A touch of grey: Time to become age-friendly
Make changes to help HCWs of all ages
The average age of an American nurse is 50. By 2020, half of all registered nurses will be 65.1 As the demand for health services continues to grow with the aging of the U.S. population, the people who care for them are aging, too. That’s why hospitals are ground zero in the new push for an age-friendly workplace.
Two leading voices for occupational health and safety have teamed up to spur employers to address the aging of the workforce with policies that will benefit all workers. The American College of Occupational and Environmental Medicine (ACOEM) and the National Institute for Occupational Safety and Health (NIOSH) held a "Summit on Advancing the Health Protection and Promotion of an Aging Workforce" in 2012 and recently issued a report to help guide employers in creating an age-friendly workplace. (See box on p.106.)
They start with an important premise: Don’t target older workers, but create adaptations that will benefit them and their younger colleagues.
"We need to focus on [encouraging] healthy aging, even starting when someone comes into their workforce in their 20’s," says Ron Loeppke, MD, president of U.S. Preventive Medicine and president of ACOEM.
In fact, older workers have occupational health needs that are very similar to that of younger workers. A study of workers’ compensation claims found that the injuries and costs of treatment are similar for workers 35 years and older. (See related article on p.105.)
"One of the myths is that health care costs for older workers are higher than they are for younger workers," says Anita Schill, PhD, MPH, MA, senior science adviser at NIOSH and co-manager of the agency’s Total Worker Health program.
Many younger workers have health risks, such as obesity, and chronic conditions, such as diabetes, she notes. "We’re actually seeing more chronic disease in younger people than we ever have before," she says.
Health and work are interconnected
As a centerpiece of an age-friendly workplace, employers should integrate health promotion with occupational health and safety, the summit experts agreed.
"All of us in the occupational health and safety specialty of health care have acknowledged for years that health impacts work, and work impacts health," says Loeppke. "People don’t leave their health risks at home in the morning when they come to work and they don’t leave their work risks at work when they come home. We need to find ways to promote a 24-7 culture of health and shift the paradigm."
For example, shift work and long hours lead to fatigue, which is associated with a greater risk of occupational injury, says Schill. Shift work and sleep disruption also have been linked to diabetes and obesity, she says.
The summit report suggests providing a flexible work schedule to accommodate older workers. But a new perspective on scheduling could produce a wide range of benefits, she says. "There’s an opportunity here to look at this age-old problem of shift work," she says.
NIOSH’s Total Worker Health program provides resources for integrating wellness programs with traditional employee health services. For example, the agency suggests incorporating joint health and arthritis prevention with ergonomics programs, tobacco cessation with respiratory protection programs, and work risks with preventive health screenings. (Related information is available at www.cdc.gov/niosh/programs/totalworkerhealth/.)
The SafeWell Guidelines, developed by the Center for Work, Health and Well-being at the Harvard University School of Public Health, provides a template specifically for health care organizations to integrate health promotion and occupational health. (See related article in HEH, September 2012, p. 103. More information is also available at http://centerforworkhealth.sph.harvard.edu/.)
Adapt to needs of older workers
The specific challenges for aging workers also can trigger improvements in the workplace that will benefit all workers, says Schill.
Improved lighting helps those who have diminished vision whether they are health care workers or hospital visitors. Slip-resistant floors reduce the risk of falls. "Employers should really be motivated to look at these issues and see how they can improve the work environment," she says.
In fact, addressing the needs of older workers is just one way of accommodating the physical demands of health care work, says Loeppke.
Employers should take a positive approach to retaining older workers, he says. "We’re all recognizing that as the workforce ages, we have to embrace age-friendly adaptations," he says. "It’s a tremendous asset to have people that have the institutional knowledge and experience in any given industry to continue to be healthy and productive at work."
That is especially true in health care, which is the fastest growing segment of the workforce, according to the U.S. Bureau of Labor Statistics.
"The reality is your workplace is aging, so just go ahead and address it," says Loeppke. "Incorporate age-friendly elements in health protection and health promotion programs. Be proactive about it, embrace it. This should just be an ongoing part of the safety and health training.
Work injuries don't discriminate by age
Similar risk for ages 35 and up
When it comes to work-related injuries, "old age" starts young. A 55-year-old worker is similar to one who is 35, according to an analysis of workers' compensation claims data by the National Council on Compensation Insurance (NCCI) in Boca Raton, FL.
The rate of injury for younger workers has dropped significantly, so it more closely mirrors the lower rate of older workers, says Tanya Restropo, MBA, an economist with NCCI. Yet younger workers also are increasingly likely to have more severe injuries, such as rotator cuff or knee injuries, NCCI researchers found.1
"We used to think that younger workers had much higher injury rates than older workers. We found that now there is very little difference in injury rates by age," says Restropo. "The injury rates for older workers have been falling more slowly than the injury rates for younger workers."
The types of injuries have been changing. "We're finding that definitely older workers have higher severity, but older seems to be starting with age 35," she says. "A lot of people think it's 55 and older. The 35 and older now, they're all right in line [with them]."
A sedentary lifestyle and rise in obesity may have contributed to the greater severity of injuries of younger workers, NCCI researchers speculated. In any case, the aging of the workforce isn't likely to significantly affect workers' compensation costs because those workers aren't actually much different from younger workers, Restropo says.
"An aging workforce does not pose a significant challenge for workers compensation," said NCCI chief economist Harry Shuford, PhD, in a report.2
But, of course, there is a different worry. "Perhaps we need to shift our concerns from older to younger workers," he concluded. "If there is little difference in their health status today, just imagine what condition these younger workers may be in 30 years from now."
Reference
- Restrepo T, Shuford H. Workers compensation and the aging workforce: Is 35 the new 'older‖ worker'? NCCI Research Brief, October 2012. Available at http://ow.ly/nQZMh. Accessed on July 8, 2013.
- Shuford H. Our workforce is rapidly aging Is this bad news? Workers' Compensation 2013 Issues Report, NCCI, Boca Raton, FL. Available at http://ow.ly/nQZXC. Accessed on July 16, 2013.
Action steps for an age-friendly workplace
• Integrate health protection with health promotion to create a "culture of health" throughout the workplace.
• Create and implement "age-friendly" programs and policies, including:
Prioritize workplace flexibility, and give additional control over work schedules, work conditions, and work location, which benefit workers of all ages.
Use adaptive technology and design work tasks to meet older workers' physical needs.
Manage noise hazards, slip and trip hazards, physical hazards, and conditions that are more challenging to older workers.
Provide ergo-friendly work environments, such as workstations, tools, floor surfaces, adjustable seating, better illumination where needed, screens and surfaces with less glare.
Provide health promotion and lifestyle interventions.
Accommodate medical self-care in the workplace and time away for health visits.
Invest in training and skills-building at all age levels.
Proactively manage reasonable accommodations and the return-to-work process after illness or injury absence.
Require aging workforce management skills training for supervisors that addresses the specific needs of older workers in addition to the needs of all generations of workers.
• Broaden the dialogue about workforce aging through stronger collaboration in the workplace between employers and worker. This requires honestly discussing issues related to aging and engaging employees, employers, and key stakeholder groups, such as labor representatives, occupational safety and health professionals, health promotion professionals, community health care providers, academics, advocacy organizations and governmental agencies in discussions of policies and strategies.
• Raise awareness of the workforce aging issues among employers and policymakers.
References
- Harrington L, Heidcamp M. The aging workforce: Challenges for the health care industry workforce. Issue brief of the NTAR Leadership Center, New Brunswick, NJ, March 2013. Available at http://ow.ly/nQYmI. Accessed on July 5, 2013.
- Loeppke RR, Schill AL, Chosewood L, et al. Advancing workplace health protection and promotion for an aging workforce. J Occup Environ Med 2013;55:500-506.
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