Transit Operator Health and Wellness Programs (2004)

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TRANSIT OPERATOR HEALTH AND WELLNESS PROGRAMS SUMMARY For many people, the bus or rail operator is the heart of the transit agency—the first and most lasting contact with the organization. Operators serve many roles other than simply transporting passengers to their destinations. They are often the primary goodwill ambassa- dors and masters of communication responsible for maintaining a loyal, diverse clientele. Operators who are healthy and have a solid sense of well-being are best equipped to fill these varied roles. Operator health and wellness issues that are not addressed or acted on can affect safety, service, absenteeism, employee turnover, and workers’ compensation in costly and negative ways. Conditions of concern include stress, hypertension, heart disease, mental health issues, stroke, back- and neck-related injuries, obesity, diabetes, tobacco use, and al- cohol and other drug-related problems. In addition, family-centered issues may affect an op- erator’s overall health and wellness. This synthesis provides a glimpse into the health and wellness issues faced by this group of employees, the impact of these issues on operators’ ability to be productive employees, and programs that transit agencies have implemented to improve the health and wellness of operators. The objective of this synthesis is to document current information on prevention and intervention strategies, and the resources that can be used by transit agencies to proac- tively address operator health and wellness issues. The synthesis surveyed transit agency experience with employee health and wellness programs. A questionnaire was developed and distributed to those transit agencies that, dur- ing telephone contacts, indicated that they operate health and wellness programs. Surveys were mailed to 33 transit agencies. In addition, contacts with transit agency health and well- ness professionals, developed while completing previous TCRP studies, were used. Particu- lar attention was paid to ensuring that the research pool represented various sizes of transit agencies, operating different transit modes, in diverse locations around the nation. For the purpose of this synthesis, a health and wellness program is defined as “a planned series of ongoing activities designed to improve the health and well-being of transit operators.” The synthesis effort also featured an extensive literature review. This review included re- search on how the nature of the job of operator affects health and well-being, health risk factors common to transit operators, regulatory mandates related to operator qualifications, specific health conditions common to operators that may prevent them from continuing their employment, health and wellness interventions in similar work situations, and health and wellness program successes in the transit industry. The survey revealed that transit agencies are embracing the health and wellness of opera- tors as a critical employee development and retention issue. Within the 14 responding agen- cies, there is evidence of proactive models of organizations seeking to improve operator physical and psychological health and well-being. These organizations have invested in, to varying degrees, health and wellness programs that focus on awareness-, education-, and

2 behavior change-oriented activities of different types. As the chapter on survey findings shows, these activities include health education, exercise, stress management, employee as- sistance, nutrition, smoking cessation, maintaining mental health, cardiovascular disease prevention, and disease management programs. The processes by which agencies have reached the program implementation stage vary and show the importance of creative and adaptive thinking in designing a program that fits the culture and needs of the individual or- ganization. The role that labor and management support plays in the successes of the 14 responding agencies is another area of variation. In some cases, support for health and wellness efforts is quite visible, and in others, less so. The degree of employee involvement in program de- sign and implementation also differs. In some cases, health and wellness committees have a large part in shaping and operating the program. This is especially true in instances in which the person assigned to lead the program has additional work responsibilities. For example, in one agency the program coordinator is an employee relations coordinator who is only able to devote 20% of her time to wellness program coordination. In a second case, the co- ordinator is the assistant director of finance and can spend only approximately 15% of her time on the wellness program. The majority of health and wellness programs have established internal organizational linkages with programs such as safety, benefits, and workers’ compensation. This strategy allows health and wellness to maintain a higher profile than if the program operated as a to- tally separate entity within the organizational structure. In a number of instances, agencies use community health and wellness resources to enhance the value of funding and other re- sources allocated by the transit agency. Although several agencies reported having annual operating plans with a clear mission, goals, and objectives statements, little attention is given to substantive program evaluation. The primary evaluation tool is the tracking of program participation, with some emphasis on participant satisfaction. Six case study agencies were selected from the 14 survey responses. The case studies describe program content, processes, challenges, and lessons learned in developing and im- plementing health and wellness programs for transit operators. These case studies also explore how the agencies align health and wellness goals with overall organizational strate- gic direction and priorities. Each case study tells a unique story, in part because health and wellness programs in these agencies have different origins. Some were started as a planned strategic approach by the agency’s management team. Others started as a result of requests made by union leader- ship or by someone in the organization who had enough interest in health and wellness to voluntarily try a few wellness activities. Similarly, each case study has its own program model. Some have a comprehensive focus, in which annual program activities and meas- urement criteria are defined in the agency’s annual budget, with as much as a six-figure al- location. In other cases, the program is shaped to fit an allocation of from $2,000 to $6,000. Even in cases with small budget allocations, the commitment to the program is strong and is articulated in a variety of ways by participants, senior management, and, in a number of cases, labor union leadership. The case studies demonstrate that there is no single right way to begin, organize, or oper- ate an operator health and wellness program. One thing these six agencies have in common is an organizational awareness of the types of health risk factors operators have in common,

3 with many risks owing to the nature of the job. Lack of physical activity, obesity, unhealth- ful diet, uncontrolled diabetes, and uncontrolled hypertension all rank close to the top of the list of these costly risk factors. Program activities focus on ways to prevent or reduce the ef- fects of these risk factors, while also making employees responsible for their own health and well-being. The many ways in which this is accomplished is refreshing and likely to be thought provoking to other agencies considering health and wellness programs as an em- ployee development and organizational improvement strategy.