchAssociate,PIHealthyWorkSurveydevelopment
EllenRosskam,PhD,MPH - HWCResearchAssociate
CassBen-Levi,MA – HWCDevelopment/GrantWriter&ContinuingEducationConsultant
DonaldGoldmacher, MD - HWCSupervisingMediaProducer
MariaDoctor,BA - HWCManager&MediaAssociateProducer
IndigoImpact - HWCImpactManager– campaignstrategy,engagement,audiencebuilding,andoutreach
AmyTurner – HWCWebsiteandOnlineToolsDesigneranddeveloper
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WorkingonEmptyINTRODUCTIONTOTHEWOEVIDEOTEASER
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Discussion1. WhatwerethemostcompellingpartsoftheWorkingonEmpty
teaser?2. Whatareascouldbeemphasizedfurtherinafeature-length
documentaryfilm?3. HowcouldyouusetheHWCincludingtheWOEfilmasaresource
foryou,yourworkplaceororganization?
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WHATYOUCANDOTOHELP?1.SUBSCRIBE toournewsletter.https://goo.gl/forms/uwuJM81P0aRMcYSO2
2.FOLLOWUS onsocialmedia.Facebook:workingonemptyTwitter:@workingonempty #healthyworkMedium.com: @workingonempty
3.SHAREYOURSTORY:Useour"ShareYourStory"formorshareitwithfriends&colleaguesforwork-relatedstories.https://goo.gl/forms/ggV77cMhj5peivy12
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Thankyouforyourtime.
Nowit'stimefor#healthywork!
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