There are significant benefits of having healthier employees, both in savings in medical costs and related insurance premium reductions, and in productivity though better well-being and fewer sick days and time off.

Safety and Wellness: The Critical Connection

Because these two fields approach their objectives with different assumptions, priorities, and methods, coordination is not common.

There is a direct connection between safety and wellness, yet most companies treat these as separate initiatives and manage them in separate departments, using separate programs, budgets, measures, and reward systems. This is not an insignificant issue, because without properly connecting them under one integrated system, accidents, injuries, and lost productivity often result, as well as higher labor and insurance costs. In addition, in certain industries and jobs, product and service quality suffers and, in general, a drop in employee engagement can occur. The purpose of this article is to define this critical connection so that you will assess your company's safety and wellness programs, then redesign and modify them to be integrated as one system.

Safety Programs: Every company with employees who work in jobs requiring physical labor and/or in potentially hazardous conditions has safety programs to communicate, train, and, in some cases, reward employees for learning about and demonstrating safe behaviors, as well as for reducing lost-time accidents and other measureable results. Safety programs are mandated by OSHA and are usually managed by safety and/or risk management professionals who are empowered to compel employees to comply or face consequences. These programs are administered from a "top down" perspective, driven by government and company mandates.

Wellness Programs: Many companies offer wellness programs to promote healthy behaviors, such as eating better, exercising, seeing medical professionals, and acting on their advice to manage risk factors and treat diseases. These programs are not mandated by the government, but are highly recommended and promoted by health insurance companies as a way of reducing medical claims and in turn, reducing insurance costs for companies. The ideal result is that employers and employees will pay less for insurance premiums and that these costs won't keep escalating each year. Secondarily, employees who are healthy and feel well are more likely to be motivated and engaged on the job and take less time off as a result of sicknesses. Wellness programs are usually managed by HR professionals who encourage employees to participate. These programs are administered from a "bottom up" perspective, based on voluntary participation.

Safety and Wellness Research: NIOSH has prepared a Research Compendium: The NIOSH Total Worker Health™ Program: Seminal Research Papers 2012, which provides a thorough overview on the relationship between health promotion and safety. It can be accessed at www.cdc.gov/niosh/docs/2012-146/.

According to the research, there are many overlaps between worker safety and health promotion, especially for work that is strenuous and repetitive and for which being in good physical shape is essential. For example, obesity is one of the major contributors to back injuries because overweight people often have difficulty using good body mechanics when moving and lifting objects. There are also numerous links between workplace stress and work-related illness because stress contributes to high blood pressure, which can result in poor decision-making and increased errors. Inadequate sleep and fatigue also directly reduce concentration and the ability to work safety, even for employees in non-physical jobs.

Because these two fields approach their objectives with different assumptions, priorities, and methods, coordination is not common. According to the NIOSH research, one concern of occupational health and safety leaders is the perception that employers might be shifting the burden for health away from management to individual workers, thus focusing less on environmental and organizational causes of disease to individual risk-taking behaviors. For example, while many unions and workers recognize that smoking is a health threat, they might be mistrustful of work site health promotion programs that provide smoking cessation services but ignore workplace safety concerns.

According to Bill Sims Jr., president of The Bill Sims Company, a leading behavior-based wellness and safety incentives company, and author of a new book on employee recognition and behavior change called "Green Beans & Ice Cream: The Remarkable Power of Positive Reinforcement" (www.greenbeanbook.com), the links between safety and wellness are significant but are ignored by many companies. Sims has developed wellness incentive systems for companies such as Home Depot and AT&T. He explains that in most firms, safety and wellness are two behavioral silos that are largely disconnected. HR watches over the wellness effort, and safety watches over safety behaviors. One intersection few leaders realize is that off-the-job safety injuries can account for 20-25 percent of health care costs, but most wellness efforts don't address it.

Hinda's Linda Wodele, Client Solutions director, and Chuck Schwartz, regional manager, say few of the companies they work with tie together wellness and safety. Safety programs are specific to certain groups, while wellness involves all employees. And because the platforms tend to be separate and visually different, their recommendation is usually to "link" them rather than try to engage both audiences with the same portal.

Job Market Considerations
The NIOSH report documents several trends that are important and support the integration of wellness and safety programs, First, there has been a shift in the labor market from 1960 to 2003, with the proportion of workers in manufacturing jobs declining from 26.1 to 12.3 percent, agricultural jobs declining from 8.4 to 1.7 percent, and the service sector increasing from 58.1 to 78.3 percent. Many workers have also been affected by corporate restructuring, with Fortune 500 companies alone reducing their total workforce from 14.1 million employees to 11.6 million between 1983 and 1993.

With approximately 500,000 U.S. employees facing job layoffs each year, job insecurity can result in dissatisfaction, lack of engagement, poor health, and psychological distress. Another trend is the implementation of new systems of work organization, such as lean production, which can also increase employee stress and health risks. Also, surveys during the past 20 years have shown large increases in job demands and "time constraints." These trends point to the importance of understanding the influence of job insecurity and work organization on health behaviors and of addressing related stressors within integrated wellness and safety programs. Employers also have increased their reliance on part-time labor and "offshoring" in order to reduce costs and have greater flexibility to adjust to downturns in the business cycle.

Integrating Safety and Wellness Programs
The NIOSH report highlights many best practice examples of integrated programs, such as Johnson & Johnson's "Live for Life," which encompasses health promotion, occupational health and safety, employee assistance, disability management, and other benefits. Administrative systems were established to promote cross-utilization of resources rather than "silos of service." A financial impact study found that this effort resulted in a cost savings on employee health care and administrative costs of about $8.6 million per year. Other companies have similarly reported the benefits of worker health programs that integrated health promotion, occupational health and safety, and other benefits, including UAW-GM. Chevron, 3M, Glaxo Wellcome, and Citibank.

The important thing to recognize is that any and every organization that funds health care benefits also must carry worker's compensation insurance. So from an insurance cost perspective, the company is at risk of loss due to health- or safety-related issues 24/7, not only for the employee, but in most cases their family, as well. It behooves an employer to consider how to influence choices and ultimately individual behavior. Properly structured and implemented, these programs have a considerable return on investment, in addition to their engagement benefits.

One major point of difference between safety incentives and wellness programs is that most health promotion incentives are offered either in conjunction with local health care providers or the major medical insurance companies. Therefore, much of the promotion of the actual program is handled by organizations other than the employer, and some programs offer incentives for involvement in various activities, such taking a health assessment, walking five days a week, joining a health club and using it a set number of days each month, etc.

Safety and Wellness Incentives
Richard Pollock, CSP, president & CEO of CLMI Safety Training and ASSE past president for 2012/13, explains that in many cases, managing workplace safety and related worker's comp costs can be viewed as much easier to accomplish than gaining broad and effective employee participation in health promotion/wellness activities. Incentives of all kinds have been a part of involving and motivating employees to engage in safety for several decades, though in some cases misapplied when rewarding for no accidents or injuries. Safety incentive programs have seen varying degrees of success, mostly due to the overall quality and maturity of the underlying safety program. Now, we are seeing numerous incentive awards applied to health promotion, also with varying success.

He points out that another overlap that is often overlooked in these programs is driver safety and texting. Usually dealt with through organizational policies, communication strategies, and discipline, promoting safe driving behavior off the job can have an even greater impact. This can be a new frontier for the use of incentives. We now see auto insurance providers offering discounts to premiums when drivers install on-board computers that track driving behavior. Companies like those involved in the Direct Delivery industry are also using on-board telematics to monitor driving behavior. Unfortunately, most of the initiatives tied to these interventions are negative in nature. In most cases, only the driver finds out about bad driving behavior and is hardly ever recognized or rewarded for good driving (no hard stopping, fast starts, etc.).

Aon Hewitt, a human-resource company, surveyed nearly 800 large and mid-size U.S. employers representing more than 7 million employees and found that 83 percent offer workers incentives for participating in health-related programs -- 79 percent in the form of a reward, 5 percent in the form of consequences, and 16 percent using a mix of both rewards and consequences. Employee health actions may include taking a health risk questionnaire (HRQ) or participating in biometric screenings. Aon Hewitt suggests a growing number of employers are beginning to link incentives to sustainable actions and results, as opposed to having employees simply participate in a program. More than half of surveyed employers indicated they saw improved health behaviors and/or an increase in employee engagement after offering incentives for health actions. In addition, almost half said they believe there was a positive impact on employee morale, satisfaction, and/or attitudes, and 44 percent saw changes in health risks. Sixty-four percent of employers offer monetary incentives of between $50 and $500, while 18 percent offer monetary incentives of more than $500.

Aon Hewitt's survey also indicates a potential shift in how many employers are thinking about designing their incentive programs in the future, with 58 percent planning to impose consequences on participants who do not take appropriate actions for improving their health and 34 percent interested in tying incentives to program designs that require a focus on health 365 days a year.

Next Steps
Here are the steps needed to create an integrated wellness and safety system that will fit your organization and be most effective:

1. Assessment. First, assess your current programs to determine where they are working and where not, in accordance with industry standards and best practices. There are many tools available, such as HEcheck, which has been developed over 30 years by Tom Golaszewski and is in accordance with the 5 Pillars methodology developed by Dee Edington.

2. Program design. Then, use the data along with senior leadership and employee participant surveys to determine program improvements and ways to integrate them. The strategic plan that will result will be the roadmap to best streamline communications, plan the most appropriate rewards, recognition and software platform to manage the system, along with a consultant, if necessary.

3. Software platform. It is extremely important to select the best platform than can manage, administer, communicate, reward, and track the program. This is the central hub and when personal health information is shared, these programs are subject to HIPPA regulations.

4. Training. Prepare and train employees at every level about how to personally be involved in the new integrated safety and wellness initiative and to train and encourage others, especially their direct reports and teams.

5. Communications. Develop a plan for communicating the program all year long, with interactive tools to keep the program top of mind and continuously engage participants.

6. Incentives. Select incentives to fit employee demographics and psychographics. Consider offering a blended program that includes financial incentives for cost reduction results, such as reducing insurance premium costs (which is a "lagging indicator"), with tangible merchandise awards for participating and taking the stated actions for health and safety (which are "leading indicators" that will predict the future outcomes).

7. Recognition. Train and communicate to managers and all employees the importance of continuously recognizing others for participating and achieving results, with both day-to-day words and e-cards, which are often a part of vendor platforms and more formal recognition ceremonies. This cultural dynamic will encourage intrinsic motivation (the joy of participating and seeing results), which can lead to ongoing behavior change.

8. Analyze. Measure all aspects of the program on an ongoing basis to notice levels of engagement. Provide training remediation where necessary, promotional opportunities, and ways to evolve the program continuously to drive effectiveness and reduce costs, while delivering a return on investment.

This article originally appeared in the September 2013 issue of Occupational Health & Safety.

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