The World Economic Forum “Global Competitiveness Report 2018” ranked the U.S. as the most competitive country in the world with an overall score of 86. The U.S. ranked 1st in labor market, financial systems and business dynamism categories.
The U.S.’s lowest competitive rank was in the “health” category. Forty-six other countries, primarily peer nations, scored better for health measured as life expectancy. Something is seriously wrong. Life expectancy is growing in many other countries. If downward trends continue for one more year, the U.S. will experience a three-year drop in life expectancy, which last occurred 100 years ago during the 1916-1918 global flu pandemic.
Part of the problem – or solution?
A major cause of the U.S.’s life expectancy decline should be of interest to OHS pros. The CDC’s July 2018 National Vital Statistics report showed that among the top-ten age-adjusted deaths per 100,000 people, unintentional injuries rose the fastest at 47.4 in 2016 from 40.5 in 2014.
Never in your lifetime has life expectancy in the U.S. been so dire. The question is, “Are your OHS practices part of the problem or part of the solution?”
For example, are OHS efforts narrowly focused on OSHA regs, engineering controls, and supervision, so much that your workforce is not taught or encouraged to manage injury risk avoidance on their own? Investments in off-the-job injury prevention may help improve life expectancy, among other solutions.
A dangerous place to have a baby
What do Afghanistan, Sudan, and the U.S. have in common? These are the only countries in the world where maternal mortality is on the rise. The question was the opening sentence from the U.S. House Committee on Ways and Means October 2018 press release. The committee announced an investigation to determine why the U.S. is the most dangerous place in the developed world for a woman to have a baby.
A tepid investigation will conclude that some hospitals do not voluntarily follow safety protocols that would prevent maternal death from causes such as high blood pressure or blood loss. A solution, in this regard, would be to make voluntary hospital safety protocols into requirements.
A root-cause analysis, however, will identify a much larger problem. In addition to global-high maternal mortality rates, the U.S. ranks at or near the bottom among its peer nations for rates of pre-term births, low birth weights, infant mortality and developmental disabilities (Google each condition to learn more).
The U.S. NHCS Data Brief (No. 291) from November, 2017 found that during 2014-2016 the prevalence of children aged 3-17 diagnosed with developmental disability experienced a “statistically significant linear increase” from 5.76% to 6.99%. Looking deeper, the NHCS report used a “more restrictive definition for developmental disability” than in the past that excludes conditions such as attention-deficit/hyperactivity disorder or learning disabilities.
A 2014 study funded by the March of Dimes found that preterm birth alone may cost U.S. employers more than $12 billion in excess healthcare costs. Poor birth outcomes, and lifelong problems they may create, are an enormous burden to individuals, business and to the U.S. society. The U.S. needs to get these outcomes back on track to at least to achieve global norms. Last month’s column provided a snapshot of how OHS pros may help ensure better U.S. birth outcomes.
Consider the rising age for first-time births in the U.S. In 2016, more women gave first-time births in their 30s than in their 20s. If trend lines continue, births among women 40-44 years old will outpace soon births among women 15-19 years old. Fertility and pregnancy risks increase with increasing age.
Demographic change alone, however, cannot explain why the U.S. fares so poorly with birth outcomes compared with peer nations. All peer nations are experiencing rising age for first-time mothers. The U.S.’s unemployment rate (September, 2018) for women is now at 3.6%, lowest in 65 years and near record low. Other countries can make similar claims. What are peer nations doing/not doing that allows them to be more successful than the U.S. with birth and life expectancy outcomes?
Middle of the spectrum
Serious problems in the middle of the life spectrum may be expected, too. Are workers really kept free from recognized workplace hazards, as OSHA General Duty Clause expects? Be aware that “recognized” has few limitations today.
Have you ever used a DNEL, measured EMF, managed stress, evaluated fatigue, sampled airborne microbiological agents, addressed emerging infectious diseases, or conducted pregnancy risk assessments (before being asked) at your workplace, to name a few examples? Other countries, generally U.S. peers, have legislative requirements to address some of these and other hazards that are not specifically regulated by OSHA.
The point is to open your mind to possibilities how OHS has great influence on such things as person’s initial path to wellness (or not) or early death and how these factors may drive a nation’s competitiveness.
The first requirement of ISO/ANSI 45001:2018 OHSMS standard is “context of the organization.” The standard’s Informative Annex A.4 reveals that context is broad and encompassing, particularly when the needs and expectations of external interested parties must be understood. Properly applied the context clause may be the most valuable of the standard’s requirements.
OHS pros must recognize that most risks don’t happen overnight. The heat has been rising on poor birth and early death issues for a while. Unlike the dumb frog, OHS pros must react to risks before the pot boils. Bias control is the most important consideration in this regard. If you’ve read this far and believe your workplace has no impact on poor birth or early death outcomes, that’s the first bias risk that must be controlled and addressed.