Preprint Concept Paper Version 1 Preserved in Portico This version is not peer-reviewed

Employer Preparedness: A Total Worker Health Conceptual Framework and Model

Version 1 : Received: 17 December 2020 / Approved: 21 December 2020 / Online: 21 December 2020 (15:45:33 CET)

A peer-reviewed article of this Preprint also exists.

Journal reference: Disaster Medicine and Public Health Preparedness 2022
DOI: 10.1017/dmp.2021.364


Background: Recent disasters have demonstrated gaps in employers’ preparedness to protect employees and promote their well-being in the face of emergencies and disasters affecting the workplace and their communities. Total Worker Health (TWH), a comprehensive perspective developed by the National Institute for Occupational Safety and Health, is a helpful framework for addressing employer preparedness. It includes attention to health and safety at work, and the promotion of the health and well-being of the employee in the context of social determinants of health, such as work-life balance. Methods: TWH concepts, including the domains of TWH and the TWH Hierarchy of Controls, were investigated for their relevance to protecting employees and promoting their well-being during and after crises such as weather disasters, pandemics, and acts of terrorism. Building upon TWH concepts, an employer preparedness framework and model is proposed. Findings: The Model emphasizes upstream prevention, workplace-community linkages, social and economic impacts, and employer leadership through a cyclical planning process. Conclusions/Application to Practice: The Model can assist employers in advancing their preparedness for all hazards through self-assessment and planning agendas based upon the proposed domains.


Employer Preparedness, health and safety, emergencies and disasters, planning, Total Worker Health



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