September 24, 2020 / Christopher J.L. Cunningham

Psychological and Social Determinants of Health, Safety, and Well-Being at Work: The Occupational Health Psychology Perspective

This blog post is adapted from Christopher J.L. Cunningham’s presentation of the same name, given at AIHce EXP 2020. It was edited by Abby Roberts, editorial assistant at The Synergist.

Occupational Health Psychology (OHP) is the practice of applying psychological theories, principles, and evidence to manage worker health, safety, and well-being, in accordance with the WHO’s definition of health as more than the absence of negative symptoms. Understanding OHP will aid the IH in implementing a Total Worker Health (TWH) program.

While IHs tend to target environmental, ergonomic, and physical hazards, OHP focuses on prevention efforts to minimize the effects of workplace exposures, promoting both healthy personal beliefs and behaviors, and organizational policies that support health. Professionals with OHP training also are involved in researching, developing, evaluating, and fostering psychologically appropriate responses to workplace exposures or crises. Generally, OHP professionals work to prevent health, safety, and well-being issues before they require a clinical response. Where traditional IH applies the hierarchy of controls, OHP complements those efforts by pushing beyond requirements to leverage behavior and social science theories and evidence at personal, group, and organizational levels. Professionals practicing OHP focus on people, and the physical, social, and cognitive features of the worksite, more than hazard identification and control—the core of OHP is the worker. OHP employs psychological science to encourage people and organizations to adopt a climate supportive of worker health and well-being, and to understand why workers engage in unsafe or unhealthy behaviors at and outside of work. This perspective can help to improve the likelihood of success in TWH initiatives.

Common concerns for OHP professionals include work stress and associated recovery; psychological and physical health; psychological and physical work demands; healthy workplaces; worker safety; incivility and conflict between workers; work-family/nonwork conflict and facilitation; the aging and diversifying population; and the psychological aspects of workload, work pace, and work schedules. A few of these overlap with traditional IH concerns, but many do not.

IH and OHP share the goals of applying scientific practices, procedures, and theories to the workplace, informing organizational policies to minimize exposure and maximize safe and healthy work. Professionals in both disciplines of occupational health can jointly work to support efforts to properly train and develop workers and work roles to support long-term worker health, safety, and well-being. Although these general goals are similar, the approaches differ (as noted earlier). While IH seeks to eliminate hazards and exposures using the hierarchy of controls, the OHP perspective is to change the cognitions, attitudes, intentions, and behaviors of workers. With this in mind, OHP can amplify IH efforts by adding a behavioral and social science perspective to influence and impact efforts, and by helping to explain why workplace injuries, illnesses, and exposures occur.

Work-Related Stress

One example of a situation in which OHP can especially supplement traditional IH approaches pertains to the pervasive issue of work-related stress. Nearly 75 percent of U.S. workers, including those in jobs traditionally considered “safe,” report experiencing stress in the workplace. Despite work-related stress being such a widespread issue with many associated negative health effects, stress is also a very personal experience. Workers exposed to the same source or kind of stress will not necessarily respond in the same way, because of subtle individual and environmental differences. A stressor might have a more severe effect on one worker compared to another due to underlying and influential individual differences and due to the presence of additional, simultaneous stressor exposures.

The outcomes of worker stress may be organizational (e.g., in the form of costs) or personal (e.g., in the form of psychological, physical, and behavioral strains). Workers experiencing stress may express anxiety, anger, depression, or cognitive impairment; experience health effects such as increased blood pressure and muscle tension; develop eating or substance abuse disorders; or negative social interactions, such as conflict with other workers. Regardless, excessive stress is a real issue impacting the health of a workplace. Its effects are also cumulative, and therefore build up over time and carry over outside of the work domain, if workers are unable to effectively recover from the effects of such stress.

An OHP perspective is helpful when attempting to understand and address work-related stress: it acknowledges that stress may be at least a partially positive force in work settings if it motivates workers to perform desirable behaviors, is not permanently present or chronically experienced in the workplace, and is handled appropriately by the worker and the organization. Despite an IH or OHP professional’s best efforts, stress will never disappear entirely from a workplace, either. For stressors that cannot be eliminated entirely, an OHP professional can help design strategies to mitigate stressor effects through more effective recovery and resource management efforts (for example, adequate sleep, taking part in leisure and spiritual activities, exercising, and healthy eating). An OHP professional can also ensure that the worker can manage his or her personal resource bank to allow for proper recovery.

Creating Healthy Work

In healthy and safe work environments, workers are well-supported and have a lot of control over their work. OHP professionals can create healthy work by encouraging organizations to reduce impediments and constraints on work; reinforce healthy emotions, attitudes, and behaviors; support efforts to manage work and nonwork stress; facilitate healthy lifestyles; and improve worker control where possible (and desired by workers). Organizations can also reduce stressor exposures by improving communication between workers and management; removing ambiguity in role expectations; improving interpersonal relations between colleagues; and generally, increasing control over common environmental triggers for stress response.

More resources for exploring occupational health psychology can be found through the Society for Occupational Health Psychology, Society for Industrial and Organizational Psychology, NIOSH, and the American Psychological Association.

Christopher J.L. Cunningham

Christopher J. L. Cunningham, PhD, is an Industrial and Organizational (I-O) and Occupational Health Psychology educator, researcher, and practitioner at The University of Tennessee at Chattanooga, the current president of the Society for Occupational Health Psychology, and a founding partner and chief science officer at Logi-Serve.


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