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Interview

Committed to Safety and Health
in the Workplace

ugaresearch editor Helen Fosgate talks with David DeJoy, professor of health promotion and behavior, about his research—and his commitment to the proposition that all working men and women deserve a workplace free from harm and supportive of good health.

Q: What is health promotion and behavior?

A: It’s the study of how to effectively prevent disease and injury while offering people the “tools” to help enhance and protect their health. Our departmental faculty deal with prevention, in its many guises, including illnesses, chronic conditions like obesity, unhealthy behaviors like smoking, injury and violence problems, and other health and safety issues.

Our current health care system is really a treatment system. Transforming it into a prevention system can provide enormous economic and health benefits, though realizing this goal will be difficult. To date, we certainly haven’t devoted anywhere near the resources or attention to the prevention approach that the treatment approach already enjoys.

Q: Why focus on the workplace?

A: Two reasons: Most people spend a majority of their waking hours at work, so their workplace environment can have both an immediate and long-lasting impact on their health. A second reason is that, for many of us, our current health insurance originates through our employer—so our prevention approaches need to be coupled with these employer-driven programs.

Occupational risks aren’t new issues. OSHA [the U.S. Occupational Safety and Health Administration] covers most workplaces, and employers have largely accepted its rules and requirements as a cost of doing business in the United States. What is changing is that more attention is being focused on the benefits of a healthful lifestyle to workers as well as employers.

Q: Fifteen years ago, you were one of the first scientists in the country to propose integrating health protection and health promotion in the workplace. Today your model is being widely adopted by American businesses and supported by the Centers for Disease Control and Prevention (CDC). Why is this a good idea, and how is it changing the workplace?

A: In the past, when I talked to those responsible for workplace safety, they didn’t want to hear about health promotion; on the other hand, those in health promotion didn’t want to hear about safety concerns. While responsibility for safety issues has historically rested with the company, responsibility for being healthy was viewed as the responsibility of the employees. Unions and other employee groups interpreted this as “victim-blaming,” and, in some ways, it was.

What became clear to me was that this separation was illogical, inefficient, and ultimately negative for all involved. It has taken a long time for the idea that “we’re all in this together” to catch on, and there is still some resistance. But things are changing. At the CDC, for example, there has been a shift in priorities so that integration is now finding its way into the funding equation. Last year, the CDC started three Centers of Excellence—one at the University of Iowa, a second at the University of Massachusetts, and a third at Harvard University—committed to bringing occupational safety and health programs together with health promotion. The graduates from these new programs will bring a more integrated perspective to the field.

Meanwhile, it’s getting easier to convince companies that integration makes sense economically, as well as from a safety and health standpoint.

Q: Some of your research addresses the costs of chronic health conditions, like obesity, in the workplace. Why are you looking at that, and what have you learned?

A: Some of the large, more progressive companies—Dow, Home Depot, and Pacific Union Railroad, for example—are beginning to measure the costs of obesity, diabetes, and other health conditions to their company—and to estimate the potential savings to be gained by reducing the prevalence of such problems among their employees. The relationship between lowering costs and helping their employees is clear to them.

Some companies are already offering exercise facilities, classes, and nutrition counseling, for example. All of these things help. But when it comes to obesity, they have to do more, including better understanding their own workplace environments. We have found, for instance, that some job and work environments actually promote obesity! We can say the same about school and community environments as well.

We assess the current workplace environment and then suggest some changes. These might include: offering more low-fat, healthful foods in the company cafeteria; including the nutrition and calorie content on food choices; changing foods in the company vending machines from high-fat, high-sugar items to more healthful snacks; introducing policies that only pay for healthful catered company lunches; posting signs that encourage employees to use the stairs rather than the elevators—including the number of calories they burn when they do. None of these things by themselves make a huge difference, but together they can result in substantial improvements in overall health.

We hope integrated programming will lead to a more coordinated and strategic approach to employee health and well-being. This will involve greater management engagement; better sharing of information and resources, and more sophisticated efforts to identify needs and monitor success.

Q: What’s next in your research?

A: I’ll continue to work for integration, knowing that it will come gradually. And I’ll continue to explore increased emphases on productivity and health outcomes, as they complement and support each other. We’re seeing that those who study safety risks, for example, should also look at obesity as a contributing factor; those who study productivity should examine the impacts of chronic health conditions.

Our reports now include a financial analysis that examines the costs of some common chronic health problems—such as depression, anxiety, back pain, carpal tunnel, arthritis, migraine headaches, and even allergies—all of which can lower the levels of employee productivity, as well as what is referred to as “presentism,” or being less than fully present, mentally or physically. By making thoughtful changes, employers can often improve the workplace conditions that cause or contribute to these problems. The benefits include increased productivity—and healthier, happier employees.

 

For more information contact David DeJoy at: dmdejoy@uga.edu