Making the Case for Integrated Health and Safety

Uniting the traditionally separate functions of occupational safety and health, health promotion, and even health benefits management has always made good sense for employee and employer alike, but now there is an even greater sense of urgency than ever before. A unique confluence of social, economic and demographic forces is acting on the working population of the U.S. making this transition towards an integrated safety and health even more of an imperative at this time.

According to Mercer’s National Survey of Employer-Sponsored Health Plans, the cost of employer provided health benefit plans has increased every year since 1997, and the projected rate of increase over the next few years appears to be rising.  The U.S. workforce is aging; According to the Bureau of Labor Statistics the 55-years-and-older age group is expected to increase from 21.7% of the labor force in 2014 to nearly 25% in 2024. On top of these disconcerting trends the generally poor baseline health condition of our adult population is expected to continue into the foreseeable future.  All this point towards increasing health related costs, and these health related costs are increasingly being borne by the employer in terms of both direct healthcare costs and indirect productivity loss costs.  However, it is the indirect costs that are of the greatest concern.  One study calculates that on average for every $1.00 employers spend on healthcare for sick or injured employees, they pay $2.30 in indirect costs mostly in the form of employee absenteeism and productivity loss for those that remain at work in their degraded condition.

At the same time we have been experiencing the rising cases and costs of ill-health, as a nation we have been maintaining stagnant workplace injury rates. According to BLS data between 2011 and 2014 the DART rate has dropped a mere 0.1 per 100 FTE, and the DAFW rate has remained unchanged.  These two facts are not isolated.  There is growing evidence that both the frequency and the severity of injuries (e.g., duration of recovery, likelihood of full recovery, and chances of medical complications) increase as the number of health risks of the injured employee increases.  In one study involving a large U.S. based employer, the group of employees who had five or more health risk factors had a nearly 300% increase in Workers’ Compensation claims over those with two or fewer risks.  Those with three to four health risks had a nearly 150% increase over the low health risk group despite adjustment for demographic factors including gender, race, age, tenure, salary level, and employee job category. New approaches are needed to break through these stagnant injury rates and continue the progress we were making up until the early to mid-2000s, and integrating health and safety offers one promising tool to do so.

Integrated health and safety offers employers an opportunity to address the health risk factors affecting the health of their employees while improving their safety performance and productivity of their organizations. Despite these significant opportunities that integrated health and safety offers, there are existing impediments to the integration of these two historically separate functions. For the better part of the 20th century different professions have evolved independently of each other to manage occupational safety and health and employee health and wellness.  Separate governmental entities regulate employer activity in these two areas. Even our culture seems to favor a sharp divide between personal health and workplace safety. However successful integration of health protection and health promotion efforts can and does occur.  There are certain things organizational can do; practices they can institute that will enhance the process and outcome of integration.  With solid evidence on the influence of these practices on successful IH&S integration efforts organizations can be better prepared for health and safety integration efforts, and expect better outcomes from their integration efforts.

An integrative approach to the health and safety of your workforce is good for the employees and good for your bottom line. A convergence of social, economic and demographic forces in the U.S including sky rocketing cost of employer provided health benefit plans, an aging workforce, and demonstrable decline in baseline health among the U.S. population is making this transition towards an integrated safety and health even more imperative now.  However there are obstacles to the organization seeking to integrate these two historically separate functions.  To be successful, employers must overcome these natural barriers by implementing those practices known to facilitate integration efforts.

Eight practices exemplify successful integration efforts: 1) top management commitment to integrated health and safety, 2) a well written integrated health and safety policy, 3) integrated health and safety incorporated into larger business plans, 4) a sufficient budget for integration efforts, 5) one or more people in the organization with responsibility for integrated health and safety, 6) frequent communications about integrated health and safety, 7) use of multiple means of communicating information about integrated health and safety, and 8) Middle managers and First-Line Supervisors are committed to integrated health and safety.  Each of these eight factors can and should be adopted by an organization looking to integrated health and safety.

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