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Total Worker Health

By Tabitha Mishra
Last updated: February 10, 2024

What Does Total Worker Health Mean?

Total Worker Health (TWH) is an initiative by the National Institute for Occupational Safety and Health (NIOSH) that aims to promote the safety, health, and overall wellbeing of workers.

TWH takes a holistic approach to worker wellbeing that is concerned not only with safety and health at work, but also how workplace safety can impact families and communities.

Safeopedia Explains Total Worker Health

The CDC defines Total Worker Health as “policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness-prevention efforts to advance worker wellbeing.”

TWH goes beyond the traditional scope of workplace health and safety by treating a safe working environment as a social determinant of health.

Hierarchy of Controls for TWH

The Hierarchy of Controls for TWH is similar to the Hierarchy of Hazard Controls used in occupational health and safety, but it is modified and expanded to include programs and strategies aimed at advancing well-being:

  1. Eliminate: Eliminate working conditions that have a negative impact on worker wellbeing, including harmful supervisory practices
  2. Substitute: Replace or substitute work practices or conditions with better programs, policies, and management practices that will improve the work culture
  3. Redesign: Modify the work environment to improve the health, safety, and wellbeing of workers (e.g. providing flexible work schedules and employer-sponsored benefits)
  4. Educate: Provide training and other resources to enhance workers’ knowledge of health and safety, including policies, regulations, and benefits
  5. Encourage: Provide support and encourage changes in personal behavior that would improve well-being

Key Elements of TWH

There are five defining elements of Total Worker Health:

  • An organizational leadership that demonstrates (through words and action) a commitment to workplace health and safety
  • An adherence to the Hierarchy of Controls to reduce workplace hazards, improve worker comfort, and meet the health needs of employees
  • The involvement of workers in the design and implementation of the program to ensure the identification of issues they face
  • A system to ensure that health and safety data on workers remains confidential, private, and only accessible to authorized personnel
  • Regular assessments of workplace systems to identify gaps, overlaps, and highlight opportunities for improvement

NIOSH Centers of Excellence for TWH

NIOSH provides funding to ten Centers of Excellence for research on Total Worker Health.

These centers conduct research and build a scientific base of evidence on worker health, safety, and wellbeing. The centers also use multidisciplinary research projects to determine which solutions are most effective.

Ready to learn more? Check out our free webinar: 5 Steps for Implementing Leading Indicators in Construction Safety!

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