092: Are Managers Making Workers Sick?

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One of the often-overlooked aspects of EHS is that middle word - health. I mean, we understand the parts related to chemical exposure and substance exposure; silica, asbestos, lead, stuff like that - which are all important. But I want to talk about health in another context - that is the overall health and wellbeing of our workers and how the workplace can be contributing to it (both positively and negatively), thus making this an important aspect of our workplace safety and health efforts. 

Cardiovascular disease (CVD) currently kills more Americans each year and costs more than any other disease, including Alzheimer's and diabetes. Over the next decade, the situation will only get worse: By 2030, the prevalence of CVD among those aged 20 and older is projected to top 40%, and direct medical costs are expected to triple to more than $800 billion.

A study published in International Journal of Environmental Research and Public Health - based on data drawn from Gallup surveys of more than 412,000 full-time workers in the U.S. suggests that workplace supervisors could be part of the solution to this deadly and costly problem. That’s right, we are going to talk about the immediate supervisor’s role impacting worker safety and health - again.

A number of previous studies have established links between workplace stress and CVD risk factors. But because trust is such an important part of social capital, particularly in the workplace, the authors of this study chose to examine the associations between trust at work and seven CVD risk factors:

1. Smoking
2. Obesity
3. Low physical activity
4. Poor diet
5. Diabetes
6. High cholesterol
7. High blood pressure.

The researchers used a work environment question that asked: "Does your supervisor always create an environment that is trusting and open, or not?"

Approximately 22% of women and 20.3% of men indicated that their supervisor did not always create an open and trusting environment

For both women and men, the highest prevalence of mistrust was among workers aged 45 to 64, followed by those in the 30 to 44 age group.

The prevalence of a mistrustful environment was a little higher for women with increasing levels of education (highest for those with college or post-graduate education, 25.2%). Men with technical training or some college/associate degree had a slightly higher prevalence (20.9%) of a mistrustful environment as well.

Divorced women (26.8%) and men (24.7%) had the highest prevalence of reporting a mistrustful work environment, which indicates a possible connection to workers' personal lives - going through a traumatic experience like a divorce may influence the way they trust others in the workplace.

Overall, the authors found that trust was associated with increased adjusted odds of having many of the seven CVD factors. Among those workers whose supervisor created a mistrustful environment (those who answered "no" to the question), the odds ratios were the greatest (more than 20%) for having four or more of the seven risk factors.

After the authors adjusted for demographic factors and whether respondents had health insurance, they found that trust was associated with seven CVD risk factors among both women and men in the sample.

• Workers who do not work in an open, trusting environment had greater odds of having high blood pressure, high cholesterol and diabetes.
• Workers in mistrustful environments also were more likely to be current smokers, have a poor diet and be obese.
• Women who work in mistrustful environments had greater odds of low physical activity.
• Odds ratios for having four or more risk factors were elevated in mistrustful environments.

Improvements in the work environment are needed to reduce CVD risk among workers. Social modification to the work environment, such as adjusting managerial style to create an open and trusting environment, can decrease work stress. Considering managerial trust from a Total Worker Health® framework meets the goals of illness prevention to advance worker well-being. Efforts can also be made to target the health behaviors themselves.

There is a range of possible strategies for addressing the risk factors in the workplace. For example, physical modification to the work environment, such as installing sit/stand desk stations and even walking workstations, can reduce sedentary behavior and may increase physical activity for those types of workers. Additionally, increased access to nutritious food in the workplace may improve diet. Take a look at your vending options - several places I worked at in the past had programs through their food vendors that let you earn points for the healthy food choices, which led to free food. Also, they helped subsidize the increased cost of some of their organic or healthier options as well.

Supervisors who support workplace wellness may help in reducing CVD risk factors in workers as well. So allowing workers to participate in walking contests during breaks, go to awareness meetings where they learn new skills that will help them develop healthier habits - all of these things can be supported by the immediate manager.

Be sure to check out my past episodes covering Total Worker Health as well as safety incentives that work. The bottom line is this; the manager has a lot of influence on not only workplace safety but overall worker health and wellbeing. HR and benefits managers need to pay attention to this as well. Their efforts can all be undone by the same issues of managerial trust that roadblock workplace safety success.

We need to target managers with efforts of professional development and safety professionals have a role to play here. We can work to develop safety leadership programs and contribute to roles and responsibilities, even job descriptions. We need to partner across the organization and focus just as much on other levels as we do the frontline workers.

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