When we talk about worker health in the construction industry, we’re usually focusing on jobsite safety, and for good reason. Construction was the most dangerous industry for workers in 2019, with 1,091 fatalities, according to the Bureau of Labor Statistics. Nonfatal injuries remained level between 2018 and 2019, but the incidence rate was highest for residential construction workers, at three cases for every 100 workers.
Some builders are inclined to focus on these high-level issues, and aren’t concerned with the more everyday issue of worker wellness. However, workers don’t leave their problems at home, and someone who is distracted or unwell can become a danger on the jobsite. There’s a bottom-line impact, too.
“In a high-consequence industry like construction, you get hyper focused on the things that can kill you,” Josh Kreger, director of safety innovation and strategy at Pinnacol Assurance, said. “However, the things that hurt us definitely hurt our business in having people out for various illnesses, injuries — that all slows production and productivity.”
Kreger sees construction workers as athletes. “If you’re a roofer and you work 50 hours a week, you’re an athlete. … Unfortunately, if you compare the average roofer in Denver Metro versus someone on the Denver Broncos, there are two different ways they’re treated,” he said.
He encourages builders to ask themselves, “How do I look at a subcontractor or a contractor in the trades as an athlete instead of a risk I have to control from just a safety perspective?”
He continued, “If I want to keep them on the field, then I need to look at them as more than just an employee that I need to worry about following the rules. I need to be personally invested in them as people.”
Blue collar, white collar
Builders who spend any time Googling wellness programs are going to come across a lot of information about designing programs for people who sit at desks all day. Wellness programs have become de rigueur in the corporate world, but Kreger said it’s “important not [to treat] construction workers just as another office employee.”
Builders need to think about what “wellness looks like for the work that we do, in the environment that we have, and then walk backwards from there,” he suggested.
For example, if builders are worried their crews will dismiss a yoga program, consider martial arts.
“I’m a practitioner of Brazilian Jiu Jitsu, and we spend a lot of time falling down the right way,” Kreger said. Slips, trips and falls are one of the biggest sources of injury for construction workers, he noted, and fall safety materials typically address fall prevention. However, he suggests that instead of worrying that workers will fall, builders should “assume they’re going to fall and work backwards. What if they know how to fall” safely so workers can avoid landing on their spine or hitting their head?
How builders talk about health and wellness is also important. Construction workers have different mindsets from office workers, Kreger said. “Sometimes, things like wellness don’t sit well with blue-collar employees,” he said, so builders need to tie the conversation to what workers care about.
“When you get off work roofing all day, if you still want to go play basketball and go play with your kids, go to your softball game, we need to make sure that you don’t have an ache or pain, or an actual injury, that prevents you from enjoying your personal life,” he said.
How common are wellness programs in construction?
While wellness programs are popular perks in the corporate world, Debra Wein, CEO and founder of Wellness Workdays, said there has been an uptick in construction companies that are offering these benefits.
“I believe that more and more construction firms appreciate the tie-in to safety and well-being,” she said. However, those companies are “not always utilizing best practices and approaches” when they implement a program.
“‘Wellness’ is a very large, open-ended term, which can mean a lot of things to a lot of professionals,” she said. The open-endedness of the term has made it enticing for startups to begin offering what they call a wellness program, but may not be designed with end users in mind, she warned.
“Rather than just utilizing the latest app, or promoting the latest fitness craze or diet, or even meditation program, there needs to be a systematic approach to how you bring wellness to any organization, including construction,” Wein said.
4 steps to successful wellness programs
There’s a four-phase cycle to implement a successful wellness program, Wein said: assessment, strategy, implementation and evaluation. It can be tempting for builders who see a problem—say, substance abuse—to dive straight into a solution—addiction treatment—but this nail-hammer approach may not lead to a program that workers will actually use.
“There’s a lot of work that has to go into building trust, and building relationships and support, at a jobsite and within an organization so that employees or trades or construction workers know that their information is safe, that their data won’t be shared, that the partners that the organization has chosen to represent them and to help them has their best interests at heart,” Wein said.
She compared it to starting a new construction project. “When you’re building something, you have a plan. There’s a layout, and you know who’s doing what.”
Builders need to start with an assessment to understand what “employees are interested in and what their needs are,” Wein said. “What are we solving for? What are we trying to accomplish?” Depending on builders’ objectives, a program can be designed to make employees more aware of behavioral health opportunities, improve the overall health of the workforce, cut medical costs or decrease workers’ comp claims, she said.
Then they need to develop a strategic plan “so that before you even start anything, you get people on board so they understand” what they program is and what it can do for them.
Well-being versus wellness
The National Institute for Occupational Safety and Health has also turned its attention to worker well-being. The research agency launched its Total Worker Health program in 2011, and encourages employers to take a more holistic approach to occupational safety.
“Our goal here is to look at the needs of workers from the broadest possible set of lenses, to look at their opportunities and challenges, to make work a much more positive experience in their lives,” Dr. Casey Chosewood, director of the Office for Total Worker Health at NIOSH, said.
The aim of the Total Worker Health program is to optimize workers’ health opportunities on and off the job, Chosewood said. “We’re interested not only in the work itself, the task and how safe that task is, but we’re also interested in how work supports their health goals.”
Nutrition, tobacco use and substance abuse are obvious targets for a wellness program, but Chosewood stressed that worker well-being is a more comprehensive way to think about worker health that goes beyond purely physical measures. Providing workers with enough time off, a supportive work culture—or at least one that doesn’t create stress—and access to health care are some of the ways builders can support workers, Chosewood said.
Job security is another issue. “Construction is a very seasonal type of employment,” Chosewood said. “It has an ebb and flow that sort of tracks the economy.” Employers who can offer some kind of guarantee of income can provide more security for valued workers they’d like to maintain relationships with.
Dr. Scott Earnest, director of the Office of Construction Safety and Health at NIOSH, reiterated the bottom-line impact that worker well-being has on construction companies.
“A lot of home builders are small businesses, and you actually get higher rates of injury and illness when it comes to the small businesses than you do for larger construction companies,” he said.
Designing A Wellness Program
Wellness programs are highly customizable, so builders can design programs that address the specific challenges they’re seeing in their workforce. However, considering the nature of construction work, there are two key areas builders should make sure they’re ready for.
Suicide and mental health. Sadly, construction workers, particularly men, die by suicide at alarming rates. The Centers for Disease Control and Prevention found suicide is 1.5 times higher among men in the construction industry than any other, including people who were unemployed. NIOSH’s Chosewood said most of the successful interventions for workers have focused on giving them opportunities to talk about issues like depression and encouraging willingness to discuss it.
The pandemic has exacerbated mental health issues, as isolation and anxiety have made it harder for some people to cope, at the same time that some public health resources may have been reallocated to curb the spread of the virus.
Wein of Wellness Workdays noted that “substance abuse information is always important, but nowadays, in 2020 and 2021, there’s a lot to be said for focusing on anxiety, depression and resiliency.”
Substance abuse. Construction workers are also more likely to struggle with substance abuse disorders. In fact, drug overdoses, particularly opioids, are five to seven times more common among construction workers, according to Chosewood. Part of the problem is that workers are often introduced to opioids through a prescription for an injury. Continuing to prevent injuries, and encouraging alternatives to opioids, are important interventions to reduce substance abuse.