The fields of occupational safety and health (OSH) and public health have become disconnected, but recent developments point to ways to reverse this widening gap. Within public health, the need to address health disparities in the US population has brought about a renewed emphasis on social and environmental determinants of disease. OSH offers a way to reach a large portion of the population experiencing these disparities. But to reconnect public health and OSH and truly improve the health of working populations, both disciplines need to recommit themselves to the health of workers.
In recent decades, there has been a shift in public health away from environmental determinants of disease to a focus on individual risk-taking behaviors. Workplace public health practice has focused on personal behaviors related to smoking, diet, drinking, and exercise, while deemphasizing physical exposures and stressful working conditions. This shift reflects a broader political trend toward reducing corporate social and environmental responsibility. Behavior-based safety programs have become prominent, directing attention toward “accident-prone” workers rather than redesigning hazardous processes. In the extreme, these programs punish workers while ignoring occupational hazards, with serious negative consequences. For example, many unions and working people recognize that smoking is a health threat, but they are mistrustful of worksite health promotion programs that provide smoking cessation services but ignore workplace safety concerns.