Integrated Health &

Safety Management:

Integrating Health Protection and

Health Promotion for Individual

and Organizational Wellbeing

E. Andrew Kapp, PhD, CSP, CHMM

Research Manager, Workplace Health and Safety

Underwriters Laboratories Inc.

2

Integrated Health and Safety (IHS) is the strategic

and systematic integration of distinct health and safety

programs and policies into a continuum of organizational,

personal, occupational, community and environmental

activities that are replicable, measurable, and integrated

across institutional silos, enhancing the overall health and

well-being of workers and their families and preventing

work-related injuries and illnesses

Definition of Integrated Health and Safety

Why integrate?

$.07

$685,000,000

1 Workplace Safety Index, Winter 2008, Liberty Mutual Research Institute for Safety

2NCCI Holdings, Inc. – Annual Issues Symposium 2008, “State of the Line”

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

$18,000

$20,000

1997 1998 1999 2000 2001 2002 2003 2004

Fre

qu

en

cy

Cla

im C

ost

s

Policy Year

WC Frequency and Severity Trends

Indemnity Severity

Medical Severity

Frequency per 100K Workers

Claims Frequency and Severity

• Medical severity rose more than twice as fast as the

medical CPI from 1995 through 2007 (8.3% vs. 4%)1

• Recent Indemnity severity trends exceed wage inflation

• Medical claim costs have increased 9+% since 20022

U.S. Workforce is Aging

Median Days Away From Work Due to Injury,

by Age Group

$0

$3,000

$6,000

$9,000

$12,000

19-34 35-44 45-54 55-64 65-74 75+

$1,776

$2,193 $2,740

$3,734 $4,613

$5,756 $2,565 $3,353

$4,620

$6,625

$7,989

$8,927 $5,114

$5,710

$7,991

$10,785

$11,909 $11,965

Annual Medical Costs

Age Range

Low

Med Risk

High

Healthcare Costs: Effects of Age

Edington DW. Zero Trends: Health As a Serious Economic Strategy. Health Management Research Center, University of Michigan. 2009. Edington, American Journal of Health Promotion. 15(5):341-349, 2001

But retirement will

take care of the

aging workforce

“problem”, right?

15

16

17

18

19

20

$0

$3,000

$6,000

$9,000

$12,000

19-34 35-44 45-54 55-64 65-74 75+

$1,776

$2,193 $2,740

$3,734 $4,613

$5,756 $2,565 $3,353

$4,620

$6,625

$7,989

$8,927 $5,114

$5,710

$7,991

$10,785

$11,909 $11,965

Annual Medical Costs

Age Range

Low

Med Risk

High

Healthcare Costs: Effects of Age and Health Risk

Edington DW. Zero Trends: Health As a Serious Economic Strategy. Health Management Research Center, University of Michigan. 2009. Edington, American Journal of Health Promotion. 15(5):341-349, 2001

Estimated Health Risks of Working Population

Body Weight

Stress

Safety Belt Usage

Physical Activity

Blood Pressure

Life Satisfaction

Smoking

Perception of Health

Illness Days

Existing Medical

Problem

Cholesterol

Alcohol

Zero Risk

41.8%

31.8%

28.6%

23.3%

22.8%

22.4%

14.4%

13.7%

10.9%

9.2%

8.3%

2.9%

14.0%

22

Overall Risk Levels

Low Risk 55.3%

Medium Risk 27.7%

High Risk 17.0%

$90,000

Healthcare Costs

Productivity Loss

$1.00

$2.30

25

Non-Fatal Occupational Injury and Illness

Rates per 100 FTE

26

Fatal Work Injuries per 100,00 FTE

27

Increases in Frequency and Severity of Injuries

Associated with Poor Baseline Health

• Numerous studies have shown an increased

likelihood of workplace injuries and illnesses for

those with poor baseline health

• Not just strain/sprains and WRMSD

• Even greater research on increased severity (i.e.,

increased duration of recovery, increased

cost/healthcare utilization, decreased likelihood of

full recovery, increased risk of complications)

28

30

Opportunities

70 % of illness is lifestyle related and thus

may be preventable

Mayo Clinic (2003), Direct and Indirect Benefits of Health Promotion

Programs

Integrating Health and Safety

Health

Focus today is how to best integrate health and safety programs to achieve optimal benefits

Safety

3 Logics of Integration

1. Avoid Gaps

2. Avoid Duplication of

Efforts

3. Avoid Sub-

Optimization/Risk

Shifting

35

20000

18000

16000

14000

12000

10000

8000

6000

4000

2000

0

Do

lla

rs

Publicly Traded CHAA Employers vs. S&P 500

$17,569.21

$9,923.14

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Portfolio Worth (6/30) S&P 500

Study Linking Worker Health with the Market Performance

Fabius R, et al. The link between workforce health and safety and the health of the bottom line:

Tracking market performance of companies that nurture a “culture of health.” J Occup Environ Med. 2013;55(9):993-1000.

VOI Study Linking Worker Health with the Market

Performance

Taking Integration to the Next Level:

The Integrated Health & Safety Summit

Gaining traction among thought leaders

Journal for Occupational and Environmental

Medicine

The Process

Plan Rationale & Motivation

Integrating Health &

Safety for Operational Excellence

Monitor & Evaluate

Plan

Review & Adjust Plan

Assess & Evaluate Current

Standings

Implement Plan

A New Integrated Health & Safety Index

aligned with the Dow Jones Sustainability Index

Dow Jones

Sustainability

Indices

Integrated

Health

& Safety

Index

Leadership & Management

Healthcare Cost, Absence &

Disability Management

Integrated Health & Productivity

Culture of Health & Safety

Healthy & Safe Environment

Healthy & Safe Workers

Prevention & Wellness

Value Based Benefits Management

Corporate Social Responsibility

impacting Community Health

Economic

Environmental

Social

Loeppke, R; Hohn, T; et.al. “Integrating Health and Safety in the Workplace: How Closely Aligning Health and Safety Strategies

can Yield Measureable Benefits.” Journal of Occupational & Environmental Medicine 2015: 57 (5): 585-597. May, 2015.

Integrated Health & Safety

1. Create an overarching management structure

2. Use a holistic approach

3. Make a commitment

4. Present the business case

5. Prepare for new education for business

professionals

6. Get everyone involved

7. Nurture a culture of health & safety

Roundtable Outcomes – The Non Negotiable

Standard

UL904Z:

Integrated Health

and Safety in the

Workplace

http://www.comm-2000.com/

UL-ASSE Integrated Health and Safety

Program Survey

23%

12%

19%

7% 2%

37%

Manufacturing

Oil & Gas

Services

Public Sector

Other

Not Specified

26 69 49 45

283

< 50 50 - 249

250 - 499

500 - 999

1,000+

• 472 ASSE members

surveyed

• Regression analysis

• Investigating the

influence of

organizational

structure, leadership

and communications

• On the perception of

degree of integration of

health and safety

Company Size

10 Factors Supporting Integrated Health and

Safety Management

1. Written policy

2. Incorporation into larger business plans

3. A discrete budget

4. Multiple ways of communicating

5. Frequent communications

6. All stakeholders coordinated in the implementation

7. At least one person

with responsibility

8. Senior management is

commitment

9. Mid-level managers

and supervisors are

committed

10. Mid-level managers

and supervisors

accept their

responsibilities

Organizational Structures: Policy & Budget

ß = .63, R2 =.39

p < .001 ß = .58, R2 =.30

p < .001

Policy Budget

Organizational Structures: Champion in Place &

Part of Larger Business Plan

ß = .67, R2 =.41

p < .001

ß = .48, R2 =.22

p < .001

Part of Larger Plan Champion

Leadership: Senior Management Commitment

ß = .65, R2 =.37

p < .001

Senior

Management

Commitment

Communications: Methods & Frequency

ß = .68, R2 =.42

p < .001

ß = .70, R2 =.39

p < .001

Multiple Means of

Communication

Frequent

Communications

Stakeholder Engagement

ß = .60, R2 =.33

p < .001

Stakeholder

Engagement

UL-ASSE Integrated Health and Safety Program

Survey - Key Takeaways

• Begins with senior management commitment

• A well written policy

• IHS is incorporated into larger business plans

• Frequent and diverse communications with

stakeholders throughout design and

implementation

Success Stories

Dow Chemical Priorities:

For Integrating Health and Safety

• Health as a Business Performance Driver and Manage Costs

• Safety

• Reliability

• Human Capital Priorities

• Engagement

• Talent: Attract and Retain

• Human Performance

• Sustainability

• Corporate Social Responsibility

• Corporate Reputation

58

Source: Dr. Cathy Baase

Corporate Medical Director, Dow Chemical

Target Behaviors and Risks that Impact

Health, Safety and Performance

59

Source: 2010 World Economic Forum

8 risks

and

behaviors

drive 15 chronic conditions

Accounting

for

80%

of total costs

for all chronic

illnesses

worldwide

Companies that target 3 major modifiable risk factors can save an average of

$700/employee/year in health care costs and productivity improvements.

1. Diabetes 2. Coronary artery disease 3. Hypertension 4. Back pain 5. Obesity 6. Cancer 7. Asthma

8. Arthritis 9. Allergies 10. Sinusitis 11. Depression 12. Heart failure 13. Pulmonary disease 14. Kidney disease 15. High cholesterol

Source: Dr. Cathy Baase

Corporate Medical Director, Dow Chemical

Dow Outcomes from Integrated Health & Safety Strategies

Health

• 9% better health risk profile

• 17% less chronic health conditions

• 17% less spend on chronic health conditions

Safety

• Dow workers are 20 times less likely to experience injury and illness when

compared to overall U.S. manufacturing injury and illness rate.

• In 2011, the Dow Injury and Illness rate was 0.28 per 200,000 hours of work.

• The 2015 Goal of 0.12 per 200,000 hours (75% improvement from 2005 rate).

Economic

• 5 + year healthcare cost trend is < 2%

• Cumulative savings since 2004 is > $150MM

Source: Dr. Cathy Baase

Corporate Medical Director, Dow Chemical

$

Health

Work Safety