Our Vision

Our vision

Total Worker Health® is a program of the National Institute for Occupational Safety and Health (NIOSH) designed to guide research and public health practice on the interconnections between health and work. NIOSH states that “The long-term vision of the Total Worker Health (TWH) program is to protect the safety and health of workers and advance their well-being by creating safer and healthier work.”1 Such a vision aligns with what the public health community refers to as primary prevention, which means preventing a disease or injury before it happens.  

This is done through two strategies.

  1. Health protection, which means safeguarding health status from specific risks (e.g., a chemical in the workplace), usually through laws, enforcement, and monitoring that can eliminate or mitigate that health risk and prevent disease or injury. 

  2. Health promotion, which means moving people toward a greater state of health and well-being.  This is a political and social process, and happens through a combination of advocacy to create changes to practices and policy that act on economic, social, and ambient environments as well as on individuals, enabling individuals to act on determinants of their health, and mediating across stakeholders with influence over the two former.2

The TWH approach emphasizes work as a social determinant of health by recognizing work as a non-medical factor that influences health. Like other social determinants such as housing or education, work and its context are shaped by broader economic, political, and cultural factors, meaning conditions of employment and work differ across the population.3 Social structure – the written and unwritten rules and negotiations of power to uphold or change those rules - is why benefits and harms related to work are not equally distributed across all forms and types of work.4

Consistent with creating safer and healthier work that advances worker well-being, the Utah Center for Promotion of Work Equity Research (U-POWER) envisions a state in which work-related benefits are maximized, harms are minimized, and both are equitably distributed. These priorities arise from our belief that all work* in the United States should be decent.

In 1999, the International Labour Organization defined decent work as:

“Work that delivers a fair income (e.g. a living wage), provides security and social protection for workers and their families, offers prospects for personal development, gives people the freedom to express their concerns, to organize, and participate in decisions affecting their lives and guarantees equal opportunities and equal treatment for all across the entire lifespan.”

Since work is shaped by broader economic, political, and cultural influences, U-POWER focuses not only on worksites, work conditions, occupations, and industries but also on issues related to where the power to change work rests.

*While non-remunerative work is valuable and necessary to societies, at U-POWER we focus on work performed for pay.

References

1. What is Total Worker Health? | NIOSH | CDC [Internet]. 2023 [cited 2023 Nov 21]. Available from: https://www.cdc.gov/niosh/twh/totalhealth.html.

2. Nutbeam D, Muscat DM. Health Promotion Glossary 2021. Health Promotion International. 2021;36:1578–1598. doi: 10.1093/heapro/daaa157.

3. Social determinants of health [Internet]. [cited 2023 Nov 21]. Available from: https://www.who.int/health-topics/social-determinants-of-health.

4. Heller JC, Givens ML, Johnson SP, Kindig DA. Keeping It Political and Powerful: Defining the Structural Determinants of Health. The Milbank Quarterly [Internet]. [cited 2024 Feb 20];n/a. doi: 10.1111/1468-0009.12695.