graphical header showing various types of workers

Enterprise Outcomes: Making the case for Total Worker Health for the low-wage workforce

The 3.5 million workers in the U.S. nursing home industry are at exceptionally high risk for chronic disease and occupational injury. The industry merits a high-priority focus because it disproportionately employs groups identified by NIOSH as at-risk for occupational health disparities: 49% of the workforce are underrepresented minorities, while 70% earn low wages.

PI: Jessica Williams, PhD

The degree to which the nursing home industry's existing programs, policies, and practices align with the Total Worker Health® approach is unknown. Yet, it’s important to understand if this approach is associated with a reduction in occupational injuries as well as improvements in patient outcomes. Our goal is to protect and promote the safety and health of low-wage workers in the nursing home industry and any other sectors that employ disproportionate numbers of low-wage workers.

In the fall of 2017, we started a small-scale, 36-month study. We’re using the Center's Workplace Integrated Safety and Health (WISH) survey tool to evaluate how well existing programs, policies, and practices in about 500 nursing homes reflect Total Worker Health® approaches. 

This project aims to:

  • Describe the degree to which nursing homes implement TWH approaches, as reflected in their scores on the WISH survey tool
  • Determine whether ownership and features of occupational health programs are associated with WISH survey scores
  • Determine associations between nursing home use of an integrated approach and annual rates of occupational injury and indicators of patient care quality