ESRC Policy Seminar Health

1
ESRC Policy SeminarHealth Wellbeing of People
of Working AgeAn Occupational Health Perspective

• Professor T Cox CBE
• Institute of Work, Health Organisations
• University of Nottingham

2
Overview

• Development of public and occupational health
  policy
• Contemporary drivers of occupational health
  concern
• Current challenges
• Health management strategies organisational risk
  management
• Delivering organisational risk management
  issues
• An international perspective

3
Policy Jigsaw
Children (Younger workers)
Women
Migrant Workers?
Who else?
Older workers
People of working age
4
Public and Occupational Health Policy

• Policy and law has been focussed traditionally on
  vulnerable groups children and women in relation
  to work
• Demographic shifts and economic considerations
  have recently forced attention to be paid to
  older workers
• This latest government publication shows that
  concern now includes people of working age
• Signals a useful and overdue coincidence of
  public and occupational health concern to which
  can be added concern for the healthiness of work
  organisations

5
Coincidence of Concern
Health of people of working age
6
Contemporary Drivers of Occupational Health
Concerns

• Current evidence suggests that there are good
  reasons for public and occupational health
  concern
• In relation to work, there are several powerful
  drivers that are changing the traditional
  landscape
• Change in age-related demography of work force
• Inclusion of increasing numbers of migrant
  workers
• Rapid globalisation of business and work
• Dominance of neo-liberal economic theory and
  practice
• Increasing precariousness of work
• Rapid developments in the technology of work
  (ICT)
• Changing nature of work and working
  organisations, of the workforce and its working
  life

7
Current Challenges

• 600 years ago, it was observed that with every
  advance in the nature and technology of work come
  new challenges to the safety and health of
  workers.
• Unsurprisingly today we observe a new profile of
  occupational health concerns focused on
  musculo-skeletal disorders and work-related
  stress.
• These also represent challenges to the
  healthiness of organisations and to public health
• They share many antecedent factors hazards
  resident in the design and management of work, of
  work equipment and of work organisations

8
Work-related Illness UK 2003-04
9
Prevalence of Work-related Illness UK 2003-2004
10
Health Management Strategies Organisational Risk
Management

• In the UK, occupational health concerns have been
  treated as health and safety issues both in law
  and in practice
• Traditionally, health and safety management has
  drawn on the risk management paradigm to deal
  with threats to safety and health at work
• The risk management process is essentially
  evidence-based and systematic problem solving
• This approach is well established for
  musculo-skeletal disorders and has been adopted
  as a means of dealing with work-related stress

11
Risk Management Approach for Work-related Stress

• Framed by EU and UK health and safety
  legislation
• Focused on prevention with the organisation as
  the generator of the risk
• Risk assessment informs discussion of risk
  reduction within organisation fit for purpose
• Relies on processes of participation, education
  and empowerment, trust building and co-operation
• Objective is to build into routine risk
  assessments good enough consideration of work
  design and management factors

12
Delivering Organisational Risk Management

• The Health Safety Executives (HSE) national
  Management Standards initiative is a good example
  of risk management for work-related stress
• It raises a number of important policy related
  issues
• The question of overall strategy
• The issue of methodological prescription vs
  equivalence of methodology
• The question of scientific accuracy vs being fit
  for purpose
• The inspection question enforcement or
  guidance and support
• The capability question defining, training and
  increasing the number of competent persons

13
The Strategy Question

• Public health strategists have in the recent past
  taken a different approach to health
  interventions than those concerned with
  occupational health.
• Public health (after Rose) has focused on the
  whole population rather than at risk or
  vulnerable groups.
• Occupational health continues to focus on at
  risk groups.
• Currently there is some debate on the
  effectiveness of the whole population approach
  for public health issues but it is arguably
  inappropriate for occupational health issues.

14
An International Perspective

• Most developed countries and supra national
  bodies have adopted the risk management approach
  to health and safety issues with a focus on
  prevention musculo-skeletal disorders and
  work-related stress are internationally
  recognised as being among the major challenges to
  health and safety
• Prevention work-related stress has been
  identified as an epidemic by US National
  Institute of Occupational Safety Health one of
  the 10 leading causes of workplace death
• We are not aware of any epidemic in the course
  of human history that has been eliminated through
  treatment
• However, in some countries but not the UK, both
  work-related stress and musculo-skeletal
  disorders are treated as compensatable injuries.

15
Thank You