Healthy Workplaces: a Global Model and Guidelines for Action

HP Live – September 24, 2010

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Life Expectancy at Birth (2007)

Global Risk Factors

3 - poor diet, physical inactivity, tobacco use

FOUR - heart disease, type 2 diabetes, lung

disease and some cancers

50 - per cent of deaths in the world

www.3four50.com

The Future Workforce...

• Older

• With more long term conditions or „lifestyle‟ conditions

• Caring for others

• Obese with diabetes and/or heart problems

• In the kind of jobs more likely to have an impact on psychological health

• Working in knowledge-intensive or service industries

Source: „The future health of the workforce: 2009 to 2030“

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Top Employer Objectives Driving Wellness Initiatives

Africa/ Mid East Asia Australia Canada Europe

Latin America

United States

Improve productivity/presenteeism 2 4 1 1 1 2

Improve morale/engagement 1 2 2 3 2 2 4

Reduce employee absence 5 3 3 2 4 7 3

Improve workplace safety 2

5

1 6 6 3 6

Maintain work ability 4 7 5 4 5 4 7

Further org. values/mission 5 4 8 7 3 5 5

Attract and retain employees 8 8 7 8 7 8 8

Promote corporate image/brand 7 7 6 9 10 10 9

Reduce health care/ins. costs 11 11 10 5 11 11 1

Social/community responsibility 9 9 9 10 9 6 10

Comply with legislation 9 10 11 11 8 9 11

Supplement gov't health care 12 12 12 12 12 12 12

Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

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3

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6Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

Health Issues Driving Wellness StrategyAfrica/ Middle East Asia Australia Canada Europe

Latin America

United States

Stress 1 1 1 1 1 2 6

Physical activity/exercise 4 3 3 3 2 1 1

Nutrition/healthy eating 4 7 1 5 5 3 2

Work/life issues 4 2 3 2 3 12 10

High blood pressure 4 10 10 8 10 4 5

Chronic disease 2 9 9 7 13 5 3

Workplace safety 9 4 6 6 4 6 11

Depression/anxiety 8 13 7 4 7 9 9

High cholesterol (hyperlipidemia) 12 11 11 9 12 7 7

Tobacco use/smoking 11 5 13 11 8 10 8

Psychosocial work environment 10 8 14 12 6 8 15

Obesity 15 15 8 14 14 11 4

Sleep/fatigue 16 12 5 9 11 14 14

Personal safety 13 6 12 13 9 13 13

Infectious diseases/AIDS/HIV 3 17 16 17 18 16 17

Maternity/newborn health 18 14 18 16 16 15 12

Substance abuse 14 18 15 15 15 18 16

Public sanitation 17 16 17 18 17 17 18

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Number of Suicidal Deaths in

Japan

Europe

• 11% estimated to have a mental disorder

• Stress-related conditions are the second

most reported work-related health problem,

affecting 22% of workers from EU 27 (2005)

• In 2007, productivity-related costs of mental

health disorders in the EU-25 was estimated

at 136 billion Euros.

Sources:

European Pact for Mental Health and Well-Being, Eur J of Neurology, 2005,

European Agency for Safety and Health at Work

Italian Legislation

• Legislative Decree no. 81/08 (106/09)

• in accordance with the European Agreement of

8 October 2004

• Stress risk evaluation is mandatory as of Dec.31

• Dynamic process: should be repeated if e.g.,

changes during the manufacturing process or

the organization of work relevant for health and

safety of workers occur

• Implications: employers now taking note and

implementing assessment systems

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World Health Organisation

• Directs and coordinates authority for health within the

United Nations system since 1948

• Provides leadership on global health matters

• Sets norms and standards

• Provides technical support to countries

• Shapes the health research agenda

• Articulates evidence-based policy options

• Monitors and assesses health trends

• headquartered in Geneva

Workplace Health Timeline

Key Conventions/Declarations:

1950 Joint Committee on Occupational Health

(WHO/ILO)

1981 ILO Convention 155

• Required member states to establish

national policies on health and safety.

1986 Ottawa Charter

1997 Luxemburg Declaration

2005 Charter for Health Promotion in a

Globalized World

• Health Promotion „requirement for good

corporate practice‟

2007 Global Plan of Action on Workers Health

• Milestone document which provides clear

objectives and priority area for action

2009 Healthy Workplace Framework Model

Timeline Of Global Workplace Health Evolution

Source: WHO Healthy Workplace Framework Model, 2010

Ottawa Charter on Health Promotion

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Basic Occupational Health Services

• Application of the primary health care

principles in the sector of occupational

health

• Occupational health services are available

to only 10-15% of workers worldwide

• Launched by ICOH

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Priorities of the Global Plan of Action on Workers’ Health

• To support workers health policies must be

developed and implemented at national and

enterprise level;

• Health must be protected and promoted in the

workplace

• Access to BOHS must be improved

• Evidence-based effective practices to improve

worker health must be communicated

• Worker health must be considered in the broader

context of education, trade, commerce, and

economic development.

46 member states

2000: Development Occupational

Health & Safety in Africa strategy

2005: Many African nations in the

process of formulating and

planning for national strategies

Priorities

- Physical work environment

- Traditional occupational health

and safety issues

AFRO: Regional Office For Africa (Brazzavile, Congo)

PAHO: Regional Office For the Americas (Washington DC, USA)

48 member states

Regional Plan on Workers Health :

• strengthen capabilities to anticipate, identify, evaluate and control or eliminate risks and dangers in the workplace

Priorities:

– Promote workers health legislation and

regulations

– Establish programmes to improve quality of

work environment

– Fostering programmes for health promotion

and disease prevention.

EMRO: Regional Office For The

Eastern Mediterranean (Cairo, Egypt)

21 member states

• Primary health care systems provide occupational health services

Priorities:

• physical work environment

• elimination and control of

physical health and safety

hazards

• gender issues

53 Member states

• Comprehensive, resource-rich and sophisticated, yet not unified workplace health network

• Various organisations focusing on variety of workplace health aspects

Priorities:

• physical, chemical, biological

ergonomic and mechanical risks

• psychosocial environment

• organizational culture

EURO: Regional Office For Europe (Copenhagen, Denmark)

11 member states

• Region with the highest regional burden of disease attributable to occupational risk factors.

Priorities:

• informal sector

• worker participation

• continual improvement process with

ongoing measurement and

evaluation

• need for corporate social investments

in the community

SEARO: Regional Office For South-East Asia (New Delhi, India)

27 Member state

• „Regional Guidelines for the Development of Healthy Workplaces‟ (1999)

Workplace health models are

based on following principles:

• Build on local practice

• use learning by doing

• encourage exchange of

experiences

WPRO: Regional Office For The Western Pacific (Manila, Philippines)

Why Develop a Healthy Workplace Framework?

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• It‟s the Right Thing to Do: Business Ethics

• It‟s the Smart Thing to Do: The Business

Case

• It‟s the Legal Thing to Do

• The Global Perspective

The Framework

Synthesis of best available knowledge and

experiences worldwide, as collected and

analyzed by occupational health experts in

diverse countries.

Lead: Occupational Health,

Interventions for Healthy Environments,

Department of Public Health and

Environment

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What is a Healthy Workplace?

based on WHO Health Promotion definition:

“A state of complete physical, mental and social well-being, and not merely the absence of disease.”

Proposed Definition

A healthy workplace is one in which workers

and managers collaborate to use a

continual improvement process to protect

and promote the helth, safetty and well-

being of the workers and the sustainability

of the workpalce by considering identified

needs’.

Work influences Physical Safety and Health

• Occupational diseases under reported and under

recognised

• 1.7 million people die per year from occupational

diseases (WHO)

• 160 million new cases of occupational disease

occur (WHO)

• MSDs: repetitive strain injuries + cumulative

trauma

Work Affects Mental Health and Well-Being

• Causation

– Work place factors may contribute to existing mental disorders

• Demand/Control and Effort/reward

• Work-family conflict

– E.g. role overload, caregiver strain, work-family interference

– Different type of conflict affect the two genders differently

• Job Insecurity

• Inclusive Work Culture

– Moral and job satisfaction leads to increased productivity

• Workplace Risk Factors for Mental disorders

The Positive Impact of Work on Health

Work is good for

physical and mental

health (in general):

• self-esteem

• companionship

• status

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Worker Health affects the Enterprise

Does ill health among employees affect the health,

effectiveness, productivity or competiveness of

an enterprise?

YES: difficult to recognize and quantify costs and

other effects on the enterprise

How Worker Health and The Community Are Interrelated

Clean water

Primary healthcare

Literacy rate

Natural disasters

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WHO Healthy Workplace Model

World Health Organization, Healthy Workplace Framework and Model, February 2010

Comprehensive model emphasises

four “Avenues of Influence”

Avenues of Influence for a Healthy Workplace

Physical Work Environment

• hazards: chemical, ergonomic, biological, driving, etc.

Psychosocial Work Environment

• hazards: poor work organization, organizational culture,

shift work issues, fear of job loss, etc.

Personal Health Resources

• hazards: physcial activity, poor diet, alcohol/drug abuse

Enterprise Community Environment

• hazards: poor air quality, polluted water, lack of literacy,

lack of access to primary health care, etc.

Evaluating Interventions

• Cochrane Collaboration“The Cochrane Collaboration is an enterprise that rivals the Human

Genome Project in its potential implications for modern medicine.”

(The Lancet)

• Non-Cochrane Criteria

• Grey Literature

• Precautionary Principle

• Evaluating the Cost-Effectiveness of

Interventions

Evidence for Interventions That Make Workplaces Healthier

Evidence for Effectiveness of:

• Occupational health and Safety Interventions

• Psychosocial/Organizational Culture

Interventions

• Health Promotion in the Workplace

• Community Participation

Keys to Success

• Leadership engagement

• Workers involvement

• Gap analysis

• Learn from others

• Sustainability

• Integration

The Process: How to Create a Healthy Workplace

Continual improvement

process:

= cycle based upon the

premise that in order to

always meet customer

needs you must

continuously improve.

Challenges

“For a small enterprise,

determining local good

practice is important.

Talking to local experts

or visiting enterprises

that have addressed

similar situations is a

good way to find out

what can be done and

get ideas on how to do

it.”37

Challenges

Developing healthy

work- places in

the informal

economic sector

is a global

challenge that

needs to be

faced.

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Questions on the WHO Healthy Workplace

Framework??

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International WHP Initiatives

• Inaugural URAC/GKEN International Health

Promotion Awards

• World Economic Forum Workplace Wellness

Initiative

• European Network for Workplace Health

Promotion (ENWHP)

• International Association for Worksite Health

Promotion (IAWHP)

• IDWellness

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The Luxembourg Declaration on WHP in the EU

„WHP is the combined efforts of employers, employees and society to improve the health and well-being of people at work.“

This can be achieved by a combination of the following:

•improving the work organisation and the working environment

•promoting active participation

•encouraging personal development

Source: BKK

Inaugural URAC/GKEN International Health Promotion Awards

1. International Community Health Awards

2. International Workplace Health Awards

www.aihpa.org

International Committee• advises the IAWHP on relevant programmatic

and cultural issues that extend beyond or

outside of the United States

• seeks to define the value for and role of

worksite health promotion globally

• lead the way as a facilitator of communication

relative to the integration of worksite health

promotion efforts among global and local in-

country companies

IAWHP International Plans

• Global Roundtable 2012

• International column in „Worksite Health“

• Global representation in membership and

committees

Your Thoughts

How can the WHO Global Guidance be

useful for employers, employees and

program providers?

- contents

- format

- distribution

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Thank you!

Questions?

Contact: wk@wolfkirsten.com Tel: 49-30-89202277

www.wolfkirsten.com