Work and Health Future Challenges and Opportunities

Work and Health - Office of Compliance

Some Unknowns: 21 st Century WorkforceImmigrationOutsourcingRe-careering• Will nations change policies to encourageor discourage immigration?• Will wage competition increase?• Does it portend a global workforce?• How do employers taken on global healthissues?• Will more workers remain in theworkforce and take on an ―encore‖ career?• Who will manage associated chronichealth conditions?• Will hurdles to continued work at olderages be removed?

Selected Workforce ChallengesLimited availability of workersChronologically giftedHealth-challenged younger workersInnovative Employment ArrangementsGlobal Competition for WorkersEncore Careers vs. RetirementAge-Related Challenges for Occupational Healthand SafetySocial Benefits & Age DiscriminationResponsibility for the Health of Workers

200220042006200820102012201420162018202020222024202620282030Growing Shortage of U.S. WorkersExpected Labor Force and Labor Force Demand250200Millions of People15010050Labor NeededLabor Available0Source: Employment Policy Foundation analysis andprojections of Census/BLS and BEA data.

Screeching to a Halt:Growth in the Working-Age Population200%1970-20102010-2050150%100%50%0%-50%Mexico Brazil India China South Australia Canada US Netherlands Spain France UK Russia Italy Japan GermanyKoreaSource: Deloitte Research/UN Population Division ( It’s 2008: Do YouKnow Where Your Talent Is? Why Acquisition and Retention Strategies Don’t Work, p.6

Dramatically Different Patterns ofGrowth by AgePercent Growth in U.S. Population by Age: 2000-201080%Rapid growth in the over-55 workforce60%48%40%20%0%-20%5% 5%Few younger workersentering-9%18%15%16-24 25-34 35-44 45-54 55-64 65+Age of WorkersDeclining number of mid-career workersSource: U.S. Census Bureau. 2000

. . . Continuing Into the FuturePercent Growth in U.S. Workforce by Age: 2000-202080%73%60%54%40%20%0%7% 8% 7%3%-20%-10%under 14 15-24 25-34 35-44 45-55 55-64 65+Age of WorkersSource: U.S. Census Bureau

In 2000, A Fairly “Young” World . . .Under 5% 5% to 12.4% 12.5% to 20% Above 20%Percent of Population Age 60+ in 2000Source: U.S. Census Bureau, 2000

. . . Rapidly Aging by 2025Under 5% 5% to 12.4% 12.5% to 20% Above 20%Percent of Population Age 60+ in 2025Source: U.S. Census Bureau,. 2000

Age8070Why?“Sudden” Boom in Life ExpectancyLife Expectancy at Birth: 1000 - 200076.560504740302530353638201001000 1200 1400 1600 1800 1900 2000Source: U.S. Census Bureau, 2000

Total Fertility Rate76And a Dramatic Drop in Birth RatesTotal Fertility Rate: 1960 ▀ and 2000 ▀1960 20005.954323.32.02.8 1.7 2.51.4 1.3 UK France Canada Japan Germany Italy China IndiaSource: Age Wave

Birth in MillionsWhy? The Baby Boom PatternThe Boom Years: 1946-19644. 1940 1950 1960 1970 1980 1990Source: U.S. Census Bureau International Data Base

What is health?Am I healthy?Do I care if others in my life are healthy?What influences my health?Where do I go for help with my health?How can I change my health?I’ve Lost my health, now what?13

Health challenges of the younger,older and those sandwiched between

Diabesity and the Future Workforce• 39 States with 40% of young adults considered to beoverweight or obese in just last decade!– In Kentucky, Alabama and Mississippi, >50% youngadults are overweight• Medical Consequences:– High Blood Pressure– High Fats in the Blood– Type 2 Diabetes (formerly called adult-onset)– Hepatic steatosis epidemic (fat deposits in the liver)– Sleep apnea (too much fat around the upper airway)• Psychological stress• Musculoskeletal disorders– what the old and the young worker share

Childhood Obesity by Country

US Childhood Obesity: 1960 - 2002

Too Fat to Fight• Since 1995, proportion of recruits whofailed their physical exams becausethey were overweight has risen bynearly 70%.• Being overweight is now the leadingmedical reason for rejection.

Global Competition for Workers• Migration of talent now plays an important role in shapingskilled workforces• In 1990s, U.S. benefited from inward migration– Brain drain and remittances dominated policy• In 2000s, more opportunities in sending countries– India, Brazil, China, Europe, Africa, South America• Increased Mobility = internationalization of the labor market• Global competition for talent is growing fast– Previously favored nations like U.S. cannot count on having nocompetition for acquiring skilled workers– MNEs now face global health issues involving their employees• Not just chronic ―American-type‖ diseases• Acute infectious diseases that are more prevalent in foreign countries• Most employer-based health promotion programs are based on American model

Innovative Employment Arrangements• ―Flexible‖ or ―Precarious‖• Contingent = work without promise of longevity• Evidence that contingent workers are at higher risk forwork-related injury, illness, and death:– Outsourcing of more hazardous jobs– Lack of experience and familiarity with operations in a dangerousworkplace– Inadequate safety training and protective equipment– Limited access to preventive measures such as medical screeningprograms– Components of current health and safety regulations, and theworkers' compensation system, which were designed in an era ofdifferent employment arrangements, play a role.• Does your employee wellness program cover all persons whowork for you or your contactors or not?

Webster's Definition of Retirement• to disappear• to go away• to withdrawSource: Webster's New Twentieth Century Dictionary

YearsMore Years Spent in “Retirement”After First Career353030 +252019.420-251513.610501.21900 1980 1990 2000 2010Source: Age Wave, based on U.S. data, andThe Concours Group

Aging Productively

EMPLOYEESImpact on Occupational Safety and HealthSeniorExecutivesHumanResourceLeadersFront LineManagersChanging workforcedemographics meanthat we all need tobe thoughtful abouthow to age and workproductively.Is aging alwayscompulsory?

Proportion of 50 yr-olds Still Employedat Subsequent Agesby Age Attained and Class (U.S.)80706050403020606570100White Collar Blue Collar ServiceUS Bureau of Census 1981-2000

Aging Workforce and Social Security• Social Security– In 1935, average life span at birth was 62– So, retirement benefits started at 65!– Rising costs impacts discretionary spending• Changing pension systems– Greece• Raised retirement from 63 from 61• Banned early retirement altogether– Other nations facing pension pressures?– Effect on blue collar workers?

Aging: A Balance of Factors• Possible Limitations– Cognitive Limitations– Chronic Conditions– Physical Capacity• Compensating Factors– Attitude– Judgment– Flexibility– Interest in learning

• Laboratory Tests– Cognition speedMental Capacity• Information retrieval slower, unless material isfamiliar– Learning and recall slower, but equallysuccessful in the end– Greater retention, higher learningachievement and more likely to complete anew field of study than younger workers

Mental Capacity:Relevance to On-the-Job Performance• Lab tests do not translate well to actual worksettings• Factors other than psychometric cognitiveabilities appear important to perform well atwork– How well worker gets along with co-workers– Desire to perform well• Individual measures are quite sensitive tooccupational class

Age and Chronic Medical Conditions

Workers with >1 ChronicCondition by Age (U.S.)706050403020100>151-64 65-74 75+ Non-workersHRS 1998

Exposure to Physical StressorsEU - 1990-200050403020100Painful/Tiring PositionsHandling Heavy Loads1990 1995 2000Working Conditions in the EU – Euro. Fnd.

Exposure to Physical HazardsBy Type of Work Contract6050403020100RepetitiveTasksRepetitiveMovementPainful/TiringWork PosturesPermanent Employment Fixed-term TemporaryWorking Conditions in the EU – Euro. Fnd.

Physical Capacity: Can Older Workers Keep Up?• Physiology Facts– Maximal strength at 20-30 years– O 2 uptake reduced to 70% (max) by 65 years– Older adults work closer to capacity!• Decreased Performance, Yes But …– For physically demanding work only– Work uncommonly demands maximal effort• Non-physical advantages that older workersbring to a job are rarely measured instudies!

Physical Capacity: Match Task to Ability!• Maintaining musculoskeletal health will beincreasingly important• Workers abilities matched to the job:– Results in less morbidity– Based on practical ergonomic principles– Accommodation practices not fully integrated yetinto employment practices:• May change with ADA Amendments Act of2008• Increases chances lawsuit will go to trial

Essential Points About Aging• Do aging workers need specialaccommodations?– A well-designed workplace benefits everyone– Work stations and job tasks need to be matched to thecapacity of each worker– There should be no conflict between ergonomic principlesvs. reasonable accommodations• Are there any specific health and safetyconcerns related to aging workers?– Older workers have fewer injuries, but when one occurs, thatinjury tends to be more severe and it takes worker longer toget better.– Injuries differ in older workers—there are moremusculoskeletal injuries– No consistent relationship between aging and workperformance!

Providing Opportunities for Health toEmerge at Work44

What’s the Evidence-Base for EmployeeHealth Promotion Practices?• Evidence:– More than opinion or testimony• ―…Growing body of empirical evidence*– Large proportion of diseases are preventable (risks are modifiable)– Risk-dependent diseases are costly & reduce worker productivitywithin short time window– Targeting risk behaviors can decrease costs and increaseproductivity– Worksite health promotion and disease prevention programs savecompanies money and produce + ROI* Goetzel & Reuters, Value in Health Care , IOM (2010)

Integration of Traditional OccupationalHealth with Health• WorkLife Centers of Excellence• Essential Elements of EffectiveWorkplace Programs for Health andSafety• Resources Page: 99 Web-LinksWorth Having46

WorkLife• Protect existing health and safety• Provide respect to workers• Build a healthy environment• Develop understanding andpartnership• Seek to engage• Recognize need for flexibility andautonomy• Integrate safety and health atevery opportunity47

WorkLifeExamples of Integrated Programs– Respiratory protection programs thatcomprehensively address tobacco abuse– Ergonomic consultations that also discussarthritis management strategies– Stress management efforts that first seek todiminish workplace stressors, and only thenwork on building worker resiliency– Integrated training and prevention programs(falls, motor vehicle safety, first aid, hearingconservation, stretching, flexibility and liftingprograms)

Selected References• National Research Council. Health and Safety Needs of Older Workers,National Academies Press (2004).• Dychtwald K, Erickson T, Morison, B. It’s Time to Retire Retirement, HarvardBusiness Review (March 2006).• GAO. Older Workers: Enhanced Communication among Federal AgenciesCould Improve Strategies for Hiring and Retaining Experienced Workers.GAO-09-206 (February 24, 2009).• GAO. Older Workers: Some Best Practices and Strategies for Engaging andRetaining Older Workers. GAO-07-433T (February 28, 2007).• Johnson, Richard et al. Older Workers on the Move: Recareering in Later Life(2009), AARP Public Policy Institute• National Institute on Aging. Growing Older in America: The Health andRetirement Study. Available at• Report of the Taskforce on the Aging of the American Workforce (2008).Available at• RW Johnson et al. Work Impediments at Older Ages (2006). Available at• Solving the Problem of Childhood Obesity Within a Generation (2010)Available at

Healthy WorkMakes Healthy FamiliesCelebrating NationalWork and Family MonthOctober, 2010

The Aging Workforce: Moving Forward in a New AgeThe Future Safety of Day, Safety Architect and of the Health Capitolin An AgingOctoberWorkforce16, 2009Library of CongressOctober 26, 2010Presented by Phyllis Cohn,Project Manager, AARPPhyllis C. Cohn, MSWProject Manager, WorkforceIssues

Demographic Trendsof the WorkforceGraying ofthe USworkforce:76m BabyBoomersLower birth ratesFourgenerationsworking sideby-sideReversal ofretirementtrendsWorkforce 2009ConcernedaboutstabilityHightalentamongtheunemployed


Boomers areReinventing Retirement‣Less likely to associate retirement with the traditionalretirement age of 65.‣Nearly 86% of workers who have not retired reportthat they plan to work into their retirement years ornever retire.

AARP Best Employersfor Workers Over 50> Announced in 2001> Recognize companies with exemplary policies andpractices for 50+ workers> Communicates best practices to employers facing similarchallenges of an aging workforce> Over 400 employers recognized> 2009 application closed in February> Next application period – 2011

Best Practices –Workplace redesign‣Lee Memorial Health‣ Transitional workcoordinator‣ Pinnacol Assurance‣ Ergonomics program reducedworkman’s compensationcosts by 33%‣Other Best Employers‣Large screen monitors,amplifiers and headsets‣Adjustment of height ofworkstations‣Modifying parking lotcurbing

Other Best Practices‣Providing a ―buddy‖ to accommodate anemployee on crutches‣Offering flex hours for an injured worker‣Adapting equipment for injury‣Paying special attention to fall potential (floors and carpet)‣Lighting, contrast and consistency in stairs

Fitness is GOOD forBusiness‣Productivity losses cost U.S. employers $1,685 per employeeper year, or $225.8 billion annually‣28% reduction in sick leave absenteeism‣26% reduction in health costs‣30% reduction in workers’ compensationand disability management claim costs‣$5.93-to-$1 savings-to-costs*Partnership for Prevention (

Stress in the Workplace• Workplace Stress costs employers an estimated$200 billion per year• Higher absenteeism• Lower productivity• Staff turnover• Worker’s compensation claims60% of lost workdays each year can be attributed to stress75-95% of visits to health care providers are due to stressrelated conditionsStress in the Workplace: A Costly Epidemicby Rebecca Maxon Copyright © 1999, Fairleigh Dickinson University.

STRESS around … Caregiving!> Predominantly female (67%)> Getting older (50 yrs old in 2009, 48 yrs old in 2004)> 46% are college graduates> 64% are married or living with partnerThe Cost to Business:$34 Billion in Lost Productivity

FLEXIBILITY is Key!Find family-friendly solutions for working people who needflexibility for child care and elder care.• job sharing,• part-time employment,• staff working from home or telecommuting,• flexible starting and stop times and flexible core businesshours, and periodic paid and unpaid work interruptions for childcare and elder care.AARP 64

“Prepare to Care Guide”(• Helps employees plan for future, better balance work andfamily responsibilities• Prepared employees less likely to be absent from jobs forfamily emergenciesAARP 65

STRESS around …theChanging Landscapeof WorkFor the first time in modernhistory, workplacedemographics now spanfour generations.This presents bothchallenges andopportunities!

Generations!> World War II/Traditionalists:Before 1945• Boomers: 1946 – 1964• Gen X: 1965 – 1980 • Gen Y: 1980 on

The Business Case for AddressingIntergenerational Dynamics• Builds on the unique values and strengths of allgenerations – promotes teamwork!• Bottom Line Impact:• Recruitment• Employee Engagement• Retention• Productivity

Root Causes ofConflict> Work ethic> Technology> Perspective> View of Authority> Relationships> Outlook> Leadership

WWII Generation/Traditionalists

WWII Generation/Traditionalists• Words that Motivate• ―Your experience is respectedhere.‖• Rewards that Motivate• Tangible symbols of loyalty,• commitment and service• Management Actions that Motivate• Connect their actions to overallgood of organization• Communication Style• Linear, logical, respectful• Turn Offs• Profanity, slang, poor grammar,disrespect

Myths aboutolder workers‣Can older workers adapt?‣Can they handle new technologies?‣Are their job skills up to date?‣Can they get along with younger bosses?

Positive Perceptions of Older Workers• Loyalty and dedication to the company• Come to work on time; low absenteeism• Commitment to doing quality work• Someone you can count on in a crisis• Solid performance record• Solid experience in job/ industry• Basic skills in reading, writing, arithmetic• Getting along with co-workers

Baby Boomers

Baby Boomers> Words that Motivate> ―We need you.You can make a difference.‖> Rewards that Motivate> Personal appreciation, promotion,recognition, status symbols> Management Actions that Motivate> Managers get them involved andshow them how to make a difference> Communication Style> Personable, Informative = Reward> Turn Offs> Brusqueness, one-upmanship

Generation X

Generation X> Words that Motivate> ―Do it your way.‖ and ―There islife beyond work.‖> Rewards that Motivate> Free time, upgraded resources,opportunities for development,bottom-line results, certificationsto add to resumes> Management Actions that Motivate> Managers give choices andpermit work autonomy> Communication Style> Direct, straightforward, resultsoriented> Turn offs

Millenials / Gen Y

Millenials / Gen Y> Words that Motivate• ―We respect you here.‖ and ―Whatare your goals?‖> Rewards that Motivate• Awards, certificates, tangibleevidenceof credibility> Management Actions that Motivate• Managers connect actions toemployees’ personal and careergoals> Communication Style• Positive, motivational, personal andgoal-oriented

Multigenerational “To Do” List• Appreciate and honor the perspectivesof all employees• Develop a system to effectively transferskills and knowledge• Turn multi-generational teams intointergenerational collaboration• Maximize all employees’ capabilities andstrengths• Recognize what the generations(people!) have in common• Evaluate how policies will affect eachgeneration• Examine how decisions will be perceivedby each generationAARP 80

Life StagesCareer StageTraditional:New:

AARP ResourcesAARP Website Resource Center Assessment Toolhttp://www.aarpworkforceassessment.orgAARP SmartBriefBi-weekly E-newsletter/Clipping Service

Resources―Prepare to Care Guide‖―Healthy Behaviors‖“Leading a MultigenerationalWorkforce”, AARP, 2007.Phyllis Cohn, Project Manager,―Decoding GenerationalDifferences‖, W. Stanton Smith,Deloitte LLP, 2008

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