As part of our Social Determinants of Health series1, an exploration of the types of violence workers may experience and the potential impacts on their health and healing.
Exposure to violence can have serious impacts on worker health. Violence in the workplace may cause direct injury and other types of violence can also be a concern in workers’ compensation. Violence that takes place outside the workplace, including domestic and community violence, can adversely affect overall health and job performance, lead to accidents, and impede recovery.
Workplace Violence: The Occupational Safety and Health Administration (OSHA) definition of workplace violence is broad and includes “any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site” 2 and, by this standard, over 2 million workers are affected by violence every year.3 In 2019, over 20,000 workers experienced trauma from workplace violence that was serious enough to require time away from work – most commonly in the healthcare industry, which accounted for 71% of the incidents.4
Generally perpetrated by a stranger intent on crime that is unrelated to the business or the workers
Violence committed by someone the organization serves, such as patients in a healthcare setting
Conflict, altercations, and harassment between workers, as well as extreme violence, such as workplace shootings by current or former employees
Usually current or former intimate partners who assault, harass, or intimidate their victims at their place of work 5
Domestic Violence: 98% of domestic violence survivors reported that the abuse they experienced made it difficult for them to concentrate at work. Of the nearly 100% who had difficulty concentrating, 17% said that the lack of concentration resulted in a work accident or near miss, with 65% of the accidents resulting in injuries.6 These numbers are considerable, especially considering that, according to one study, 21% of fulltime employed adults reported that they were victims of domestic violence.7
of domestic violence survivors reported difficulty concentrating at work
Community Violence and Crime: In 2020, over 4.5 million violent crimes were committed in the U.S. and 44% of violent crimes reported to police were committed by strangers.7 People who are victims of violent crime and behavior – and even those who are merely exposed to violence by association with victims within their communities – are at higher risk for depression, anxiety, and PTSD.8 These mental health conditions can manifest in physical symptoms, such as insomnia, headaches, and chronic pain, potentially resulting in decreased productivity and increased accident risk.
Americans are victims of workplace violence each year9
U.S. businesses lose an average of
annually due to workplace violence10
Violence preparedness and prevention costs healthcare facilities nearly
Victims of intimate partner violence (IPV) lose
workdays per year
at a cost of over
per year to employers12
The lifetime lost productivity cost due to IPV, sexual violence, or stalking is
per victim or
across the U.S.13
of IPV victims reported disruption in their ability to work and
lost at least one job as a result of abuse14
Violence is now widely considered a public health issue15 and regardless of whether workers experience domestic, community, or workplace violence, the health impacts and risks are similar.
Exposure to violence can lead to an increased risk of:
In addition, people who experience violence are more likely to engage in unhealthy behaviors, such as poor sleep, smoking, social isolation, and substance abuse,16 any and all of which can hinder a patient’s recovery from injury or illness. Opioid abuse is, of course, a particular hazard in workers’ comp.
Any one of these comorbidities will obviously make an individual less healthy and there has long been evidence that chronic conditions negatively impact job performance, causing poor productivity at work and absenteeism.17 Comorbidities can also complicate injured worker treatment and recovery and cause claims cost to escalate.
Community, domestic, and even workplace violence are unfortunate features of society over which no workers’ comp payer has complete control. But there are some steps that employers and insurers can take to mitigate risks and facilitate better outcomes for injured workers, including: