Work and Health Initiative Scientific Meeting Report

Contents

1. Introduction and background

2. What we heard at the meeting

3. Next steps

• Appendix 1: List of participants

1. Introduction and background

Canadian workplaces are a reflection of our society: our population is aging. The number of people with disabilities, chronic conditions, and work-related health issues is growing. More and more working Canadians are devoting considerable time and energy to the care of their loved ones. For some Canadians, health issues and disabilities are a barrier to entering the workforce; for those who are already employed, they can be a barrier to sustaining meaningful work. Employers are grappling with changing skills requirements and the challenges of accommodating their employees’ needs as they strive to develop and retain their workforces. Policy-makers, insurers, clinicians, workplace safety and insurance boards, unions, professional associations, and other stakeholders face challenges and opportunities as they adapt to the unique needs and characteristics of the 21st century workforce.

The Work and Health Initiative reflects growing interest in maintaining a healthy, productive and inclusive workforce – for example, recent federal investments in the supporting the labour force participation of people with disabilities. This initiative aims to bring together researchers and stakeholders from a number of sectors, in an effort to develop innovative, evidence-informed approaches to designing workplaces that support the health and productivity of Canada’s diverse workforce. The Work and Health Initiative focuses on creating the conditions for healthy work – more specifically, on the accommodations and interventions necessary to foster the labour force participation of people with health issues (e.g., injuries, chronic conditions) and disabilities, as well as workers with caregiving responsibilities outside of their paid work. For the purposes of this report, “accommodations” are defined as modifications to work and work environments designed to enable participation in meaningful work. These include both formal and informal accommodations and adaptations at various levels (individual workers, organizations, workplaces, sectors, policy/regulatory, educational institutions, the health care system, etc.).

The Work and Health Initiative is envisioned as a collaborative effort between the Canadian Institutes of Health Research (CIHR), the Social Sciences and Humanities Research Council of Canada (SSHRC), and a diverse and growing community of partners and stakeholders. In September 2013, CIHR and SSHRC co-hosted a one-day invitational Scientific Meeting in Toronto, ON. This meeting brought together a multi-disciplinary group of leading researchers with expertise in work and health. (For a list of participants, see Appendix #1.) The purpose of this meeting was to seek input from leading researchers on the proposed focus and future directions of a transformational research initiative on work and health. The meeting had several main objectives:

1. To brief participants on progress to date in the development of the work and health initiative.

2. To seek expert input on the proposed focus of the initiative (workplace accommodation).

   1. To validate the proposed focus of the initiative

   2. To refine the focus of the initiative (how can we optimize the initiative/make it most impactful? are there gaps in how it is presently conceptualized?)

   3. To identify and prioritize relevant multidisciplinary/multisectoral research topics and questions (what are the most significant research topics and questions relating to workplace accommodation?)

   4. To gauge Canadian research capacity in this area (do we have the highly qualified personnel necessary to achieve the goals of this initiative?)

   5. To identify potential partners for this initiative

The following report summarizes the feedback and suggestions put forward by the researchers who were present at the Scientific Meeting.

2. What we heard at the meeting

Overall, participants highly valued the possibilities for a transformative, transdisciplinary, collaborative research initiative to create a more inclusive workforce and workplaces. The group articulated the desired impacts, provided insights about the scope and framing, and suggested how to describe and structure the initiative for the most meaningful collaborations.

Desired impacts of the initiative:

• Canadian workplaces enable full and meaningful participation for people with health challenges and workers with caregiving responsibilities, leading to greater productivity and a healthier population.

• There is an overall appreciation of the value of an inclusive workforce that includes and supports the participation of groups who may require more accommodation or support at work, including older workers, people with disabilities, and workers with physical and mental health challenges. Workplaces attract, retain, engage, and accommodate a diversity of workers with inclusivity in mind.

• The determinants of workforce participation are understood and enabled, both inside (e.g., structural and supportive changes within organizations) and outside of workplaces (e.g., the role of supportive transportation in enabling people to work).

• Workplace interventions and best practices that enable full participation are based in evidence, and understood and valued by all stakeholders.

• Comprehensive policies are in place that enable full participation, within workplaces and across jurisdictions.

• There is heightened collaboration between researchers, workplaces, all relevant levels of government, and other stakeholders.

• Leadership by both SSHRC and CIHR creates opportunities for new and productive collaborations.

Scope and framing of the initiative:

• There was extensive discussion of the term “accommodation,” which has a narrow and specific meaning for some stakeholders (i.e., employers’ legally-enshrined duty to accommodate their workers).

• Some participants suggested that we explore broader frames for the initiative – for example, enabling Canadian workplaces to enable full meaningful participation for people with health challenges and caregivers, leading to greater productivity and a healthier population.

• Participants emphasized the importance of approaching these topics from multiple levels (i.e., individual workers, individual workplaces, sectors, etc.), with and from the perspectives of multiple stakeholders (e.g., workers, employers, government, unions, etc.), fostering trans-sectoral and transdisciplinary collaboration, and enabling the development of evidence-informed interventions.

• Participants emphasized the importance of attention to transitions throughout the life course – for example, a young person’s transition into first-time employment, or an injured worker’s transitions in and out of the workplace.

• Participants noted that there are multiple generations in the workforce. Younger workers and older workers have different health needs, priorities, and vulnerabilities.

• Medical and technological interventions are enabling people with chronic conditions to remain in the workforce longer.

• Changing demographics – in particular, population aging – provide an opportunity to consider how cognitive issues and competencies can be successfully dealt with by employers and employees. They also represent an opportunity to further understand and support the needs of working caregivers.

• Examples of specific populations of workers who might merit attention are workers with mental health challenges, children with disabilities who will eventually enter the workforce, and people who are currently working with, or not working because of a disability.

• It is important to acknowledge that policy has the potential both to drive exclusion and promote inclusion.

• There is the perception that clinicians and employers are struggling with accommodation.

• There is great awareness about health in the workforce but current interventions are rarely based on evidence informed decision-making. There is a need to explore how to encourage the widespread adoption of already proven interventions, as well as the development of new interventions.

Structure of the initiative:

• Canada has strong research capacity in research on work and health. For example, Canada is home to leading researchers studying assistive and rehabilitative devices, work disability prevention research, and return to work.

• The research being supported must be transformative and contribute something new to our understanding of the issues.

• Participants emphasized the importance of investing efforts to measure economic costs and benefits resulting from innovative methods of accommodating and supporting participation in work.

• There is a need for support for increased research capacity to develop methods for trans-sectoral/transdisciplinary research.

• Peer review processes must be designed to support the type of research required for an initiative of this kind.

• There are opportunities to be gained through multi- and transdisciplinary collaboration among researchers, as well as trans-sectoral collaboration with partners and knowledge users.

• There is a diverse range of partners who may be interested in being part of this initiative, including public and private sector employers, federal, provincial/territorial, and municipal policy- and decision-makers, insurance companies, workers’ compensation boards, unions and professional associations, non-governmental organizations, and health charities.

• To succeed, partnerships must be meaningful and based on relationships. Partners should have the capacity to shape the direction of the initiative so that it is relevant to their needs and priorities.

• The initiative must support collaboration among knowledge users (e.g., employers, unions, workers, policy-makers, health care providers, etc.)

• The initiative should include support for collaboration (for example, funding to offset the direct or indirect costs of participating in research, as well as recognition of the direct and indirect costs of leading major research initiatives such as this one).

• There are a diversity of stakeholders with the potential to contribute to and benefit from this initiative, and a diversity of opportunities for engagement.

• Knowledge users need support in building their capacity to receive and implement research evidence.

3. Next steps

The Work and Health Initiative is in the early stage of development. Through our combined input, efforts and resources we will inform the design of funding opportunities that will address our shared objectives. It will develop strong evidence and approaches that support interventions and policies focused on accommodation and enabling healthy work, and build capacity and infrastructure for measuring and demonstrating the broader health and economic impacts of these interventions and policies. The Work and Health Initiative is being developed through an iterative process of consultation with the diversity of stakeholders who share an interest in developing innovative, evidence-informed approaches to designing workplaces that support the health and productivity of Canada’s diverse workforce. The researcher input summarized here will shape this evolving initiative, as will the next phase of consultation with partners and knowledge users. A partner forum is planned for 2014. In the lead-up to this forum, we will continue seeking input from key stakeholders. Resources for the Work and Health Initiative will be leveraged through partnerships – both financial and in-kind – such as providing access to work environments where studies can be carried out or interventions tested. These partnerships will be formed early in the initiative so that partners’ priorities will shape the development and direction of the Work and Health Initiative.

Appendix 1: List of participants

Pierre Côté, Associate Professor and Director, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology

Cate Creede, Facilitator, The Potential Group

Carolyn Dewa, Professor, Psychiatry, University of Toronto; Head of the Centre for Addiction and Mental Health’s (CAMH) Centre for Research on Employment and Workplace Health

Linda Duxbury, Professor, Sprott School of Business, Carleton University

Hani El-Gabalawy, Scientific Director, CIHR Institute of Musculoskeletal Health and Arthritis

Janet Fast, Professor, Human Ecology, University of Alberta

Renee-Louise Franche, Clinical Psychologist, WorkSafe BC and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, School of Population and Public Health, University of British Columbia, and Dalla Lana School of Public Health, University of Toronto

Tanya Gallant, Associate, CIHR Institute of Musculoskeletal Health and Arthritis

Monique Gignac, Associate Scientific Director and Senior Scientist, Institute for Work & Health and Senior Scientist, Division of Health Care and Outcomes Research, Toronto Western Research Institute

Brent Herbert-Copley, Vice-President, Research Capacity, SSHRC

David Holdsworth, Professor, Diagnostic Radiology and Medical Biophysics Western University and Scientist, Robarts Research Institute

Yves Joanette, Scientific Director, CIHR Institute of Aging

Joy Johnson, Scientific Director, CIHR Institute of Gender and Health

Mieke Koehoorn, Associate Professor, School of Population and Public Health, University of British Columbia, and CIHR Research Chair in Gender, Work and Health

Christian Larivière, Senior Researcher, Institut de recherche Robert-Sauvé en santé et en sécurité du travail

Sally Lindsay, Assistant Professor, Department of Occupational Science and Occupational Therapy and Scientist, Holland Bloorview Kids Rehabilitation Hospital

Katherine Lippel, Canada Research Chair in Occupational Health and Safety Law, University of Ottawa

Linda McKenzie, Deputy Director, Strategic Program Design and Analytics, Canadian Institutes of Health Research

Zul Merali, President and CEO, University of Ottawa Institute of Mental Health Research

Joy MacDermid, Professor School of Rehabilitation Sciences, McMaster University and CIHR Research Chair in Gender, Work and Health

Lynn McDonald, Professor, Faculty of Social Work and Director of the Institute for the Life Course and Aging, University of Toronto

Cindy McIntyre, Policy Analyst, Corporate Strategy and Performance, SSHRC

Cameron Mustard, President and Senior Scientist, Institute for Work & Health

Sylvie Nadeau, Professeure titulaire, École de Réadaptation, Faculté de médecine, Université de Montréal

Emily Neff, Project Manager, CIHR Institute of Musculoskeletal Health and Arthritis

Michelle Peel, Assistant Director, CIHR Institute of Aging

Sergio Rueda, Assistant Professor, Psychiatry, University of Toronto and Associate Scientist, Ontario HIV Treatment Network

Zena Sharman, Assistant Director, CIHR Institute of Gender and Health

Kim Shuey, Associate Professor, Department of Sociology, Western University

Liz Stirling, Assistant Director, CIHR Institute of Musculoskeletal Health and Arthritis

Emile Tompa, Assistant Professor, Dalla Lana School of Public Health, University of Toronto and Scientist, Institute for Work & Health

Holly Tuokko, Professor, Psychology and Director, Centre on Aging, University of Victoria

Catherine Ward-Griffin, Professor and Scientist, Lawson Health Research Institute, Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University

Allison Williams, Associate Professor, School of Geography and Earth Sciences, McMaster University and CIHR Research Chair in Gender, Work and Health

Date modified:

2014-01-24