NIOSH TWH Affiliate Program Rapidly Creating New Worker Well-being Opportunities

Posted on by Emily Kirby, BPH; Chia-Chia Chang, MPH, MBA; L. Casey Chosewood, MD, MPH


The NIOSH Total Worker Health® Affiliate Program is growing quickly, demonstrating enthusiasm for Total Worker Health (TWH) approaches by employers, researchers, and practitioners. With over 55 members as of March 2023, the TWH Affiliate Program aims to advance worker safety, health, and well-being through non-funded collaborations with governmental and nonprofit organizations, including labor, education, training, and research organizations.

Innovative Program Fosters Collaboration and Increases Reach

The TWH Affiliate Program is the first of its kind at NIOSH. The program helps increase the visibility, uptake, and impact of TWH approaches to advance the safety, health, and well-being of workers. The program also attracts new collaborators to enrich and broaden TWH-related research, practice, and dissemination efforts. This facilitates a community of practice for mutual learning and sharing examples of TWH in lived practice. The program publicly recognizes affiliates’ contributions to the development and dissemination of TWH research and practice.

Win-Win Relationships

The Affiliate Program benefits Affiliates (including their workers), NIOSH, and the field of worker safety, health, and well-being. Affiliates are among the first to know about TWH-related resources. NIOSH staff consult with Affiliates to offer technical assistance and guidance and regularly communicate updates, sharing webinars, events, toolkits, and resources. Affiliates learn from and collaborate with each other, the Centers of Excellence for TWH, NIOSH researchers, and others in a vast network of professionals dedicated to worker well-being. Two Affiliates became Centers of Excellence for TWH, demonstrating the leadership and expanding expertise in its science and practice.

Examples of collaborative activities between NIOSH and affiliates include:

  • Engaging in joint research
  • Developing TWH programs and interventions
  • Collaborating on seminars, meetings, trainings, and educational events
  • Creating and disseminating publications and other communication products
  • Cross-promoting individual and joint activities

NIOSH convened affiliate meetings in 2015, 2017, 2019, and 2022. During the meetings, discussions identify emerging issues and TWH approaches that can help, including successful and ongoing efforts to advance worker safety, health, and well-being. Regional networks also provide opportunities for collaboration. The University of Illinois at Chicago’s Center for Healthy Work, a Center of Excellence for TWH, and the Miami Occupational Research Group, an Affiliate, convened virtual regional meetings to share best practices, research, and experiences from the field.

Meet the Affiliates

In 2021, a new feature in the quarterly TWH newsletter, “Total Worker Health in Action!”, was created to introduce readers to the current affiliates and recognize their contributions to the field. See how they responded when we asked about their work:

When did you become an affiliate and why did you want to join the program?  

  • “The Laborers’ Health & Safety Fund of North America (LHSFNA) became a NIOSH TWH affiliate in 2015. The TWH health paradigm is expansive and covers a lot of different topics not always considered traditional workplace topics. The LHSFNA believed having a formalized platform to address these types of issues made a lot of sense. However, some of the issues that fall under the TWH umbrella can also be considered controversial in some industries. We believe it is important to have a seat at the table to be able to contribute to the direction and growth of TWH in relation to the construction trades and other industries in general.” – Laborers’ Health & Safety Fund of North America, December 2021
  • “UC Davis became a TWH Affiliate in 2022. UC Davis values networking and developing best practices. As a TWH Affiliate, we can be part of a network of progressive organizations who all share the same vision to build a healthy work environment and improve worker well-being.” – UC Davis, March 2023

How do you incorporate TWH practices into your organization’s work?

  • “Many of the faculty have been actively engaged in TWH-related research. Current and recent research priorities have emphasized human factors in job design, fatigue prevention, organizational interventions, built environment supports, healthy community design, and changing workforce demographics. A main thrust of the department’s research efforts is the designing for and accommodation of workers of varying abilities.” —University of Buffalo, April 2021
  • “The Center for Social Epidemiology and Healthy Work Campaign align with the TWH statement that “work is a social determinant of health.” Job-related factors like low wages, work hours, job demands/workload, supervisor/coworker support, work-life conflict, and more are “sources of stress” in the workplace that impact the health and well-being of workers. The TWH approach offers practices that organizations can use to reduce these job-related factors.” — Center for Social Epidemiology, March 2022
  • “Safety, health, and wellness are embedded in our culture. From the top of the organization throughout the utility, we are invested in robust programs that encourage the safety, health, and wellness of our employees as well as our community. Our mission and core values are closely aligned to the principles of the NIOSH TWH approach- both internally, in our efforts to improve the safety, health and wellness of our employees, and externally, as we strive to enhance our community’s vitality by delivering drinking water and electric services consistent with our core values.” —Eugene Water and Electric Board, June 2022

How has being an affiliate helped you in your work?

  • “NIOSH TWH has provided us with resources to share with our members, and we disperse this knowledge to all of them. It has helped us all focus on our own health and the health of others at work and home.” —Association of Occupational Health Professionals in Healthcare, April 2021
  • “Being a TWH affiliate has allowed us to learn from others in the TWH network and has helped us to improve the quality of our research and practice by looking at worker health from a more holistic perspective.” —Kentucky Injury Prevention and Research Center, September 2022

What are you most proud of having accomplished as an affiliate?

  • “In 2019, we launched a long-term mental health initiative that has had fantastic uptake by the members and unwavering support of our organization’s leadership. We’ve woven mental health training into our apprenticeship, shop steward, leadership, and standalone courses addressing suicide prevention, stigma, coping strategies, the mental health continuum, and more.” International Brotherhood of Boilermakers, September 2021
  • “Through our partnership with the Healthier Workforce Center of the Midwest, we produced two action-oriented publications, like this employer guide, to help employers understand how to apply key TWH practices to modern employee health challenges.” St. Louis Area Business Health Coalition, December 2021
  • “We are very proud of our work to identify barriers and supports to breastfeeding in the workplace.” —New Hampshire Occupational Health Surveillance Program, March 2022

Join the NIOSH TWH Affiliate Program

Nonprofit and government organizations interested in becoming affiliates discuss shared goals and plan possible joint activities with NIOSH staff. The affiliate status is then formalized with a Memorandum of Agreement (MOA) or similar document. Affiliate status demonstrates a long-term commitment to shared values and goals. Learn more about the program on the NIOSH TWH Affiliate Program webpage. Organizations interested in advancing worker safety, health, and well-being through the NIOSH TWH Affiliate Program can contact for more information. Please note that organizations awarded Affiliate status are not provided with any funding.  There are also no fees associated with Affiliate status.

How do you incorporate TWH practices in your work? Tell us below!


Emily Kirby, BPH, is a Health Communication Specialist in the NIOSH Office of Communication and Research to Practice.

Chia-Chia Chang, MPH, MBA, is a Public Health Analyst in the Office for Total Worker Health.

L. Casey Chosewood, MD, MPH, is Director of the NIOSH Office for Total Worker Health.

Posted on by Emily Kirby, BPH; Chia-Chia Chang, MPH, MBA; L. Casey Chosewood, MD, MPH

One comment on “NIOSH TWH Affiliate Program Rapidly Creating New Worker Well-being Opportunities”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    It is excellent, I have reviewed its principles, it seems to me that this is the vision in Workers’ Health. In line with the joint report of ILO and WHO in relation to the Health of workers. I also share it with my students.
    Best regards
    L. Soto
    MD Occupational

Post a Comment

Your email address will not be published. Required fields are marked *

All comments posted become a part of the public domain, and users are responsible for their comments. This is a moderated site and your comments will be reviewed before they are posted. Read more about our comment policy »

Page last reviewed: June 5, 2023
Page last updated: June 5, 2023