They may be small, but they are mighty.
Collectively, small businesses represent about half of private-sector U.S. employers. Between 1993 and 2011, they accounted for 64 percent of newly created jobs, according to the Bureau of Labor Statistics.
Sole proprietors and small companies (less than 500 employees) stimulate entrepreneurship and frequently function as incubators for starts-ups. In addition, small enterprises comprise a significant book of business for service providers such as insurers, health care organizations, IT, accounting, law and real estate.
The occupational health and safety concerns of a small business may seem trivial in comparison to those of a multi-national corporation. However, a big company is likely to have an EH&S team, while a smaller company may have only one or two people responsible for all aspects of workforce protection.
It’s a big deal when a single catastrophic incident threatens to take down a small company with limited resources. Meanwhile, work-related injuries and illnesses that routinely occur disproportionately in small businesses continue to take a toll.
Small Business as Change-Agent
The National Institute for Occupational Safety and Health (NIOSH) gives small employers a voice. During a recent webinar sponsored by its Total Worker Health (TWH) program, two of NIOSH’s four TWH Centers for Excellence – the University of Iowa Healthier Workforce Center for Excellence and the Center for Worker Health and Environment at the Colorado School of Public Health in Denver – were featured.
During the webinar, we learned that the Colorado center is collaborating with Pinnacol Assurance, a leading workers’ compensation insurer, and Health Links Colorado to engage small companies in TWH approaches that combine safety and health promotion (wellness) to improve employee and dependent health, boost morale and productivity, and encourage retention. The goal is to help small businesses recognize and adopt cost-effective, evidence-based best practices for sustainable workplace health and safety solutions.
Webinar presenter Lee Newman, M.D., a professor at the Colorado School of Public Health, said success stories are starting to emerge but barriers that are daunting to small business operators remain. They include cost, lack of employee buy-in and/or management support, insufficient expertise and access-to-care issues. (Refer to Health Promotion in Small Business: A Systematic Review of Factors Influencing Adoption and Effectiveness of Worksite Wellness Programs, Journal of Occupational and Environmental Medicine, Vol. 57, No. 7, July 2014, L Newman, K McCoy, et al.)
In the real world, “economic stress trumps wellness and safety,” Dr. Newman said. “Small employers largely don’t know how to accomplish an individual or integrated model. There are gaps in evidence as far as what works. We can’t succeed at reaching millions of small business owners unless we have something that is scalable. We can’t tackle this one small business at a time.”
Health Links provides seed capital and onsite assistance for qualified organizations to implement workplace wellness and safety programs. In one year, it certified 130 businesses that satisfy certain healthy and safe workplace standards and is on track to certify up to 500 by next year. Among small companies that have achieved certification:
- 77 percent offer nutrition and fitness programs that feature written policies, environmental awareness, education, subsidies and incentives
- 50 percent provide stress management interventions
- 44 percent have integrated health and safety programs
- 44 percent set annual safety goals such as increasing protection and eliminating/reducing the use of hazardous materials
In Iowa, the Healthier Workforce Center for Excellence is building on research in occupational health and safety, ergonomics and health promotion, James Merchant, M.D., DrPh, a professor and center director explained during the webinar. The center gives small businesses in Iowa (about 97 percent of all employers in the state) guidance on the development and evaluation of healthy workforce programs.
Much of the center’s efforts have been informed by results from a survey of Iowans on the relationship between health status and work. (Refer to Employment Status Matters: A Statewide Survey of Quality-of-Life, Prevention Behaviors, and Absenteeism and Presenteeism, another article published in the July 2014 edition of JOEM.) Researchers found employment status (unemployed, self-employed or employed by an organization) is related to measures of well-being, which are associated with absence and working at less than full capacity. Interestingly, the survey shows that self-employed individuals tend to have better quality-of-life scores than those employed by organizations.
Dr. Merchant and his colleagues have concluded that TWH centers of excellence and individual programs need to be expanded so more companies and employees can benefit from them. “They are important to the national transition from a sickness-based medical model to a health-based model of care as described and authorized under the Affordable Care Act,” he said.
Karen O’Hara, Director of Marketing and Communications for WorkCare, has more than 24 years of experience in the field of occupational health and safety.