Keynote 1: Total worker health - an integrated approach to work, health, safety and wellbeing

Keynote 1: Total worker health - an integrated approach to work, health, safety and wellbeing

Dr. L. Casey Chosewood

Presented by: Dr L. Casey Chosewood (Director, Total Worker Health, National Institute for Occupational Safety and Health)

Run time: 45:34

Download a copy of this podcast (MP3, 21 MB)

Download the presentation of Keynote 1: Total worker health - an integrated approach to work, health, safety and wellbeing(PDF, 3128.56 KB)

Read transcript

Keynote 1: Total worker health – an integrated approach to work, health, safety and wellbeing

Presented by: Dr L. Casey Chosewood (Director, total Worker Health, National Institute for Occupational Safety and Health)

[Start of keynote 1 transcript]

Madonna King:

So now let's go to our first keynote speaker for today and we are just privileged to have our first keynote speaker fly all the way from America to talk to you this morning. He arrived just on Saturday, and remember you can lodge a question for him also as we go through. Dr Casey Chosewood is Director at the Office of Total Worker Health at the National Institute for Occupational Safety and Health which is part of the Center for Disease Control and Prevention in the United States, and in this role he promotes the protection and improvement of the safety, health and wellbeing of workers around the globe. His office has led numerous workforce protection programs and today Dr Chosewood will discuss the total worker health program and an integrated approach to work, health, safety and wellbeing. Ladies and gentlemen please give a big Aussie welcome to Dr Casey Chosewood.

Dr Casey Chosewood:

Well good morning folks. It's a real pleasure to be here. This is my first trip to Australia. So thanks for already making it very warm, very welcoming and such perfect weather. It's summer in Atlanta, my hometown and pretty miserable if you can imagine. I would imagine sort of like your summers here, so we share that in common.

So thanks for having wonderful weather for my arrival and also the food and wine festival that was just next door. I certainly enjoyed that completely. I'm also feeling quite adjusted to the time zone so I don't think I'll fall asleep on you today but if you want anything later in the day I cannot promise anything, okay?

So first let me say again thanks to Nita and her team for inviting me to this important meeting and also just more generally thank you all very much for the work you do each and every day to support the health, safety and wellbeing of workers. Our institute within the CDC, this public health agency for the US government, is really dedicated to healthier, safer work. We believe very strongly that if you're going to have people home safe at the end of the day, which I know is a major goal of many of the work that you do each and every day, it starts by better job design, the better crafting of work to produce health and safety, not only as an outcome of what workers experience, but the very nature in which a job is created, crafted, designed, organised.

Really ideally you should not just send workers home with the same level of health that they arrived with that morning. Ideally work should be salutogenic. Work should create health. It's not acceptable in the modern age to trade health for wages, and for too many decades that has been the nature of the way work goes. People slowly give part of their existence, their lives, their productivity, their toil and in exchange for wages they have shorter lives, more miserable lives, less enjoyment, less opportunity for health and health expansion throughout their work. That's not acceptable in today's age.

It might surprise you to know that we have some very challenging professions still existing. There are professions in the United States that after you've done that job for a period of time your likelihood of being obese is 70 to 80 per cent. That isn't because when these jobs are open that only obese people sign up to take the job.

This is the very way that job is arranged, organised, created, the very conditions of work produce that high level of obesity which we know will commit people to shorter lifespans which will dramatically increase their risk for diabetes, heart disease, certain types of cancer. So there are tremendous opportunities especially if you influence how jobs are created, crafted, designed and organised, to influence the health of almost every person alive in your country. That vision is what drives the Total Worker Health program.

I mentioned that I'm from the Centers for Disease Control and Prevention. We are the US public health agency. The Centers for Disease Control is about a collection of 10 different activities. We're perhaps best known for our work in infectious disease but actually we have quite a bit of other lines of business as well including chronic disease prevention, after all most of the people in this room and certainly in the United States are not going to die of an infectious disease. They're going to die of a chronic disease. About half of everybody in this room will die of one chronic disease – coronary vascular disease and another big chunk from cancer. So if we’re not thinking about the most common ways that people's lives end as a function of employment then we're missing tremendous opportunity to change the focus of the work that we do.

So I want to start with a very picture that's near and dear to my heart and that's of my granddaughter Lily. I think a lot about what Lily will do when she grows up and if you ask her now, 'Lily what job do you want when you grow up?' she quickly mentions 'princess', something about a princess. Okay? It's like, 'I know those jobs are in quite high demand. It's a bit competitive. There are only a fixed number of princesses at any one time in the world. So are there any other things you might be interested in?’ I also must say that if you are contemplating grandparenthood, go for it. Okay? It is perhaps one of the best things in the world to see the world and the way it's changing through her eyes. It also reminds me why I get up every day. The future of work, the future of our civilisation of workers, the future of economies, of our security really depends on our getting this issue right.

I mentioned that ideally people go home with the same or better level of health that they come to work with each day. Well that's great for the individual, it's great for their families, it's great for them being able to work a longer life if they wish to do so, or are required to do so based on their financial circumstances. But here's the secret. Those people who go home at the end of the day with more health than when they arrived, they come to the workplace the next day with more health as well and that translates into more productivity, decreased injury and illness rates, better profitability for the enterprise that they work for, better public service, better customer service and that lets our organisations and economy thrive. When it comes to work and employers and workers, it's oftentimes a very contentious space. So it's one of the few win-wins when we take this integrated approach to health, safety and wellbeing.

We're doing quite a bit of thinking about the future of work and if you look very closely to this picture you might notice that this driver isn't actually driving. So this is on the roads in Nevada. Many of you may have been to Las Vegas so not very far from Nevada. The whole state actually allows semi-autonomous big rigs or trucking. This driver is in the truck in case there's an emergency but he's not doing any of the driving. Now it's interesting because motor vehicle accidents are the leading cause of workplace death in the US and very likely here as well. Many of those deaths are not in the transportation industry even though this worker is in the transportation industry and we believe the safety of semi-autonomous driving not only is it going to make that job safer, we're also seeing the obesity rates in these studies in this group decrease as well. Now they're still seated for as long as before, but their stress level is down and with stress in many of our studies going down in any profession, obesity rates go down as well.

Now I mentioned a profession where eight in 10 will get obesity. That's it. That's the profession – big rig driving. So it's important that we look at technology as a way to capture opportunity when it comes to better health at the end of the day. We also know that this – we talk a lot about semi-autonomous driving in other settings too – taxis for instance. Really harsh profession. Taxi drivers in New York City drive the equivalent of between New York and South Carolina every single day. Imagine a job where you would wake up every day and know that you have to drive for 15 hours straight. So their risk for obesity, for sedentarianism which has a host of health problems associated with it, and significant violence also associated with that profession, a real challenge. We need better solutions for those high-risk workers.

We talk about the global pace of change but to be honest with you the word 'global' is not adequate anymore. NASA, the National Aeronautics and Space Administration, just celebrated their hundredth anniversary and I had the opportunity to speak at their hundredth safety conference just a couple weeks ago. We were talking about asteroid mining which is definitely on the drawing board. There are asteroids that are reachable in our solar system today and it's going to be very tempting for companies, for private industry not to reach those asteroids and begin mining. It is hypothesised that reachable asteroids have more gold reserves upon them greater than the GDP of every country on Earth. So keeping people bound to jobs on earth will be increasingly a challenge. What are the implications not only of globalisation of work but of interstellar work? That is something that we have to address if we're going to get it right from the beginning which often times we don't. As new jobs are created we're from a safety standpoint behind the eight ball. We learn by disaster. We only intervene when there's a problem instead of proactively approaching some of the challenges that we face.

I want you to think about the last news story you read. There's a very good chance that a computer wrote that story and not a human journalist. Journalism is a dying profession. What isn't public generated journalism which is definitely a trend of the future, there will be fewer and fewer news article writers. Almost all sports writing in the US is done by computer. They add local colour as they're scanning through the game itself and when the last strike or the last inning or the last out is over, the article is ready for publication.

So, rapidly many jobs that have traditionally been done are disappearing. The real prediction is that about half of jobs that exist today will not be needed in the future. Now in the future, I'm not talking about in a generation from now or half a generation. Ten years from now half of the jobs that we experience today, that are available today, will not be needed in the future.

This is an interesting photo of the interaction between man and machine and when we think about this, this is historically how it's been, that people have been working on machines or working closely with machines to produce something at the end of the day. But the future of that picture really would be most accurate if we flipped it around with the machine working on man and it will start subtlety. It will be the pharmacy aid that's already in wide use in many hospitals delivering medications, filling prescriptions. In fact, all of my last prescriptions were filled by a robotic pharmacy filler.

Hospitals routinely now use mechanics to lift patients, certainly something that impacts MSD risk dramatically. You may also have heard of robotic surgery where a surgeon actually is doing less and less of the work and as the machine learns, the machine is doing more and more of the surgery, far more accurately, more precisely, with fewer errors, with fewer complications and here's the kicker, the surgeon doesn't even have to be in the same room. Heck, he doesn't even have to be on the same continent to do the surgery.

So what will be an interesting change is for us to continue to monitor the interaction of man and machine, something that will happen even in the smallest of workplaces in the future. Already the US Navy is using exoskeletons to build ships 20 per cent faster in one year than they could do the year before. In one year they can build a ship 20 per cent faster. Now that means 20 per cent fewer workers needed to do the same level of production. It also dramatically impacts worker safety and some of these workers with exoskeletons can lift 300 kilograms with movement of the wrist, be very accurate in its placement and positioning.

My question is this though, as we embrace technology are we keeping the needs and the challenges facing workers in these settings front and centre? What if Lee on the left needed to get to the restroom and hurry? Okay? Not so easy I would imagine. So as we find ourselves juxtaposed with the changes that technology is bringing, it's critical that we keep the human element front and centre. It is the worker that we serve not the technology that we serve, and that will be increasingly challenged for our profession as we move ahead, because see in truth while there lots of changes and the future of work is spinning faster than ever and in fact I just love this quote that I heard just a few days ago. 'Change is happening at a pace that's never been seen before … and it will never be this slow again.' Right?

So we are lulled into believing that change occurs at the same pace that we've experienced to date but in truth it's very likely to be an exponential pace of change. So imagine every change that you can imagine for the last 10 years. The rapid growth of social media, Facebook, Instagram for instance, all basically within the last decade, that tremendous change about how we interact with technology, imagine that pace of change occurring in the next one year, and the pace of change in this coming year happening in the next month after that. So it is that pace of change that we're very likely to see. But despite that, Omar in this picture is faced with legacy hazards that still threaten the health and safety of many workers.

So while it may be sexy to talk about the changes that we're going to experience from technology, there's still a tremendous number of workers facing traditional hazards. We cannot forget them because you see, it's people in this workplace setting, the last to have access to technology, the last to see the promise and the opportunity that comes from integration of health and safety programming in the workplace, tends to be the most vulnerable of workers. These workers are the ones that tend to have the off shift, the most hazardous job, the most insecurity in their employment arrangement, the lowest wage and that unfortunate collection is an important reminder that when we are intervening for health and safety there are quick ways to know where the money is, where the priority for intervention is, and a very easy, early way is to look at wages.

Lowest wages workers in general will have the highest health and safety risk. They will come from communities that are least supportive of health. They will have the least security when it comes to long-term employment, the least opportunity for professional development and advancement and obviously wages strongly equilibrated with health outcomes. Perhaps the strongest of all social determinants of health is wage. So it's an excellent place to begin when we're thinking about where to intervene.

We've already mentioned taxi drivers. Here's a set of other jobs that are quite common, that encompass quite a large sector of the workforce. These are workers again, that have lower wages, that have fewer opportunities. It's a good starting place in any workplace to think about people in the, in entry level jobs, low wage jobs, shift working jobs because that's where a tremendous amount of the health challenge lies.

I'd also like to draw your attention to sort of an emerging growing sector of the workforce and it’s what I might term 'high consequence workers'. So think people in emergency operations centres, in the military, in security positions, in public safety positions, in high-stakes healthcare. These are workers that have tremendous challenges facing them and increasingly as society becomes global, as the demands on people really span around the clock and around the globe, high consequence workers are really hit with a double whammy. Many of them have prolonged shifts, they have high expectations and very little opportunity for error, very little opportunity to make a mistake. That brings with it high levels of workplace stress.

I hope I'm creating a vision that work is really all encompassing, that work not only is about wages and security and our stress level but work really is very, very difficult to separate from our home life, from the rest of our being. It's inextricably linked to who we are as people and because obviously work is a requirement for most people, we don't have the chance to separate it from the rest of our lives very cleanly and that's especially true as technology keeps us tethered to work 24/7. It's those things along this border, this interface between work and home, that oftentimes create the most challenge for as health and safety professionals. Some of these topics I'm certain you deal with each and every day as cofactors, as influencers, as risk factors for the MSD and other occupational safety and health outcomes that you face. Getting this intersection of work and the rest of life right is critical to a total worker health approach.

I love this, it’s a very busy slide, but I love it for showing a couple of things. First of all let me just sort of talk about what's on the top half of the slide above the black bold horizontal line. This is where our perception of risks that we face actually lies. So for instance the big blue circle on your left is our perceived risk of a terrorist attack. Now the actual real risk is the corresponding colour underneath, a very tiny level of risk and you can see how we overestimate in our minds the risk of a terrorist attack.

Now let's move to the other side, the right side of this graph. Take a look at what we estimate our work-related risk to be, the white circle relatively small in size. Compare it to the actual risk down below, the bold orange circle. This says that we vastly underestimate the level of risk that work in and of itself actually faces us with each day. That's an important take away for everyone in this crowd. The people that you're serving do not really fully completely understand the risks that their work entails. So that's something that we must do to continue to remind them.

There are a host of reasons that work is important to our health. We've already talked about wages. One of the ones that I'm really interested in though is this concept of how work especially in the new way work is organised, is really oftentimes a constellation of jobs. We piece together 'gigs' if you will, in order to make a living. Some people have called it 'the Uberisation' of work for instance.

So basically though what that means is that for every job you have, you have twice as many commutes, right, or three times as many if you have three jobs. You have time wasted as you move from job to job. Basically when you have to piece together a number of gigs for full time means of income it leaves no time for anything else. It's a term that's been called 'time poverty' and if I were to ask how many in this room have time poverty, my guess is most of you would say, 'Yes, that's me'. That's especially true for low wage workers who oftentimes have multiple jobs, side gigs, side jobs, even if they have full-time work.

Also even the location that you work is a strong influencer of your health. So the length of your commute translates into how you will spend your time. The nature of your job may determine if you're a cat person or a dog person. So, so many intimate decisions are made about work. If we don't have the promise of permanent employment, so we have what we would call 'contingent work' or 'insecure work'. Then that colours every future decision we make about our future. 'Do we buy a house?', 'Do I buy a car?', 'Do I go in debt for any reason?', 'Do I go to school?', 'Do I get married?', ‘Do I have children?'.

If I were to ask how many of you have ever moved to take new work, how many could raise your hand if that applies to you?

More than half of the people in the room have picked up, left their loved ones, left the security of their surroundings and moved to a perhaps relative unknown all for work. Work strongly influences our health.

We talk about long work hours leading to time poverty. It also has a tremendous influence on the type and quality of life we will have, benefits that come from work, extremely influential in many health outcomes. Shift work for instance increasingly common. In fact almost all public safety work and healthcare work involves long hours of work and shifts. We have increasing evidence from our own centres of excellence in research that show shift work is a strong carcinogen. Shift work is obesigenic. Shift work is a diabetogenic condition. We know that shift work in and of itself is detrimental to health.

Now you say, 'Dr Chosewood, we cannot get rid of shift work. We need cops 24/7. We need nurses and doctors who fill our emergency rooms'. You're right. There's some hazards that we cannot get rid of, but we can intervene with more intensity and frequency with pro-health programs in those groups.

For instance would you like to guess how many health fairs in hospitals occur on the third shift? Not very many. Most of those are in the daytime where the healthiest, most well paid, most healthy, most health opportunistic workers already are. The third shift is where we need to have our health fair. So there's a hospital in the States that was concerned about all of their third shift workers, overnight workers having to eat out of the vending machines because the cafeteria was closed. Very common I would imagine in many hospitals across – so what, most workers would do a stop and get fast food on the way to work. This hospital decided to do things differently.

So not only did they open their cafeteria for a meal in the middle of the overnight shift, but they gave that meal for free. Providing it for free did a couple of things. First of all people could leave the fast food behind, right, and they knew they were going to get high-quality food, low cost. So it helped people use their wages for some other purpose. They also could control the quality of that food, the nutritional value of that food. So it was a strong influencer in a third of the calories those workers ate every day. That's a win win. That's tackling the diabetogenesis, the obesigenesis that comes from shift work, a very important intervention.

Would it surprise you to know that the most obese profession in the US is police, firefighters and security guards?

They have more than 50 per cent higher obesity rates than the general population. The people we would expect to run into a burning building, to come help us when there's something going wrong, is the most obese of all professions in the US and this has been shown in another study as well, the Regard Study which looks at risk factors for stroke and vascular disease, again police officers and firefighters. It's the reason that most firefighters in the US do not die of collapse of a burning building or burns. They die of a heart attack in the middle of their duties.

Some people say, 'Well what is it about that work that you know, makes cops so overweight?' and whenever I asked always someone hollers, 'doughnuts,' okay? I think they get pretty bad rap from that. Yes doughnuts might be one factor. Nutritional choices. Certainly we eat more when we have shift work and long hours, there's no doubt about that, well proven.

But our research shows that it's workplace stress levels, it's the high demands of that work, the high public visibility and the inability to make any mistakes coupled with shift work and with long hours of work and fatigue. Many cops do not make enough money to live in the communities they serve. That's increasingly true in city after city in the US. So they have long commutes as well and that leads to time poverty which means no time to pursue health off the job. Cops are also very much into gig work. They oftentimes have multiple lines of work, security work in addition to their regular full time largely because of wages. So it's a real challenge.

This is some dramatic, dramatic study that's basically looking at life expectancy. So what is it about work that threatens how long we actually live, and this is looking at a number of different ethnic groups, men and women, and looking at the disparity between the least and most educated people in that demographic. Then it asks the question, 'What is it about the nature of your work that has such a deficit to your health?' and if you look at the big, bold, orange or red, pretty dramatic. No health insurance. Increasingly in the gig economy in the US workers do not have the guarantee of health insurance coupled with employment. The Affordable Care Act began this separation of employment and health insurance, and this is a significant threat to the health of our workforce, to the health of our nation as a whole. Other big colours – blue there, that represents insecurity. No health insurance and insecurity. Another big one, the lime green – low job control. 'I don't have a say in the nature or the quality of the hours of my work.' Pretty dramatic.

Now those three things together unfortunately are part and parcel of something that's all the more common in the US and that's this issue of contingent work. So I don't have the traditional job that my father had, that my grandfather had, it was with one company for a long period of time. Or full-time work for one company, serially over my lifetime, usually getting better pay from job to job.

So I might ask you what percentage of work in the last decade in the US do you think has made up this brand of work, contingent work? So of the jobs created in the last decade what percentage have been non-standard alternative work arrangements other than full-time? Would you guess 50 per cent of those jobs over the last decade?

You'd be quite underestimating. It isn't 50 or 70. Ninety-four per cent of all jobs created in the US from 2005 to 2015 were non-standard, non-full-time, contingent work. That's dramatically impacting these health metrics.

So in such dire circumstances NIOSH, the National Institute for Occupational Safety and Health thought it was important to take a new approach to the way we craft healthier work. We introduced about 10 years ago this concept of total worker health. It really is about using the workplace, not just a venue for health promotion, but the workplace as an actual place where we can create better health through the design of better jobs. We don't discount physical activity and nutrition programs, tobacco cessation programs. We embrace them but that alone is not enough. How can you actually create more health through the way the work is designed, through the programs, policies and practices that can create worker wellbeing at the end of the day?

So we sort of take three simple steps here. First and foremost, first dollar investment, create safer work. You're not going to have total worker health if people go home with less health than they arrived. It's impossible. They go home with one less digit. They go home with an injury, a debilitating condition, a disability, but that's not enough. So good companies will keep their workers safe but the great ones, the ones the people clamber to work for are the ones that establish additional measures to advance health. Those policies, practices and programs that improve the health of workers, not just the safety of workers but the overall health of workers. This is our integration of the safety piece and the health piece to create worker wellbeing at the end of the day.

We do it by connecting all elements of the workplace and I'm so happy to do some reading about the work of the Queensland Government in this area and the word 'integration' keeps coming up again and again and again. That's music to my ears because we believe that's where the synergy lies.

We also are very much about culture change. This is not a vendor program that you can introduce for one year and then expect everything to be fine. This is about long-term culture building, increasingly difficult when workplace turnover is as we've described. It's unreasonable to expect people to change their behaviour when the social, cultural and physical environments around them fully conspire against them. Take a look at some of those images, right? Poor dog. No one's happy in that picture, certainly not the dog. There's this wonderful set of steps up to the fitness centre. 'No, we’re all going to take the escalator up to the fitness centre. That seems like the right thing to do.' For me this quote though says for every behaviour change program I want to put in place like a Biggest Loser contest or physical activity program that I want to introduce, at least for every one of them I need a social, cultural and physical environment change first, because see those are the sustainable things that will allow the behaviour change efforts to actually stick, to actually succeed.

Remember we were talking about Omar earlier? He's not interested in the noonday Tai Chi class, okay? Not his priority. He also reminds us that you cannot overcome eight, 10, 12 hours of difficult working conditions with a 30-minute ‘lunch and learn’ on any topic. There is no miracle topic for 30 minutes or an hour that will overcome eight, 10, 12 hours of harsh working conditions. This is where the money is. If we want better safety, better health outcomes, better longevity, better economic outcomes for our industry, getting this health quotient right.

The other thing this tells me is he's not interested in Tai Chi but there could be a lot of things that he's interested in and we'll never know unless we ask Omar what he's interested in when it comes to his health. It may not be a health promotion program at all. It may be all about benefits, may be about shifts, it may be about supports for his family, it may be about education but unless we ask the question, what we would term the 'participatory approach' to program design, we'll never know, nor likely will he ever engage.

So you know it isn't, ‘if we build it they will come’. It's, ‘if they build they will come’. That's the power of the participatory approach.

We're doing a lot of research in a lot of these areas through our network of centres of excellence and we'd invite you to learn more about all of that research by visiting our website. You can see that yes, we still have some traditional programs on here, but we have a lot of others too. Control of hazards and exposure will always be first on our list but we're looking at the health impacts of compensation and benefits, on the role of communities and how that produces healthier workers because basically every worker is part of a much broader community. We're also studying new employment patterns, something that's taking the US by storm and I'm certain it will be here as well.

So is this the future of work? My father had one job in his life. I've had six in mine. My kids are likely to have six at one time. This whole nature of gig work that we've been talking about has health consequences and we're just starting to uncover them. In fact some of the most dramatic ones really apply to this whole issue of uncertainty. Imagine the stress that you and your family would be under if you had no guarantee of an income four weeks or six weeks from now. I can't think of hardly anything more stressful than if that were the case but yet increasingly larger and larger percentage of the workers are facing that very fact, that uncertainty, that insecurity of employment. So we must think about ways to intervene even as these dramatic changes are occurring.

I would also be remiss without mentioning perhaps what is the number one health crisis in workplaces today. It's always on the top of the list when we're asked about challenges that are facing workplaces and that's this epidemic of workplace stress. Now in general there are a number of approaches to workplace stress. In fact you ask companies, 'Well what are you doing already?' when they bring up these challenges, it's very likely that we'll hear about resiliency building programs or employee assistance programs. That tends to be where we hear most of our response. But I would argue that in general resilience is not an adequate approach. Resilience sort of is giving the turtle if you will, a harder shell on the outside, right, so that that turtle can withstand more pressure from above, maybe a stronger hammer to hit the turtle with. Well that harder shell, larger shell comes at a price. It's first of all much more difficult to move, much more difficult to make it through if you're carrying such a hard shell.

See the solution to workplace stress is to get rid of the hammer, to decrease the size of the hammer instead of building the harder shell.

What that means is approaching the way we design jobs, organise jobs, create work so that stress is minimised. We've come up with a number of ways to do that and I'll share those with you, just a few statistics here on is stress an epidemic at work. Two things I'll point out. Almost 80 per cent regularly encounter physical symptoms caused by stress, 73 per cent regularly experience psychological symptoms caused by stress, 60 per cent of US workers said that they would prefer to choose a new career altogether. Talk about lack of engagement in their work, talk about risk for injury and illness translated from that. Well risk for poor customer service or risk for high turnover and looking for a serial employment.

So when it comes to interventions one of the most promising that we found in our research is to retrain the way our supervisors supervise. So I ask often, 'Is it your doctor who is most influential in your health?' and we get a lot, 'Yeah, that's pretty important'. Our research shows that it's actually your frontline supervisor who is far more impactful in your health at the end of the day than your doctor will ever be.

So if we retrain the way we approach supervision, if we give people the skills they need to better understand how to manage with health outcomes in mind, we believe that's where there's tremendous amount of opportunity. What does that look like? Maximising flexibility. Most workers want more flexibility than they want more vacation. So having people have a say when, where, how they do their work. Yes, have the same expectations at the end of the day as you have always had, but between assignment and execution giving as much freedom as possible in that spectrum is a strong predictor of decreased stress, of higher levels of engagement, of more personal fulfilment to the job. People need a voice in the nature of their work.

To the extent that employers can address this growing problem of insecurity it will have tremendous payoff when it comes to engagement and productivity. Even if it's only short term reassurance that, 'Yes, we know times are tough but I can guarantee you a job for six months,' that's certainly better than people not knowing if they have a job from week to week. The participatory approach we've already talked about, providing this concept of meaningful work.

I love this story. There were three brick layers on a job site. Someone walks by and he says, 'Hmm, I wonder what they're doing?' So he asks the first one, 'Can you tell me about your work?' He said, 'Well, clearly I'm a brick mason. I'm putting one brick right on top of the other. You can see what I'm doing'.

The second one was asked, 'Well tell me what you're doing?' and he said, 'Well I'm working hard. I'm making $20 an hour. So it's a good job. I'm providing for my family'.

The third one was asked, 'Well tell me what you're doing?' and he said, 'I'm building a cathedral where my children will get married and my grandchildren will be christened'. They were all doing the same thing but the work meant something vastly different to each of them. Our job as health and safety professionals, you say, 'What? This is not my job'. It is our job to give people meaning to the work they do. That is a health and safety intervention. It will produce lower injury and illness rates at the end of the day. Greater engagement in work is golden when it comes to better health outcomes in this integration of work, home and life, something that will be increasingly challenging as we move ahead.

One study here said that meaningful work should be every CEO's top priority and there's research in our centres that back up this as well.

I'll just speak a little bit about culture. If you don't actively work to build a culture there will be one that develops without you. So it's going to happen one way or the other. In fact every workplace has a culture today. It's part of our job to influence it with health in mind, with safety in mind, with this issue of meaningful work in mind because one will develop, even in the absence of doing anything at all.

What do those PPP's look like? We don't have time to go through every one of these but if you will join me tomorrow and a shameless plug for the two-hour workshop, we will go into great detail on all of these programs, practices and policies because this is where the long term sustainability of programs lay, not in the flavour of the month, the health promotion intervention. It's this enduring long lasting approach that really will produce health at the end of the day.

We have a lot of unanswered questions when it comes to total worker health in this integration of health and safety for the creation of worker wellbeing and here's some of the most important ones that are pressing. I know there's some academicians in the audience. We would invite you to look at these research questions with us.

Perhaps the one that I'm most interested in is this connection between work and chronic disease.

If most people in our countries die from chronic disease how can we use the workplace as a venue to create better opportunity for longer, healthier, more fulfilling lives at the end of the day?

I mentioned we had a number of centres of excellence and an affiliate network around the US. We have not had any international partners yet but based on some of the work that you guys are doing we would love to talk about having an international partnership around total worker health. We see a lot of promise in the approaches that you guys are taking and we're really looking forward to learning more in my two-day visit here.

There are number of ways that you can connect with us. I'd invite you to follow us on LinkedIn, on Twitter and subscribe to our Total Worker Health and Action eNewsletter. We now have 71,000 subscribers. It's one of the most subscribed newsletters in all of the US Government and we would love for you to be 71,000 and 400.

I'll leave you with a picture of Lily and again my sincere thanks for what you do each and every day.

Madonna King:

Wow. So much to take on board Dr Chosewood. Thank you. You know, that idea that a frontline manager can have more impact on a worker's health than their own GP hit me and so did this quote. 'Change is happening at a place we've never seen before and it will never be this slow again.' I'm sure we have lots of questions for Dr Chosewood and you will get the opportunity to do that shortly after our second keynote speaker of the morning.

Before we do that though, can I ask you just to take out your trusty device again? I'm going to ask you three brief questions in relation to the presentation that you have just seen. Remember you can continue to lodge a question for Dr Chosewood in the activity section in Zeetings at any time.

So our first question is how would you rate Dr Chosewood's presentation today?

Of course this is a private response, but just give us some idea for feedback.

Yes, I was going to say Dr Chosewood, you can only vote once.

I'll just get the hands up when we can move on. Thank you.

Our second one is will you change your current approach to managing MSDs in the workplace based on what you have just learned?

Just waiting. Yes, thank you, and our final one is what is your take away message, and for this you know, can you think of a word, a phrase, a sentence? What's the message you'll take away from hearing Dr Chosewood's presentation? I'll just give you a few seconds to answer that and we appreciate you doing this.

Just looking for the hands up before we can move on.

Thank you. Thank you very much for doing that and I'm sure we'll get much quicker as we go throughout the day.

[End of keynote 1 transcript]

Keynote 2: What does the future of work look like?

Dr Stefan Hajkowicz

Presented by: Dr Stefan Hajkowicz (Principal Scientist, Data 61/CSIRO)

Run time: 56:14

Download a copy of this podcast (MP3, 23 MB)

Read the Data 61/CSIRO report - Tomorrow's digitally enabled workforce.

Read transcript

Keynote 2: What does the future of work look like?

Presented by: Dr Stefan Hajkowicz (Principal Scientist, Data 61/CSIRO)

[Start of keynote 2 transcript]

Madonna King:

And now to our second keynote speaker this morning and that's Dr Stefan Hajkowicz, a Principal Scientist at CSIRO and a wonderful speaker. He's widely published internationally in the fields of decision theory, economics and policy analysis, and he's helped government and industry adapt to a rapidly changing world. During his 15 years at CSIRO Dr Hajkowicz has delivered more than 50 research, consulting and advisory projects and services to clients from the public, private and not for profit sectors. Today his discussion is going to centre around Data 61, CSIRO's research on the future of work especially their report Tomorrow's digitally enabled workforce.

Ladies and gentlemen please welcome Stefan Hajkowicz.

Dr Stefan Hajkowicz:

Thanks a lot and after seeing that evaluation I think I've got a bit of workplace stress happening here because I know I'm next for the chop. But I appreciate the time to come and speak to you and sorry for the turnover there, although that was a fascinating presentation and I took a lot of photos of the slides and I'll be trying to put some of it into practice this afternoon. I'm building a new team in this space. We do analysis of trends, patterns of change mostly on the digital economy, sort of five to 20 years into the future.

Last year we were contracted by the Australian Federal Government in partnership with ANZ Bank, Boston Consulting Group and the Australian Computer Society to conduct a study into the future of work in Australia. A lot of what we just heard is going to be reaffirmed in this presentation as we look to the next five to 20 years of the workforce. So we started to examine trends that would be impacting jobs. We looked at aging population, computerisation, artificial intelligence and robotics got a lot of attention in our study. We examined how things would be changing over time using this method here where we look at the current situation of the workforce and I'll give you a bit of a snapshot of the pressures and tensions we're seeing in Australia. I don't think Australia has yet seen the casualisation of the workforce to the extent that we can see in the United States, but it is coming is our view. We haven't got a dataset that shows it happening yet but it is coming. So it's one of the pressures.

We then go into a horizon scanning phase where we start to look at trends and drivers. So a trend is different to a background issue in that it has directionality. It's pushing work into a different space. Our trends are classified as political, economic, social, technological, legal and environmental.

We then go into a validation and screening of those trends, evidence and relevance. 'Prove to me this matters.' 'Prove to me that it's happening and that it will impact work and jobs.' Then we synthesise those trends to form these concepts of megatrends which comes from an idea from a US academic called John Naisbitt who wrote a book on the same topic and this is where trends combine and coalesce to give us a more significant trajectory of change, in this case pushing the workforce into a different space from where it is today. A scenario is a story about what the workforce looks like by the year 2035 in this study. We had that as a benchmark, roughly 20 years from where we are now. So there are different multiple scenarios and I'll show you how they're constructed.

So let me tell you the results and then I'll tell you about all the data and information that sits behind that. So this was launched at Sydney Opera House in February last year and has had a whole lot of media attention. I'm still being asked to do interviews on it. There is a lot of angst in the Australian workforce about salaries and job security actually I think, partly driven by automation.

So we came up with a set of megatrends that are shown here in a Venn diagram to emphasise overlap between the different megatrends, the first of which we borrowed terminology from Ray Kurzweil the ex-Director of Engineering at Google who talks about the second half of the chessboard in terms of digital technology and what it can do, about how much better it's going to get. It's not a linear improvement in digital technology. If we look at artificial intelligence, device connectivity, computing power, we end up with these exponential curves. The analogy actually comes from the inventor of chess winning an award from the King which was one grain of rice on the first square, two on the second, four, eight, 16, 32 and it builds a geometric progression.

For the first half of the chess board the King is okay. It's a couple of hectares of rice. He can pay the debt but then exponential growth into the second half gets a lot steeper and completely reinvents the landscape. So by square 52 it's Japan and square 64 at the end of the board it’s four times the surface area. Well now if we if we take that analogy and put it into digital technology, the pure grunt power and connectivity of our digital devices and what they can do in the workforce, we would see a line that goes like this. So the argument is beyond 2020 we see quite a different world from the one we're living in today.

For example, the engineers at Intel who make the chips which go into our computers. I had a phone hook-up with them recently and I asked them how long they can keep Moore's law happening for. Moore's law is doubling the number of transistors on an integrated circuit at the same cost every year. It's why our smartphone now powers a computer filling this room in the 1960s and that's an exponential growth in computing power. Their answer was out to 2025 using current tech and then beyond that, but then there's quantum computing and other breakthroughs. So our computers and devices we operate with are set for huge improvements in the computing power.

But I know from my colleagues inside Data 61, that's Australia's biggest digital research agent, science agency in digital in CSIRO, it's the algorithms and the code that we're developing behind the scenes.

This is a story and I'll jump into some of the data that sits behind it of a world of computing devices which are much more capable than they are today. The costs of artificial intelligence will come right down and it will make a lot further inroads into a wide range of jobs. We'll have a look at those jobs in this presentation that are likely to get replaced and disappeared, and those ones that are likely to get created.

Porous boundaries I think hits onto the point made in the previous session there about the changing nature of work and how employers engage employees. This is the platform model. It's the peer-to-peer economy, the Uberisation of the workforce if you like. It's the boundaries are being taken away that used to exist and there's opportunity here for people but there's also a lot of risk and concern as we move towards this much more flexible working environment that we're in. So this is the story of porous boundaries.

We also put into that the boundary around disciplines is becoming a lot more porous too. Skills and expertise in one area is starting to become a lot more transferrable into other spaces. A lot of what Australia needs here is more fluidity of movement. People capable of making more fluid movements across boundaries.

Here the entrepreneur is the next one. I think that we are likely to see jobs in the big organisation, big organisations in Australia, the ASX250 list, large government agencies are counting for less and less of net employment increase. They're actually job destroyers not job creators on average in those large corporates. The job creation is happening in the small to medium enterprise sector and small businesses and start-ups. So I think the environment actually and digital technology actually favours the entrepreneur because you can test a new business model and scale up quite rapidly. So we're seeing a shift into – I think we're into the era of the entrepreneur.

Divergent demographics captures – we put in there the chronic illness issues that are raised in the previous session. Overweight and obese in Australia by BMI measures at the moment is around 50 per cent of the population. Then it gets to 70 per cent by 2025 and I was surprised to see the different work, like the police and fire surprised me, but I suspect there is a strong link there to stress, workplace stress. That's certainly something that's happening, but the graphs we have show the rate slowing down. So it's not growing as aggressively as it was but it still will increase out to 2025 where it starts to level off. So we've got a huge challenge.

Interestingly on those it's also not just the wealthy countries in the world that show those patterns. This is happening right across the Asia-Pacific region as they are replicating all of the diet and lifestyle issues we have. The vast majority of Australians get well below their daily amount of physical activity for adults, half an hour of intense, raised heart rate per day. For kids it should be an hour. Almost 70 something per cent of Australian adults aren't making that and the majority of children aren't doing it either as screen time has gone up so quickly.

The rising bar tells us about the increased standards of performance and education and skills to get a job. We can see this happening over time. The last 20 years has seen a big increase in the entry level qualifications and skills required to get a job. Also the job types and the salary premiums that are growing faster, so they're all at the higher skilled end as well and that's likely to continue. But we also mix into this what's happening within the Asia-Pacific region as we know that 40 per cent of people with a tertiary qualification of some sort will live in India and China by 2025 alone and 60 per cent of the world's people with a STEM – science, technology, engineering and mathematics qualification will live in one of those two countries as well. So there's this huge amount of deep skills and capability in the region that we live in and that internet connection is plugging that right into our own economy. So the future workforce is going to have this to deal with increasingly.

The last one is about the rise of the service sector which has grown to be pretty big in Australia. The vast majority of Australian workers work in services – health, education, finance, administrative services. This has been where health and education have been the two biggest job creators in Australia in the last 10 years and are set to continue for another 10 years out into the future to grow jobs. But this is going to be replicated across the region that we're living in. The services sector is where the jobs will be created which introduces different types of risk – less physical risk and more workplace health and safety stress.

So, well actually before I jump into that we took those megatrends out. They've got a 20-year timeframe around them and put them out into the future. We used this way of – here this is a set of scenarios for what the workforce might look like by the year 2035 and we used a water metaphor. Depth of water is depth of technological impact on the workers, how good did artificial intelligence get, and the rate of flow is the extent of institutional change, a shift into the peer-to-peer economy that was described in the – and has gone so far in the United States that could happen in Australia, the possibility that most of us in the audience here today don't have one employer but four or five and that we're mostly working as freelancers.

So those are our two area axes of uncertainty – institutional change, limited growth of the peer-to-peer economy and then major growth of the peer-to-peer economy. This is low task automation by artificial intelligence and this is very high, making the point that both are more than they are today. We don't see a world where there's less of a peer-to-peer economy and there's less task automation. It's just uncertain about how far it will go.

So lakes is our scenario where not too much has changed. The world has moved a bit into those spaces but still in 10 and then 20 years' time the workforce doesn't look too much like the one we had today. Harbours is the scenario where the way employment is we still work for large organisations predominately as we do now and that's still the dominant way that someone gets a job in Australia but we're heavily digitally enabled. Lighter jobs have disappeared to robots and computers and new ones have been created in that space.

The other one is the task automation promises weren't as big as we thought. This is rivers but we're working with very different institutional structures and the fourth one is oceans where the workforce as we know it is turned on its head. So we describe what Australia's future workforce looks like in all these four scenarios and it’s in our report that you can have a look at online.

Why are we doing this? We found out we weren't the only ones doing a future of work study at this time. Probably the first to kick off a lot of this thinking was the United Kingdom Government who put out a similar report on the future of work and jobs. This this was followed by CEDA did a study, the Committee for Economic Development of Australia. The World Economic Forum released theirs soon after and the International Labour Organisation has just kicked off its Centenary Initiative on the Future of Work. So a lot of people are thinking about this. I think it's a worldwide phenomena associated with stagnating wages across a lot of the OECD countries.

Let me just jump around in my presentation a bit. If we look at this graph for Australia here, there's a lot of ups and downs but this is per cent year on year real wages growth. Sort of last five to seven years have seen it average out at a lower rate. Wages aren't growing that quickly in Australia and if we get into demographics and regional Australia the situation looks even worse, okay? This has definitely happened in the United States since the Global Financial Crisis. A large chunk of the US workforce has not experienced a pay rise since that 2008-09 financial crisis and they're feeling the pain of that. In the United Kingdom, especially regional and up north, and this is often attributed to Brexit and the US election result was this sort of dissatisfied, large population that we have which are not getting pay rises.

So this is one thing that's going on but I think anxiety about job loss and a lot of researchers from MIT, Andrew McAfee and Erik Brynjolfsson have written on this a lot. One of their books, The Second Machine Age goes into this where they're arguing that what's really happening is it's not off-shoring of jobs, its technology replacing them, it's technology providing a lower cost solution requiring much fewer workers to do the same job. Even though the economic theory tells us in time technology creates more jobs, it takes a while for it to happen. If this is the industrial revolution has been heavily studied by economic historians, this shows us real wages, it's just an index, over the 100-year Industrial Revolution.

For the first 60 years or so there wasn't any significant improvement really. It did after about 60 years and similar could be seen for life expectancy in Wales and the British Midlands didn't actually improve over that time. In fact life expectancy in the first half of the Industrial Revolution declined as people were subject to unsafe work conditions in factories. It then starts together. So Erik Brynjolfsson and Andrew McAfee point this out and say, 'This doesn't bode well for the 100-year information revolution that we're just starting'. Maybe 10 or 20 years into, are we sort of somewhere here and do we have a lot of hardship ahead before the benefits of information technology are realised?

The OECD Global Strategic Foresight Community, we meet in Paris every year and we had the low growth trap of OECD country story given to us in Paris last year of really low productivity, low wages, lower than long-term average GDP growth rates. Then the question asked is this productivity paradox for digital technology has been around for 20 years. Why is it not associated with improvements in productivity, improvements in working and fewer hours worked per week? In Australia our hours worked per week are going up while all this is happening and it could be argued that it's like the Industrial Revolution. Digital technology will take a while to have broad-based benefit out there in terms of productivity, wages, job opportunities for people. We're going to go through this period of adjustment and change is one possible explanation for it.

We do note that while wages are stagnating, national income especially in recent times in Australia, and this is more pronounced in US economy, GDP growth rates overall on aggregate have returned to quite high levels, it's just not well shared across the workforce of these populations. People aren't seeing their wages grow at the same time the national economy is growing. Wealth is becoming more concentrated. Gini coefficients are something used to measure wealth in society. When it's zero everyone has exactly the same amount of money. When the Gini Index gets to one, then one person has it all and no one else has any.

So Australia is currently about .32 on the Gini metric. Switzerland, Norway, Denmark, Scandinavia all do pretty well around .22 and .24. US is .39. UK is .34. All are moving upwards. US, UK and Australia are moving upwards more quickly. Mexico is .55 and we know from a lot of studies that have been done, having a high Gini coefficient is not a good thing for your country. It leads to all sorts of negative outcomes and it slows down GDP growth rates too. It's not something we want to see happen.

So from one point of view I think this is the Tyler Cowen view of the world and his book The Average is Over is that digital technology effectively evaporates a big part of the workforce and concentrates onto a fewer. The analogy he gives in his book is if I was a musician here in Australia in the 1800s it didn't matter how good I got, I could only get to a certain number of bars and pubs to play my music. I could do well but there was a natural limitation. If I'm a musician today I can upload onto You Tube, I can put onto iTunes, any number of online music applications and start to sell to a massive global population, thereby concentrate a huge amount of market share onto myself and all the other musicians miss out. So digital technology has this effect of amplifying onto fewer individuals the benefits of growth in the economy. So that's easy. I don't think it's all as glum as that and I'll try and go into why.

So let me now jump into some of the trends and drivers that are pushing us towards this world. I mentioned computing speed and power. That's Moore's law. It will continue. Our devices are going to be way more powerful by 2025 alone compared to where they are today. We have the possibility of quantum computing. Device connectivity is on its way up. This is making, and breakthroughs like this, Microsoft research is getting a 5.9 per cent error rate on speech recognition which was a bit of benchmark because human transcriptionists achieve that. Now we're seeing the voice recognition get a lot better. You may notice this on your smartphone when you talk to it now it's got a lot better at turning your words into text and that's only going to improve.

We're going to see more Amelia's emerge. Amelia is a virtual assistant. Australia has created one called Nadia based on Cate Blanchett's personality to service customer enquiries on the National Disability Insurance Scheme. They are software algorithms which are much more capable at listening to a customer query and finding a solution. Or I can even in theory put Amelia on my research team as a research assistant and ask her to generate a dataset or perform a function. We're going to see these devices get a lot better and they will take a lot of jobs.

Michael Osborne from Oxford Uni kicked off a lot of the debate here. When he released his study saying, '47 per cent of all jobs are going to get done by a robot or a computer,' this was based on an analysis of 702 unique job types in America. We found similar here. Anywhere between 44 per cent and 55 per cent of jobs here were identified within the next 15 years of being high risk of computerisation. So what jobs aren't through and this is Moravec's paradox. It doesn't mean you'll get to fold towels, but this gives us an insight here.

This is UC Berkeley, a good robotic school. Had this challenge to make a robot fold a towel and after seven years’ effort they got 20 minutes which everyone other than a teenager can be. Teenagers just don't see it there in the first instance. So it's because a towel on the floor has irregularity and a lack of structure and this is an insight into the types of jobs that are incubated from digital disruption. Okay?

If we look at the Australian photography industry we see two job types. One is rules-based structures, highly repetitive. That is this red line here that is coming down, developers and printers who actually create the print film. This is something amenable to automation because it's so rules-based. On the other end is the field photographer who has to have creativity, judgement, self-complexity. Emotional and social intelligence is really important for a wedding photographer, right? They've got have these skills to get through a day and we are decades off, even with Amelia, they're decades off actually resolving those complex social and emotional tasks that we do on a regular basis.

We saw this shift happening in many different sectors of the economy. Accountants and keyboard operators, printers, graphic press workers versus graphic designers. Graphic designers is something. People with skills in graphic design are under massive demand in the Australian economy. So we see that shift occurring.

We also see this, it's about working smarter not just harder. A tech and digitally-enabled economy will reward intelligence more than brute force. This is labour productivity GDP per hour worked and average hours worked per person per week and it's a pretty linear shift. The Norwegians don't work so many hours per week on average but have high GDP per capita and it's a height. It comes to the top of the World Economic Forum's digital connectivity rankings as a country.

Mexico at the other end would be performing in a different way and this is not the space we want to be in. We want to be into this digitally-enabled space to basically increase the returns on our output.

We also know this is average hours worked per week from the Australian Bureau of Statistics, from 1978 to 2015 the dataset goes to. It's on the way up and this is a bit of a pity to me to see this graph because we've invented all these robots and computers. Why aren't we having more holidays? We also know what we've heard in the previous session. This was a big study in The Lancet which I think was quite a landmark one of 530,000 men and women and we found 50 hours or more per week 1.3 times higher incident risk of stroke. So this extra work isn't doing us any good.

We also know not everyone is making the transition. Out of all the study we did this is the most significant graph I think I would pull from that study. This is the per cent of working age males who are not participating. Or this is the participation rate in the labour market here. We can see it's declining from about 80 per cent down to closer towards 70 per cent there and this is a national dilemma. This is a lot of car workers in Geelong who have lost their jobs and they don't go and get other ones.

There's also a lot of technology replacement and I think that what we've seen happen in the manufacturing sector last century where robots were put onto the manufacturing floor, it's the administrative services centres, downtown Sydney, Brisbane, Adelaide, Melbourne, administrative services and financial services where we can see so much technology coming to play that can replace a lot of jobs. Blockchain and distributed ledger technology for example is fantastic in what it offers but for legal positions, especially the sort of analytical, clerical, legal work, it can evaporate. Or financial auditors, Blockchain solutions can have one person doing the work of 100 because of what's called a turnkey solution.

So I think I probably need to move towards a wrap-up because time is coming short. I think we are rethinking the way – Ronald Coase won the Nobel Prize for his Theory of the Firm which came down to transaction costs and asymmetries of information. The digital world is taking those away. The digital world is taking away the transaction costs of engaging labour for small tasks like TaskRabbit and those platforms which allow me to engage. It was too expensive before digital platforms happened to get those skills and engage them for a day or a week for a small job. Digital has made that possible. is an Australian one which allows people – it's often used in the ICT space and allows someone from the Philippines to do a software programming job here and it happens at very low cost.

Asymmetries of information are also disappearing with the ratings, rating systems in that it gives us insights and the marketplaces adjust quite quickly. This is data on the number of Uber drivers in the United States which has been released. We can't get the dataset yet for Australia but this was done in collaboration with Princeton University. But this is how I think a lot of the platform models in the workforce will happen here in Australia. It will be a fairly flat line of not much activity and then something happens in the marketplace and it just grows exponentially. Within months the taxi industry saw a complete reinvention of its marketplace and I think Amazon showing up here and the retail sector in Australia employs a lot of Australians, hundreds of thousands. I don't know if it gets up to a million. Quite probably would be over a million Australians working in retail.

I think what Uber did to taxis, Amazon is capable of doing more than that in the retail sector when it starts to take delivery times below what it takes you to get to the store to buy the thing. Again the US is experiencing this a bit ahead of us but there's been major change in the retail sector in the US.

I'm going to skip forward a bit towards a wrap here. This is the percent of Australian bachelor degree holders working full-time shortly after graduation. It would seem to be coming on the downward trend. Anecdotally we got a lot of feedback on this report that Australian graduates are finding it harder and harder to get that first job on the career ladder in that the organisations aren't recruiting at the same volume they used to. They've decreased their intakes and a lot of them are faced with it. They have to create their own job. They have to go into some sort of entrepreneurial option because it isn't there.

Flexible working is on the rise in Australia. The number of Australians entering into flexible workplace agreements with their employer is going up really quite sharply and I think there's a lot of positives associated with that. We're also seeing the co-working space. Where I work now, I'm in the Fortitude Valley start-up precinct which is a lot of hot desks in there of people just coming and working and going. It's kind of a good culture but a different sort of work environment we're moving into.

There is a STEM dilemma in Australia's workforce that we picked up here as well. Science, technology, engineering and mathematics. This is associated with the best job opportunities and premium high wages basically into the future. Australians aren't all that interested. We're seeing 75 per cent of the fastest-growing occupation wage premiums but today 11 per cent less Year 12 students studying maths since 1992 and there's been a 35 per cent drop in enrolment in information technology. So this is why we have the Visa 457 program and all of the stuff that happened around that is that companies here say they just can't get the skills from Australia. But we're looking into our databases.

We're starting to build databases on skills demand relative to supply and there are spaces in ICT, cyber security especially where very good salaries, organisations are screaming out for people but they're not getting filled. It doesn't seem to be sending a message to people yet to train into these areas. So there is a challenge and this is Matt Barry saying, 'In my company we hire software developers by the tonne but we are lucky to get two applicants a day. We put up an ad for an office manager and we get 350 applicants'. I think this is a bit of an issue of the Australian workforce, future workforce. We're training in the wrong areas. We're getting the wrong sorts of skills. It's a digital economy that we're moving into that wants a different set of skills.

It's been recognised that 40 per cent with a university degree in India and China by 2020, but it will be by 2025 60 per cent of those with a STEM qualification are in those two places. So look, that's a bit of a snapshot of our study into the future of work. There's a report that goes with it.

Thank you very much for your time.

Madonna King:

Thanks Stefan. Forty-four to 55 per cent of jobs in 15 years at high risk of computerisation. Lots of questions and if I could ask Dr Chosewood to also join us on stage and we'll go to questions in just a moment. But I think you know the drill by now. If you can get out your mobile or your tablet and open Zeetings and answer the same three questions we had earlier, and this is private feedback.\msd2017. The first question is how would you rate Stefan's presentation today, Dr Hajkowicz's presentation today? Thank you.

Thank you. Our next question is will you change your current approach to managing MSDs in the workplace based on what you have learned?

Our final question is what has been your takeaway message today? What's that takeaway message? A word, a phrase, a sentence.

Mine is to ask you what our children should be studying at high school but I'll come to that in just a moment.

Thank you. Thank you and remember you can do Zeetings at any time during the day to ask a question anonymously or with a name. You can actually do that now through the 'Activity' section in Zeetings and you can keep that anonymous. Or you can ask a question the good old-fashioned way and that is by raising your hand and we will make sure we have a runner deliver a microphone to you so that everyone else can hear.

So I might start if that's okay and I'll start with you Dr Chosewood, so much to ask you but I'm wondering where the responsibility of people in this room lay because you can only cater for what your worker does while they're at work. So how much is it changing the way they think so that they don't stop at a fast food shop on the way home and then sit on the couch for six hours, which we can't have control of? Or how much is it just the responsibility of while they are with us?

Dr Casey Chosewood:

Yeah thanks Madonna. That's a great question and you know I would say that some of the most prevailing trends in employment in the way we interact with the job is changing so dramatically that employers and those who sort of establish the nature of that relationship between employment and employee, do have a tremendous opportunity to influence the rest of that work day.

We talked about the concept of time poverty, about lack of flexibility, about lack of how really working conditions drives even the energy level that we have when we leave the job. We're so exhausted and fatigued from long hours and long shifts that we don't feel like going to the gym for a couple of hours, or we don't have time the shop for healthy foods and prepare better meals for our family. Or perhaps more importantly we don't have time to interact on a social level with those people who enrich us or give us support and warmth.

So providing as much flexibility around scheduling, around shifts, I think is a critical intervention that has implications far beyond just the eight-hour workday or the 10-hour workday. Making sure that benefits and wages are one less thing that people have to worry about. I know it's hard for each individual company to influence wages but there are some studies in the US that show that those companies that actually work hard at building this comprehensive culture of health and wellbeing not only do they have workers who are happier and healthier at the end of the day, not only do they have productivity levels that are higher, engagement levels that are higher, but these companies perform better in the stock market over time as well.

So I think there are more opportunities that employers have perhaps more than ever to influence time away from the job. Remember we're talking about this blurring of what is on the job and off the job. That's increasingly a complex space and increasingly I think a challenge for employers to address.

Madonna King:

At the heart of that from your presentation is being able to make cultural change and you said that's not a fast thing to do. In the minds of people in the room how long does genuine cultural change take? Are we meaning a year or months?

Dr Casey Chosewood:

Yeah, you know it is I think years for sure, but I would also say it's a job that's never done, right? I would like to see folks on this continuum of improvement in their workspace because the challenges that are going to face that worker or the working conditions is going so rapidly change as we've really heard from this last lecture, that a fix that's good for today may or may not have any validity just you know, a few years from now. So constantly reassessing the needs of that workforce, asking them what their health challenges are, asking them where they would like assistance in balancing work responsibilities with the rest of life, and working continuously to improve our connectivity with the workers that we have.

It's going to require probably some new technological solutions to engage with workers to understand what their needs are and be a lot more responsive with our programming, with our development of practices and policies than we've ever been.

Madonna King:

Now remember if you want to ask a question just raise your hand and we'll get a microphone to you, or just pop it on the 'Activities' section on Zeetings.

Our first one sir, thank you.

Audience member:

I work for the Queensland Police. So I was quite interested when you were talking about the obesity and the health issues with the police in the States. Are you able to enlighten us as to have they actually been able to achieve better health for the police and the firies over there? Or is it just a continuing issue?

Dr Casey Chosewood:

You know it is improving especially in the firefighters. They've been a little bit more proactive and maybe have a little bit better national organisation that are moving some of these health activities forward a bit faster. But for many years there was almost no sort of attention in firefighting or in the protective services that looked beyond just the shift itself. They really didn't look at the challenges that were part and parcel of the work.

But increasingly we're seeing especially among firefighters this commitment to healthier cooking, healthier nutrition in the firehouse because often times 100 per cent of your nutritional intake over those 24- or 36-hour shifts is controlled by the nature of employment.

Increasing the amount of flexibility in scheduling. There are a lot of studies that show it is the 24-hour schedule, the 36-hour schedule that's a strong predictor of poor health outcomes. So giving the flexibility for workers who only want to do an eight-hour shift, who don't want to have those prolonged shifts is another intervention that we've seen be quite successful, and increasing the amount of physical activity that is allowed and paid for as part of the job. So building into the nature of the work itself physical activity, physical opportunities to be active, to avoid sedentary behaviour.

We really love the promise of sit-stand workstations and walking workstations that are incorporated into the work itself, not just an add-on at lunchtime or after work or before work, that are part and parcel of the actual job duties.

Madonna King:

Can I ask a supplementary question before we go to our first on Zeetings and that is what about the role of sleep? I hear where some US employers are actually paying workers if they can prove that they've slept a certain amount of hours a night?

Dr Casey Chosewood:

Yeah, that's true. In fact I think you can get $50 every quarter if you keep a sleep log and it shows that you're averaging more than seven hours of work per day. Especially like the Googles and Intels and Microsoft that are really working hard. They're really working hard to attract workers. So they're doing all sorts of things like onsite free dry cleaning and onsite free meals not only that you can have there but you can take home to your family.

The flipside of that is they're increasingly encroaching into your own personal or private space, right? It's to their advantage that you will be willing to stay there 12 or 14 hours a day. So it's sort of a mixed bag but very much so the topic of sleep and its health impacts is extremely hot right now. There are tons of studies that show the correlation between length of sleep and occupational injury and illness, safety outcomes, but increasingly we’re seeing these linkages between sleep, the quality and quantity of sleep and the health effects from a chronic disease perspective.

We already know that stroke is much higher in people with poor sleep, diabetes, obesity, all strongly correlated with insufficient or poor quality of sleep.

Madonna King:

I know from a book I've just written that there is pressure on Australian schools to start later to give teenagers more sleep and Stefan I can see you nodding as Casey answered that question.  Is the sleep issue big in Australia in the workforce, or what was prompting your nodding?

Dr Stefan Hajkowicz:

From my own personal observations, yes I think it is and there is a lot of data and evidence that I understand is mounting really showing us the relationship between productivity, sleep, anxiety and mental health and wellbeing. I think it's one of these low-cost, high-value solutions that is sitting before us.

Another thing for physical activity and mobility Australia needs to have a look at is how people get to work. It's actually an opportunity for a lot of movement. We can see data on car commuting times continuing to rise. Sydney has the highest commuter stress. A lot of people's stress in Sydney is actually commuting to work in the morning. It's one of the top three of the world's cities in a commuter stress ranking.

We also know from town planning literature that when you build it they will come when it comes to bikeways, urban recreation and also public transport. You build that and build it well, people start using it. I think we need to have a look at how people get to work in Australian city centres because that's a key opportunity to get them moving every day.

Madonna King:

Can you see pressure for employees to have to pay for the time period that workers travel to and from work?

Dr Stefan Hajkowicz:

Yeah, I think so. We're waiting to see the pick-up of co-working centres that are in the suburbs away from work. I think that's promising. For some reason that's not yet happening. They have been experimented with in New South Wales. They built five of them in cities like Rouse Hill which has a big commuter population and to me it stands to reason that that would work because most of the work they're doing is knowledge-based work. It's over an internet connection. So why that co-working centre didn't really take off, I don't know.

Madonna King:

Okay. Let's go to our first question on Zeetings. It's by Pat. Thanks Pat. 'How can I best manage MSDs in an aging workforce doing physical work?' Casey?

Dr Casey Chosewood:

Good question and an important question because about 40 to 45 per cent of your workers come to work each and every day with an age-related MSD condition. Whether they're complaining or tell you about it or not it's there and that's arthritis, largely a result of the obesity epidemic that the developed world is experiencing. So arthritis in the knee and hip the leading cause of chronic disease that actually impacts workers and when you add on top of that a physical demanding job, the risk for occupational injury and illness dramatically higher. So MSDs, no wonder it's five to six in 10 of the workers' comp claims in Australia, certainly similar in the US.

Then you add to that the aging of the population, a trend that clearly the US and here in Australia is experiencing. It's only going to become much more a challenge.

So we've developed a new centre that is dedicated to what we term 'productive aging' and it looks at this intersection between how can we create working conditions that will allow people in advanced age to continue to thrive on the job even when the demands remain high? It almost demands this integrated approach. If you're looking just at that worker in the few hours that they are with you in the workplace and don't address arthritis self-management strategies, the quality of their rest, their physical activity, you're going to fall short.

It is one of those conditions that is so pervasive and so influenced by work and non-work factors that trying to just address it from an ergonomic standpoint in the workplace is far from sufficient. I would also say that any intervention you do for aging workers is dramatically important for workers of every age, right? There's only one group of people who are not aging and those are not going to be reporting to work tomorrow.

Madonna King:

Okay. Thank you.

Our next question up the back. Thank you mam.

Audience member:

Hi. Good morning. My question is to both panellists. Given that you've said that the larger organisations are more likely to be the ones adopting more automotive approaches to their workforce and hence won't be the contributors to employment necessarily, and more but yet we know that our profile of the workforce, most people are in small to medium businesses, how does minimum legislative standards impact on MSDs as well as the general health and wellbeing of the population since they're going to be competing against each other and if graduates can't find work and have to be entrepreneurs themselves, that whole mix, how does all that play out with the role of government in all of this?

Madonna King:

Thank you and I might go to Stefan first.

Dr Stefan Hajkowicz:

Yeah. I think government health and safety regulators have a challenge to keep pace with the platform based peer-to-peer models that are digitally enabled, that recruit labour for small tasks because it's not an organisation that is looking after a group of employees. They're engaging on an individual basis and a regular basis. How do we ensure health and safety is maintained in all of those? I think the answer lies in the platform-based models themselves. Regtech is now identified for us as one of the big areas of R&D and building better regulation technologies that keep pace with the digital technology.

Governments were caught off guard by Uber. For a good couple of years it was illegal but happened anyway and they didn't know what to do with it. That's changed now but I think the analogy is there for the freelancer workforce that is going to be engaged by digital platforms. The government needs to get in and start to build the sort of same agile, speedy, digitally delivered regulatory models. I don't really know what they look like but I think we need to start building them.

Madonna King:

Thank you. Casey do you have anything to add?

Dr Casey Chosewood:

Yeah. It's a wonderful question and quite challenging now in the US as you can imagine. Our regulators are within the Department of Labor. The research that we do at CDC and NIOSH is in the Department of Health and Human Services. So we don't have the connectivity that we really would love to see to try to influence regulatory intervention to the extent we would like.

We also are all part of the official administration. So we are all in the executive branch of government and work for President Trump and this is not an error when we're seeing a tremendous amount of interest or you know, effort around changing regulatory approaches. So that constellation of challenges I think makes it very, very difficult for us.

Our role is to show the value in having some standard of required safety and health intervention as part of the work itself and to show organisations that it's in their own best interest to have that minimum standard if you will, of performance and behaviour. Our research is designed to do that, to talk about value of these interventions, to talk about the return on investment of these interventions, to show that not only is it the right thing to do for the protection of workers but your company will thrive if you do these things as well.

Madonna King:

Right. Our next question. Thank you mam.

Audience member:

Thank you. Is this working?

Madonna King:


Audience member:

So Lori Deakin. I work in the health industry and you would think that perhaps the health industry would look after their workers, in an extremely informed and an integris way and I think they do a lot. But what I'm interested in is if it's not measured it doesn't get looked at. So I think looking at that principle I'm wondering if you can direct us to tools that organisations or workplaces could use that measure that the workplace is putting real skin in the game, as in real money to measure the workplace health? We have a lot of that for the patients. I'm working in Queensland Health. So we have lots of measures, how many falls our patients have etc. We have negative measures for how many workers get injured, how many nurses get back injuries etc., but I'm looking for those tools that show that we really are doing something to improve wellbeing.

Madonna King:

Positive, positive measures for the workers?

Audience member:


Madonna King:

Yes, yeah. Casey? Stefan? Who's like to take that one?

Audience member:

Otherwise we tend to hide behind legislation.

Madonna King:


Audience member:

We're doing it. We're doing health and safety. Thank you.

Dr Casey Chosewood:

I'll start in any event.

You're right. That's an increasing challenge because in general the safety field is really just looking after the incident, right, and counting injuries and illnesses.

There have been some improvements in the prevention side in the US. The voluntary protection program, VPP program from the Department of Labor really tries to reward and move companies who are interested in doing above and beyond the bare minimum, a better consultative sort of approach instead of just a heavy handed regulatory approach. So the VPP model used by the US Department of Labor is one example of a positive invention.

Part of our research too has led to the creation of several tools that I think would definitely be applicable to your question. Harvard, one of our centres of excellence has the SafeWell Guidelines which really does look at how you integrate programs and how you introduce these policies, practices and then measure the outcomes from them. That's a promising area. We also have a couple of tools that do sort of organisational assessments. The CDC Workplace Health Scorecard is a great first tool to find out what your gaps are in workplace health and it has an extensive safety section as well. So that would be another thing.

Madonna King:

Okay. Are we that far advanced Stefan in Australia?

Dr Stefan Hajkowicz:

I'm not sure we are but I think we've got – the sort of solution I'd like to see in place is that when I go for a job with an organisation that the crowd, the workforce of that organisation is using platform-based solutions. The same way I'm continually rated online, employers are rated in terms of their performance for health, safety and wellbeing. We have websites like Glassdoor which give us insight to salaries and culture and what it might be like. I think we need a lot more of that giving us detailed information on health and safety risks inside the company that is there and maintained by the workforce of that company. I think that those sorts of platform solutions are the ones we want to look for.

Now they need to be well-designed and they can't be giving us erroneous information but the employees in the company itself are going to be amongst the best holders of information about health and safety risks and what the stress levels are like working in that place and then we can start to make informed judgments about where we want to work. So I think one of the roles of government is to fill an information gap. If it can provide me with better information on the health and safety performance of my employer that's a good thing to do. I think that we're not doing enough of that yet.

Madonna King:

Thank you.

To our next question on Zeetings. 'Can you define or illustrate healthy supervision Casey?'

Dr Casey Chosewood:

Great question. Yeah, healthier supervision is really about having folks understand that the decisions that they make in leading their team day in, day out have health implications and that there are better ways and worse ways to do that.

We talked about flexibility. So giving people the ability to control the nature of the conditions, the start time, stop time, the pace of their work still with the belief that they're going to accomplish work in a reasonable amount of time, that's an extremely important intervention. Another is to educate our team leaders, supervisors, managers into the connection between working conditions and health. Most people probably don't understand the relationship between high workplace stress levels and high disability levels. They're very common in many workplaces.

So sharing with supervisor’s information about those conditions, those stressors that lead to poor health outcomes, looking at hidden illnesses. There are estimates that maybe more than half of workers come to work every day not with a proclaimed disability, but with some underlying, hidden illness that does influence their opportunities.

So those are a few examples. We developed a two-hour training course that I'm happy to share with anybody who would like it, that looks at a number of these exact interventions.

Madonna King:

How would people in the room access that?

Dr Casey Chosewood:

Yeah, we'd love you just to Google 'total worker health'. That's the fastest way to see all of our resources.

Madonna King:

Okay. Over to you Stefan. Can I just ask who's got school-aged children in the room? Just, okay, a big proportion. Yes, including Stefan and you saw Casey's little grandchild Lily up there at the beginning and end of his presentation. You said three things Stefan that struck me. One was that graduates are finding it harder and harder to get a job at the end of their course. Secondly that creativity is one of the reasons why jobs like photography is remaining and growing, and that STEM is really important and fewer and fewer students are studying it but it is one of those areas that's needed for the future.

So in terms of Lily or someone entering high school now, what kind of subjects should our children be choosing, a language, science or a creative area?

Dr Stefan Hajkowicz:

So Queensland and Victoria are the only two states to have coding on the school curricula as compulsory and I think we need to go across the board and do that. We needed numeracy and literacy to get a job when we were starting out. Digital literacy has become important. That's not just meaning you can use an iPad. Anyone can do that. You need to understand the mechanics and you need to know coding because that lets you manipulate the iPad.

My school where my children are at has a coding program that begins in prep. In the prep centre they have a grid of five by five squares on the floor and they have a robotic bee with a forward, backward, left and right button. Then they put obstacles in the way and you've got to get the bee from one square to where a teddy is on the other side. That requires coding. That is your beginning into coding and there are a lot of resources, Scratch is another online programs for kids to learn coding.

But there are a lot of resources for young kids to learn coding and how to manipulate a computer because that computer and all of the robotics that go with it, it's getting so much more powerful and capable by the time they're graduating. They need to be able to control it. Learn to race with the machine not against it because it's there to beat you.

But I think at the same time we're not seeing enough of a move by Australians into these high opportunity jobs that are getting created by technology. Cyber security, the area of functional programming we learned last week was a different sort of approach to programming where there's huge skills demand. So we are in the process of the next phase of this work is building a forecasting tool where we can look at a job and ascertain the likelihood that it's going to disappear or which ones are at risk. Then we look at the skills that underlie the job. We're trying to forecast skills more than jobs because they're more durable over time.

We can say, 'This set of skills this person has is highly transferable to these other jobs,' and we build a transfer pathway because we know it's much easier to get a job when you've already got one and we want people to be making that decision to transfer into a new space before job loss occurs and we get a much better outcome. So we want to provide them with the information to do that. I think we also need the behavioural economics. It's gets into, some people have very good information that their job's going to disappear but don't take any clear action. We want to try and work out what is the signal.

In Singapore, I was there last week, they have a digital retrain fund. If your job is likely to disappear due to digital technologies you're given a small fund before that happens to retrain and it's more really the kick it gives you. It gives you an inspiration or a reason to go and study and do something else.

So I think we need to get a lot better at the transitions. We absolutely need to have a look at our schooling system. It's not just the STEM and technical skills. It's the creativity, entrepreneurialism, social and emotional intelligence get important too. I don't think we can beat the Asia-Pacific at pure STEM. It's already won and it's so much on a path to winning, but a differentiated STEM product out of Australia is what we can do.

Madonna King:

Ladies and gentlemen please put your hands together for Dr Chosewood and Stefan.

There are several other questions that have coming in on Zeetings including that great one that was just up there on you've only got three or four workers, how do you actually fund or access these programs? We will endeavour to find the answers for those and provide them to you as delegates.

If I can just get you to stay where you are for a moment to explain what is happening after morning tea. Morning tea will conclude at 11:15 and we will break into three streams – Back to Basics stream and that is MSD Prevention – How to get started and that is in P9. This is also in your programs. It's presented by Tammy Robertson and Allison Morris from Workplace Health and Safety Queensland.

In P10 is Good Work Design and that will be Using Technology to Prevent MSDs. That's presented by Rob Hanson and then Business Integration will be in P11 and that starts with Performance Indicators and Executive Reporting.  It's presented by Karen Wolfe and I will join you there.

Remember you are able to switch between the streams throughout the day. If you refer to your program you will be able to see what sessions are on in what rooms.

During morning tea don't forget to visit our sponsors and exhibitors, get your passport signed and a tone will sound to end morning tea at which time you should move back to your chosen room as quickly as possible. That means it's best to take your belongings with you now.

Let's have a cuppa.

[End of keynote 2 transcript]

Last updated
10 December 2019