How COVID-19 Has Changed the Standards of Worker Safety and Health — and How Organizations Can Adapt

Two warehouse workers wearing a mask and hardhat. The female is in the foreground pointing to the left and the male is in the background operating a vehicle.
The COVID-19 pandemic has uprooted existing assumptions about worker safety, health, and well-being – while highlighting benefits and work environment issues. Organizations that effectively implement Total Worker Health are more resilient and have a healthier workforce.

Ensuring health and safety in the workplace is already a critically important issue; organizations that invest in occupational safety perform better, reduce turnover, and help workers do their jobs more effectively. But COVID-19 has forced companies to act quickly and decisively to keep workers safe. As employers endeavor to slow the spread of the virus while keeping a supportive and productive work environment, they’ve had to adapt new business processes and address existing structures that are lacking.

“COVID-19 has stressed the system. All the flaws that have been in place are totally exposed and have come to the forefront of our daily conversations,” says Jack Dennerlein, adjunct professor of ergonomics and safety in the Department of Environmental Health and co-director of Work Health and Well-being: Achieving Worker Health at the Harvard T.H. Chan School of Public Health. From distancing procedures to the availability of remote work, the pandemic has metaphorically ripped off the mask covering the flaws in organizations’ working conditions. How has COVID-19 changed the standards of worker safety and health, and how can employers adapt to these changes?

Total Worker Health and Its Impact in the Workplace

Total Worker Health (TWH) aims to address, reactively and proactively, the challenges of worker safety, health, and well-being. At its core, it measures and assesses what a worker experiences, collects data to understand what to change, provides approaches on how to modify an environment, and encourages collaboration across traditional organizational boundaries to ensure a safe workplace. It’s both an acknowledgement of workers’ existing health, and initiatives to keep them healthy.

“These two general fields — protecting and promoting health — work together in a single workplace. It makes sense to think about this as an integrated effort instead of two siloed efforts that act in parallel,” says Nico Pronk, adjunct professor of social and behavioral sciences, president of the HealthPartners Institute, chief science officer at HealthPartners, Inc., and co-director of Work Health and Well-being: Achieving Worker Health.

As an example, he explains, “If you have diabetes, your eyesight might be diminished, and you might end up with an injury because your work is putting you at risk.” Critically, though, TWH focuses more on an organization’s framework rather than solely on an individual: “the conditions of work rather than on the behaviors of the work. You set the environment — physical, social, economic — which shapes how the workplace is organized. Within that, these factors start to drive the behavior of the individuals within it.”

COVID-19 has fundamentally uprooted assumptions about worker safety, health, and well-being and been an accelerant of addressing these issues. The pandemic has also highlighted classic social issues that workers face, like childcare, sick leave, and disability issues, and underlined safety concerns in health care environments where professionals need to treat patients. The absence of TWH — where workers don’t feel safe in their workplace — is also much more visible. Implementing TWH effectively helps make organizations more resilient during this time.

Even though COVID-19 can be used as a leverage point, Dennerlein notes, “We should be doing it for the good of the people, not just because of COVID-19. If we want this country to be productive, we have to invest in the health and safety of our workforce.” Adds Pronk, “What if you didn’t get sick? What if you didn’t get injured? The benefits come back in spades. You cannot be successful if you don’t have healthy workers, but that recognition is still hardly there.”

“Protecting and promoting health work together in a single workplace. It makes sense to think about this as an integrated effort instead of two siloed efforts that act in parallel.”

Applying and Adapting Total Worker Health During the COVID-19 Pandemic

While the values of TWH may not change, the implementation has evolved to protect workers against COVID-19. In a paper titled “An Integrative Total Worker Health Framework for Keeping Workers Safe and Healthy During the COVID-19 Pandemic,” Dennerlein, Erika Sabbath, Susan Peters, and Glorian Sorensen outlined six key characteristics that are essential for applying TWH in this context:

  • Focusing on working conditions for infection control and supportive environments for increased psychological demands
  • Utilizing participatory approaches involving workers in identifying daily challenges and unique solutions
  • Employing comprehensive and collaborative efforts to increase system efficiencies
  • Committing as leaders to supporting workers through action and communications
  • Adhering to ethical and legal standards
  • Using data to guide actions and evaluate progress

In this way, organizations can address the unique demands (including physical, ethical, and legal) of counteracting COVID-19 alongside the needs of workers to complete their tasks in a safe space, while using data and feedback to make changes.

According to the researchers, the most challenging aspect of using a TWH framework is getting top-level support. “Overall organization engagement towards this shared vision of a goal is critical — some key performance indicator for the institution has to include TWH or recognizing its impact. You have to think about that at the systems level,” says Dennerlein.

“If we want this country to be productive, we have to invest in the health and safety of our workforce.”

The Practical Implications of Implementing Total Worker Health in a Pandemic

The researchers have worked with companies to take these theoretical constructs and translate them to practical insights in the workplace. “It took companies as much as six months to learn how to bring health and safety together. Health is in HR, safety is in Operations, and the two don’t usually interact,” Pronk says. Not rushing the organizations and giving them up to a year to develop an implementation plan was key.

After buy-in from leadership, the next step is to test these six characteristics using data and feedback. Previous studies show that program design principles or characteristics are correlated with good health outcomes. “The business units that scored the highest had the lowest number of health risks in their populations. The more they followed these characteristics, the healthier their group was,” Pronk says. Following implementation, organizations would then be able to make changes and use a team-based approach to maintain awareness and continue to evaluate efficacy.

Thus, TWH can be effective, and not just in the short-term. Even after COVID-19 is no longer an immediate threat, the challenges of worker health and safety remain. “What are we doing to create a more resilient workforce? When we start thinking about the work of the future, workers are going to have to continually reinvent themselves, because work is constantly changing. COVID-19 was a big slap in the face for that. How do we all adapt?” says Dennerlein.

“We rely on the human element in the workforce so much because humans are problem-solvers. TWH tries to broaden that and realize what a great resource we have here. Why aren’t we using that element better? Why aren’t we weaving it more effectively into our organizations to help them make better decisions to affect the bottom line?”

Harvard T.H. Chan School of Public Health offers Work Health and Well-being: Achieving Worker Health, which provides the full set of skills needed to improve worker health, safety, and well-being in the workplace .