Total Worker Health Strategies for Age-Friendly Workspaces

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According to the U.S. Census Bureau’s 2017 National Population Projections, all baby boomers will be older than age 65 by the year 2030. That means that in a decade, one in every five residents will be retirement age. So, what does this important demographic turning point mean for workplaces? How can employers provide a safe and healthy work environment with training and protections against age discrimination? Those are just a couple of the key points your instructors will answer during PDC 110, which will establish a foundation in Total Worker Health®. TWH is a holistic approach to worker well-being; it recognizes work-related risk factors that affect health conditions as well as safety. 

We spoke with Chia-Chia Chang, who is the lead instructor for PDC 110: Total Worker Health® Maximizing Well-Being at this year’s AIHce EXP. Over her more than 18 years at the National Institute for Occupational Safety and Health, Chang has engaged with American Industrial Hygiene Association (AIHA) through its tremendous support of NIOSH’s research and programmatic activities. She’s also delivered presentations at regional AIHA conferences about TWH. 

AIHA: First, could you please tell us a little bit about yourself and your background? 

Chang: I am the coordinator for partnership and new opportunity development for the Office of Total Worker Health at NIOSH, Centers for Disease Control and Prevention. I lead initiatives to share promising practices for integrated approaches to advance worker safety, health, and well-being. I coordinate a project with RAND Corporation to conceptualize worker well-being. My previous duties in the NIOSH Office of the Director included leading enrollment and outreach for the World Trade Center Health Program and serving as assistant portfolio coordinator for emergency preparedness and response. 

I was a biology major at the University of Alabama at Birmingham and earned a Master in Public Health (MPH) in health behavior and health education at the University of Michigan and a Master of Business Administration from the University of Maryland. 

AIHA: TWH was developed by the NIOSH Office of Total Worker Health and the National Center for Productive Aging and Work. Could you tell more about it? 

Chang: TWH starts in 2003, originating from earlier initiatives called Steps to a Healthier U.S. Workforce Initiative and, later, the NIOSH WorkLife Initiative. In 2011, the effort was renamed Total Worker Health. Based on growing research findings and comments from stakeholders, the concept has evolved. The current definition of TWH refers to 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 well-being. A few years later, NIOSH established the National Center for Productive Aging and Work to advance lifelong well-being for workers of all ages and support productive aging across the working life. 

We apply the hierarchy of controls to TWH to prioritize system-level interventions rather than relying on individual behavior change. A core principle is that work is a social determinant of health. Policies and practices related to pay and compensation, hours of work, flexibility, autonomy, and relationships with coworkers and supervisors can all influence the well-being of workers, their families, and their communities. We believe there is opportunity to design healthy jobs so that work actually contributes to well-being. 

AIHA: What’s been the biggest shift in workplace health over the past decade? What kind of changes and challenges can we expect in the coming year? 

Chang: These are some of the changes and challenges facing worker health: 

  • The prevalence of chronic health conditions and the cost of health care continue to rise. As the life span increases, there are also increases in comorbidity — that is, having more than one chronic condition. Most chronic diseases are preventable, so there is hope. 
  • Since aging is a relevant process experienced by all workers throughout their life, it is important to understand how organizations are addressing the needs of an aging workforce and to identify interventions and strategies to support workers (of all age groups) and the organizations that employ them. 
  • Technology, automation, and robotics are becoming more and more prominent in jobs and work. What are the positive and negative consequences? How can organizations and workers better prepare and adjust to these changes? 
  • Contingent or precarious employment is becoming more prevalent. Again, this can be nice because it provides more flexibility, or it can be detrimental to health because it increases job insecurity and thus, job stress. We also know that contingent workers are more likely to be in more hazardous industries. How can we take advantage of the opportunities while mitigating the hazards? 
  • Given all these changes, protecting the psychological safety of workers is increasingly being recognized as a necessary priority. Perceptions of job insecurity due to automation or the temporary nature of new employment patterns can have a harmful effect on the mental health of workers, which is related to chronic health conditions. Providing autonomy, health-supportive policies and benefits, and healthy jobs are ways to contribute to worker and thus, organizational well-being. 

So, what will you walk away with at the end of this incredibly informative course with a brilliant instructors like Chang, Jim Grosch, Julian Scholl, and Constance Franklin, who are bringing decades of experience to the room?

Chang: From a TWH perspective, we want to provide industrial hygiene professionals with information that they can use to apply organizational-level strategies to meet the safety and health needs of the workforce. 

Specifically, regarding the aging workforce, we believe participants will be able to use the information from the workshop to apply the components of the work ability model, including setting goals for meeting the needs of aging workers and learning at least three strategies that can be incorporated into the workplace to create a more age-friendly environment.


Berrak Sarikaya is a natural conversation driver with an undeniable belief in the power of community. A proven content strategist and speaker, she resides in Seattle, WA. Follow her on Twitter.​

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