ADDRESSING VIOLENCE FROM A HEALTH MANAGEMENT PERSPECTIVE

Gregory O. Ginn University of Nevada Las Vegas 4505 Maryland Parkway Box 45602 6 Las Vegas, NV 89154-6026 (702) 895-3091 gregory, ginn@ccmail, nevada, edu

L. Jean Henry University of Nevada Las Vegas 4505 Maryland Parkway Box 453050 Las Vegas, NV 89154-3050 (702) 895-1744 [email protected]

ABSTRACT

This paper addresses the problem of workplace violence from a health management perspective. Health management casts wellness as a business issue. The paper reviews articles that have appeared in the literature about workplace violence. These articles were written from the perspectives of human resource management, law, occupational safety and health, public health, psychology, sociology, and wellness. The authors then consider the literature on workplace violence from a health management perspective. The authors conclude that the health management perspective subsumes all of the other perspectives of workplace violence and thus offers a more comprehensive approach to prevention.

INTRODUCTION

According to the U.S. National Institute of Occupational Safety and Health [ 1], workplace violence is a substantial contributor to occupational injury and death. Workplace violence has received increasing attention over the last three decades. According to the Occupational Safety and Health Administration [2], the Occupational Safety and Health Act of 1970 declared that employers had a general duty to provide safe and healthy working conditions. In 1989, OSHA [2] published voluntary, genetic safety and health program management guidelines for all employers to use as a foundation for their safety and health programs, which can include a workplace violence prevention programs. In 1998, OSHA built on the 1989 genetic guidelines. The new OSHA [2] workplace violence guidelines include policy recommendations and practical corrective methods to help prevent and mitigate the effects of workplace violence.

STATEMENT OF THE PROBLEM

This paper is written to address a fundamental problem. From a public health perspective, it makes sense to approach workplace violence prevention in much the same way as other types of illnesses or injuries.

476 However, from the perspective of an , the connection between workplace violence prevention and the attainment of broader organizational objectives such as financial performance may seem very tenuous. At the same time, the organization is uniquely situated to exert a powerful influence over the environment of the workplace, and because of its position, has far more ability to effectively reduce both the incidence and severity of incidents of workplace violence: Thus, the problem is to convince that 1) they can be effective in accomplishing a public health objective such as workplace violence prevention, and that 2) the attainment of broader organizational objectives is very much facilitated by success in workplace violence prevention programs.

OVERVIEW

This paper reviews articles that have appeared in the literature about workplace violence. These articles were written from the perspectives of human resource management, law, occupational safety and health, public health, psychology, sociology, and wellness. The literature review establishes a case for using a health management framework to accomplish both public health objectives and organizational objectives.

REVIEW OF WORKPLACE VIOLENCE PREVENTION LITERATURE

One major category of business literature is the technique approach. Some of this literature outlines procedural approaches to preventing or handling incidents of workplace violence. Other literature suggests policy and program approaches to dealing with workplace violence. This literature resembles the public health approach to disease prevention in that it stresses record keeping, data collection, tracking, education, and training.

Another major category of business literature acknowledges the role of the work environment in workplace violence. It considers that a lack of organizational justice can precipitate violence. It also addresses the possibility that the structure of an organization can cause communication failures that can lead to violence. Further, it considers that certain management strategies can be so dehumanizing that they can provoke violence. Last, it suggests that the organizational culture may shape employee behavior in such a way that it produces violence on some level.

Still another category of business literature recognizes the role of the personality of the employee in workplace violence. Negative affectivity and agreeableness can be moderator variables in determining the way an employee will react to a given situation. In addition, jockeying for position and power is common in many . Employees may resort to intimidation or sexual harassment to improve their position or power.

One last category of business literature takes what could be called a wellness approach. It suggests that wellness programs such as stress management and employee assistance programs can have an impact on workplace violence. In the next section, the authors of this paper expand on this literature by expanding the linkages between wellness programs and workplace violence prevention.

DISCUSSION AND CONCLUSIONS

When narrowly defined, workplace violence includes anything from physical assaults to homicides. It affects retail industries and the health care industry more than other industries. It is a major cause of

477 death and disability in the United States and in many other countries. Workplace violence is the direct cause of medical expenses and workers compensation, and it can expose organizations to legal liability.

When broadly defined, workplace violence includes threats, intimidation, and some forms of sexual harassment. This type of workplace violence pervades many industries. Its economic impact is more insidious. It lowers profits through lost productivity due to , and low morale.

Worksite health promotion and wellness programs are uniquely able to influence the health behaviors and lifestyle of employees. Public health agencies can gather statistics, set standards, and disseminate valuable information, but they are severely limited in their ability to affect organizational culture, group factors, or even personal behavior at the worksite. In contrast, the organization can exert a powerful influence over the environment of the workplace, and it has the ability to directly access all of its employees in a way that a public health program simply cannot. Worksite health promotion and wellness programs are the logical vehicles in that they have the requisite variety to affect lifestyle and health behavior.

Health Promotion and Wellness Programs are heavily influenced by a social ecology view of health. According to the social ecology perspective, the healthfulness of a situation and the well-being of the participants is assumed to be influenced by multiple facets of the physical environment and the social environment. A basic assumption of this perspective is that healthfiflness encompasses physical health, emotional well-being, and social cohesion [3].

Health management is essentially health promotion and wellness with an eye on the bottom line. In health management, the success of workplace violence prevention would be measured not only by the welfare of the employees but also by its effect on productivity. Health management offers promise for workplace violence prevention that a public health approach does not. With strictly a public health approach, workplace violence prevention programs are too easily dismissed as a compliance burden. Moreover, the public health approach ignores the fact that organizations have such an enormous influence on the physical and social environment of employees. Without the emphasis on organizational objectives provided by the health management perspective, workplace violence prevention efforts could end up as only a half-hearted attempt at social responsibility. When workplace violence is cast as a health management issue, it becomes clear that organizations have not only a social responsibility but also an enormous financial incentive to prevent violence of all types in the workplace.

REFERENCES

[1] NIOSH Current Intelligence Bulletin 57. Violence in the workplace: Risk factors and strategies. Washington, DC: Author, 1996.

[2] Occupational Safety and Health Administration, U.S. Department of Labor. Guidelines for preventing workplace violence for health care and social service workers (OSHA publication No. 98- 3148). Washington, DC: Author, 1998.

[3] Stokols, D., Pelletier, K.R., & Fielding, J.E. The ecology of work and health: Research and policy directions for the promotion of employee health. 1996. Health Education Quarterly, 23(2),_137- 158.

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