Dr. Shannon Guillot-Wright from UTHealth School of Public Health | How Workplace Systems Shape Health and Well-Being

Christine: [00:00:00] Welcome back to another episode of the HR Scoop. I’m Christine Muldoon, your host, and today we’re talking about political and economic systems shaping health outcomes. My guest today is Dr. Shannon Guillot-Wright. Dr. Shannon is an associate professor at UT Health School of Public Health in the Department of Environmental and Occupational Health Sciences.

She’s also Deputy Director at the Southwest Center for Occupational and Environmental Health, and the Director of Health Policy at the Violence and Injury Prevention Research Center. Her program of research focuses on occupational health equity and the use of evidence in policymaking with an emphasis on health outcomes among precarious workers.

Her work has been featured in the American Journal of Public Health, national Academy of Medicine, New York Times National Public Radio, time Magazine and Texas Monthly, and [00:01:00] she’s President-elect for the Society of Advancement of Violence and Injury Research. Wow. Welcome Dr. Shannon Guillot-Write to the HR scoop.

Shannon: Thank you so much for having me.

Christine: That is an impressive background and I kind of wanna break this down a little bit because when I think of things like medical research, not that I think about it often, but I typically think of things like the biological factors, individual behaviors, and then the clinical treatment.

But you focus on political and economic systems that shape health outcomes, and maybe it’s the idea of really understanding why groups are more likely to get a disease in the first place, which is fantastic. I don’t know if I did that justice, but maybe you could start off by explaining what political and economic systems research means and how that would relate to our audience, which is typically those in the workplace.

Shannon: So you’re absolutely right [00:02:00] that we often think of clinical care or behavioral healthcare as medicine. Um, but there’s something that we like to call the other half of health. So those, um, only make up about 50% of your health outcomes. And then the other half is. Where you live, where you work, and the neighborhood that you grew up in, your community, and all of the social factors that end up impacting your health.

And if you take that one step further, we then also can understand what are the structures and systems, what are the politics and the economics that are even impacting? Social level. And so whenever we talk about social structural, that’s really what we’re thinking about is that other half of health and how it [00:03:00] impacts, um, our long-term outcomes as well as our family’s health.

Christine: So would you say that it’s sort of similar to social determinants of health?

Shannon: Exactly. Yeah. So social determinants of health or non-medical drivers of health. Those are, um, definitely other terms that we can think of.

Christine: And so when you talk about this, is it looking at both sides, the clinical, but also the social and political aspects as well?

Shannon: Whenever we’re talking about the political and economic drivers of health, we’re looking at, uh, the totality of it. And so what we wanna do is be able to pinpoint a policy. And then start to, you know, draw different lines of how that policy may impact our social world, our social fabric, as well as our individual health outcomes, which could be, um, you know, our [00:04:00] primary care or, you know, behavioral healthcare as well.

Christine: Okay. So I’m trying to think of an instance or an example that this may play out in and. Maybe it would be the COVID times, which many of us would love to completely forget about that. But it definitely was a period of time where yes, there’s financial stress. We talk a lot about the unsafe conditions that we all went through, the social strain or lack thereof, having the, that social, um, element of what we do every day.

Um. And it probably, depending on maybe where you were or certain areas you felt more of an impact than others. So if we think about that, are there key lessons that employers. Should have taken from that period to really think about how to strengthen [00:05:00] moving forward, their preparedness for any sort of crisis and really protecting their workforce should, let’s all hope not that another type of situation like COVID comes into play.

Shannon: Yeah. So what we learned during COVID, and we can, you know, then start to think about this in more everyday terms as well. Not just, you know, a. Pandemic, but paid sick leave ended up having a really big impact on people’s, uh, long-term health. And there were, at the very beginning of COVID, there wasn’t a lot of paid sick leave, um, paid sick leave access for all workers.

That started to change right? As people understood that. Being home was really important, and that if you weren’t getting paid while being at home, you [00:06:00] might go into work anyway. So that policy is a really good example of how we saw a shift in people’s health outcomes because they were then able to take that time off.

And still receive their paycheck. You know, for someone who may be in like shift work, right? Who isn’t a salaried position or a contract worker, and at the same time. What we saw was that some employers really took advantage of that policy and worked with their employees who wouldn’t normally have that paid sick leave.

And then we also saw some employers not really take advantage of it. And so we did research, um, and ended up meeting people from, you know, both sides of that and in the middle, and really were able to see how it impacted people long term. Not only their health, [00:07:00] but uh, if they had to take a month off of work and they weren’t getting paid, that then impacted their ability to pay for medication or for their child’s medication or, and to, you know, continue eating healthy foods instead of cheaper, more processed foods.

And so you really start to see the impact. On a really, on a large scale with that one policy and then how different employers use that policy.

Christine: You know, that is a great example. ’cause I, I don’t think I ever thought about how paid sick leave really could have that, um, effect as you continue to go, like into the details of employees, what they have, what they don’t have.

Then if I, if I take the time off and I’m not getting paid, then it impacts the foods that we’re eating or how we’re showing up. Um, one of the things that I have seen some organizations do [00:08:00] not, I don’t know if you know the answer to this, but just curious. I mean, some employers have now gone to sort of like an unlimited like.

Really putting, I guess the, the trust in their employees and not creating those boundaries that I don’t know if that’s a result of COVID or also just encouraging their employees to take sick time because they’re not taking it.

Shannon: Yeah, I, so I see that as well. I think the jury is still out on how that would impact people.

And so I think there’s one, um, people who have the mind that. People might end up taking less days because you kind of have many days available. But then there’s other people who would say no. This gives people the flexibility, the full flexibility that they need, uh, for their families. And so, uh, I think definitely more research needs to be done.

But either way, I think it’s great [00:09:00] that employers are trying something new and they’re thinking about how can we help our employees? Um, and then, you know, continuing to evaluate it and see how it’s affecting people.

Christine: Okay, thanks. Um, so one of the things I said in my intro is that your studies focus on precarious employment.

Can you explain what that means and then why HR leaders should maybe have this on their radar as they’re thinking about job insecurity? Um, if they have contract workers and they’re not. They’re not actually getting benefits and how that maybe ties to this idea of a public health issue.

Shannon: Yeah. So when we say precarious employment, what we’re talking about are the workers who are often contractual, um, gig workers, contingent workers, all those different, um, types of workers.

The reason that I really center the term [00:10:00] precarious employment as opposed to those other terms is because. Then, um, you know, really centers the workplace and doesn’t put the onus on the worker. And so whenever again, you know, we can talk about paid sick leave and we can think about if a contractual worker, a gig worker, doesn’t have the opportunity to take a day off of work, how that’s going to then impact their long-term healthcare.

And then, you know, I briefly mentioned this, but we also see that it impacts the family healthcare. And not only because they might not have access to funds, but it could be that that parent can’t take the child to a doctor’s appointment. So you know, the child ends up missing more school. Right? There’s all of these, these effects that.

We see from something, I don’t wanna say as simple as paid sick leave, ’cause it’s a very complex, you know, [00:11:00] political and policy issue, but how one policy can have such huge effects on people and their families.

Christine: And there’s, there’s others of course, if you are, uh, under this precarious worker employment, I mean, there’s things that you don’t have access to.

Medical benefits in some cases, I assume so, yeah, that all, that all has a role and impact on those individuals.

Shannon: You also might not feel comfortable, think something, um, you know, at your job if something is unsafe, right? And so if you don’t have the security of, uh, you know what, you know, certain jobs and salaried.

Employment can bring you, you might be more hesitant to say, Hey, you know, I saw that um, you know, the floor was really wet and, you know, there [00:12:00] weren’t any signs or, you know, I saw this dangerous, no neck hanging and we’re not wearing hats or whatever it might be. Um, there’s also that, that impact that maybe an employer.

Would absolutely fix those issues, but, um, because of that precarious condition that people are in, they might not feel comfortable talking about it.

Christine: Ah, okay. Another good example. I don’t think I think of all these things. Um, okay, so switching over to then this idea of bio-psychosocial social aspects. So many organizations focus on.

Safety protocols. We know that. So depending on your work environment, you might have to, uh, wear a mask if you work on a production line or hard hats or obviously machinery guards for whatever that you’re working with. But your [00:13:00] research suggests there’s bio psychosocial aspects as well. So can you explain that?

Shannon: Yeah. So. We don’t leave home and then come to work different people, right? So if we get in a fight with our kid at home, you know, because they weren’t putting their shoes on and now they’re late to school and now they’ve made you late to work, we’re not gonna just leave that at the door when we walk in.

Uh, I know that’s a very small example, but, um, you know, you can then take that to, you know, larger. Pieces, right? Larger factors. So you know, if there’s been a death in your family or if you have your own mental health issues, or if you have diabetes, right? All of these things aren’t being left at home when you go to work.

And so looking at bio-psychosocial, um, you know, there’s another term that has been used more frequently lately as well called Total worker health. [00:14:00] And, uh, it’s really that same idea of. Um, a worker is in the workplace, but there’s a lot of different factors that are gonna impact them. And their safety at work as well as their health outcomes.

And that matters to employers, right? It, we want a healthy workforce. We want people to continue with us long term and to grow in companies. And, uh, you know, we, we want to see, you know, their families involved and part of that as well. And, um, if we can look at the total worker and look at their, you know, entire.

Um, you know, situation they might be bringing. Then we can, um, oftentimes have healthier workers and healthier workplaces.

Christine: So that completely aligns to kind of, we look at it as, um, holistic wellbeing and uh, really looking at the whole person. [00:15:00] Very similar. And, you know, if you are a caregiver. And you also, you know, have a job, um, or you have financial stress at home, um, you know, or mental or emotional, like the example you provided.

It’s that idea that when you come to work and your employer really wants to. Demonstrate that they genuinely care, um, about your overall wellbeing and they’re committed to your wellbeing. A holistic wellbeing program also needs to think about the caregiver financial wellbeing. Um, we call them dimensions of wellbeing, right?

So financial, social, physical, emotional. And work as a dimension of your wellbeing. So it’s very similar. Um, of course we look at it holistically from a wellbeing perspective, but you’re talking a little bit, I think more about like holistic safety. So maybe, you know, what does that [00:16:00] strategy look like or how do you put that?

Practice in place when we think about holistically, maybe keeping someone safe or recognizing that they don’t leave that at the door when they come to work.

Shannon: Yeah, I, I would say it’s, I agree with you that it’s bigger than safety. I, that I do think safety is one component of this. Um, in safety at work. Um, the total worker health paradigm.

Also takes the holistic and individual person and puts that other layer of policy on top of that as well. And so that could be, you know, capital P policy, like, you know, a federal sick leave program. And it could be also little P policy, like what’s happening in the workplace to ensure that. It’s a place that people feel safe and that they feel like [00:17:00] if there is an issue, that they can go to a manager or go to someone and say, Hey, this isn’t happening.

And, uh, it, it needs to be happening. It’s impacting our health. It’s impacting our, um, our safety as a group or as a person. And that can only happen if that person. Feels trust in that relationship. So if they don’t feel that they can go to their manager and say, you know, this is wrong, without them getting penalized themselves in some type of way, or, or, you know, feeling like they’re, you know, now, um, you know, exposing somebody else and getting someone else in trouble, right.

That, um, that hope, the whole culture of trust and relationships. Um, it’s all like in intertangled in that, right? And so you’re not gonna build that trust. And so it’s this [00:18:00] continuous circle. You’re not gonna build that trust if you’re not seeing somebody as a whole person. And if you’re not seeing that they’re coming in and they’re, they have a really bad day, right?

We just all have bad days sometimes. And if we can recognize that and see them as a whole person. They understand they’re not just an employer, that they are somebody who cares about about the people that work for them. So it becomes. A people centered relationship instead of an employer employee relationship.

Christine: That makes a lot of sense. And I think it can also be tied to, um, the culture of an organization. So we often look at, I mean, similar to what you’re saying, like psychological safety, where an employee, a person feels safe to speak up even when they might disagree or you know, they wanna share something that maybe isn’t.

Exactly, um, aligned with the conversation. [00:19:00] And they have that comfort level to speak up because they, the organization maybe has this culture of the trust or feeling safe, psychological safety to, to speak up. So I think that that’s a critical element to an organization’s culture, um, showing that they care and, um.

Not, it’s not my way or the highway, you know, it’s, it’s really about having employees be able to share all aspects.

Shannon: Yeah. And I think with that culture, sometimes we think about culture as purely the interactions between people, which is a huge piece of that. But something else within that culture and how you create that culture is that you have policies in place.

To ensure that people, um, you know, feel like they can, um, you know, report something or that they know that they [00:20:00] can take a day off and not get penalized. Um, you know, that’s something else. There’s sort of two sides to sick leave benefits. There’s people who don’t have them, right, which we’ve talked about.

There’s also organizations where people do have. Sick leave benefits, but they don’t take them because they feel like, you know, they might get penalized for not being in the office. So there’s this other side of fear, um, of taking that day. And so, um, you know, having that culture as well as having those policies in place, um, I think that marriage is really important.

Christine: Okay, so let’s keep on that theme of sort of this fear. Um, not that we want to, but your research has also uncovered that, um, workers often would, might conceal their injuries or, you know, not share something because they have a fear of [00:21:00] losing their job, their work. And, and I, I wanna talk about this ’cause I think there’s also some similarities and parallels.

From a wellbeing perspective as out as well. So what should leaders understand about the culture of silence or that lack of trust, um, that can exist in high risk industries or really any industry, I think for that matter.

Shannon: Yeah, so that is something that was. Not necessarily what we were expecting to find when we were doing this research, we were looking at people’s healthcare benefits and how they would access healthcare.

Um, and it was people who had those rights to do it right, who had those benefits. And as you said, you know, what we found is not only was there a lack of access to healthcare, but people were simply not even reporting, um, a work related injury. And, you know, for [00:22:00] employer, again, you know, I, I think this goes back to making sure that you have people at all levels, you know, from high management to mid managers, um, you know, all the way to people on the ground floor who are, you know, really encouraging people and creating that sense of safety that people can, um, you know, can go and.

Seek healthcare or, you know, have healthcare services provided to them if something happens on the job or if they’re heard off the job, I need to take days off of work, right? That, that both of those aspects can happen. Um, I think that there’s probably somebody much smarter than me who can talk about all of, um, you know, the different ways that employers can create that sense of safety, um, and that sense of trust.

But, and that is something that we’ve, that we’ve found to be [00:23:00] very important to long-term health of people, and then that they want to stay with your company and that they want to continue there.

Christine: Um, I can add to that because one of the things that we talk about is making sure leaders are supportive, but that middle managers are trained.

You know, it’s important for them to, um, be able to. Feel like they have the right tools to support an employee, whether it is, um, you know, that, that sense of safety and they know something’s wrong, but how do they approach the topic and let them know? So having that training, I think is important. And it doesn’t, I mean, it applies to multiple things within an organization.

So. Thinking about, um, you know, we have, um, employees that are going through a health condition, but they don’t wanna share that because of [00:24:00] fear of judgment. Uh, they think I’m not gonna be present in my job, or I’m not gonna do a good job, or just the impact that it could have on their careers. So there’s all these different elements, um, and I think middle management training is an important aspect.

And of course, leadership support is. Equally important.

Shannon: Yeah. And you know, something else that, um, it, it’s a simple, um, you know, phrase, but can be hard to implement sometimes is to be nice to people and something that simple can really go a long way. Um, you know, whenever we start with a sense of understanding that this person isn’t, um, you know.

Out to steal from us or out to get us, you know, whichever side it is. But you know, being kind and being nice to each other and being understanding can go a really long way.

Christine: [00:25:00] Okay. That’s gonna be our tagline for today. Everybody. Be nice to, so you’ve used things like text messaging, um, you’ve looked at healthcare navigators and other types of models to.

Reach field workers who are traditionally underserved. Again, there’s many organizations that could understand this, this scenario because they have workers in the field. So are there specific types of communication strategies that you’ve seen that are more effective in reaching those kinds of populations?

Shannon: It really depends on the specific group that you’re working with on what strategy is going to work best. Uh, and so if you, um, you know, don’t have, you know, a research arm as part of your organization to see what that is, then uh, I [00:26:00] think three strategies are, you know. One-on-one communication, you know, like face-to-face communication.

Um, and text messaging can be, um, one avenue, although that one can be tricky depending on the group that you’re working with. Um, but it has been shown to be successful with, with some populations. And then, you know, working through different media apps that, that you might be able to access. Um, but really, you know, those communication strategies at the end of the day, um, are all about how are we, how are we getting information from people to find out what’s important to them and how are we alerting, um, our team.

To, uh, what might be going on. And so that, you know, it might be that for some groups, [00:27:00] newsletters and email campaigns work best, or Facebook post or Instagram, right? Where someone else, a texting campaign where somebody could then respond in real time, could work. Um, you know, or it might be, you know, more traditional communication.

Like, you know, having meetings, office meetings, you know, monthly and making sure that people are up to date on what’s happening in the workplace.

Christine: I think that’s, uh, really important for any employer, um, who’s listening in, you know, really understanding you have different populations and how are you communicating with them.

Um. Whether they’re in the field. I think the underserved part is important to consider too, because not everyone has access to a computer. Uh, believe it or not, or a cell phone. So, you know, you have to really look at your full population and it takes multiple modalities, [00:28:00] um, to really make sure that your message or whatever it is that you’re communicating gets out to all employees.

So, um, and yeah, sometimes it’s a team meeting, believe it or not, in person, or, you know, to actually make sure, um, you know, you’re, you’re sharing the right information. So you have actually. Translated your work into real policy change. So for organizations, um, you know, how can employee voice really inform health and wellbeing strategies?

We know it’s an important part. You, you need to ask your employees what their needs are, but how does that actually translate into to change?

Shannon: So. There’s one piece of that where you, as you know, the manager, employer, uh, is, are gathering, um, information, data, stories from your employees and then elevating back to, um, you [00:29:00] know, whatever that, that next stage might be.

So whether that’s, you know, making sure that the owner. Uh, knows what’s happening and changing company policy, um, or, you know, working with state or federal policy makers or local policy makers, um, if it’s something outside, you know, those four walls at the same time, um, it’s important for employees to know that they can also advocate for themselves, um, outside of those traditional ways.

And so. Uh, you know, if they are seeing an environmental, um, or occupational hazard that’s in impacting them or, you know, other people, they can also, um, take their voice directly to legislators. They can, um, you. Call their local commissioners and people would be amazed at how many [00:30:00] times these policymakers are so excited to actually hear from constituents in that way.

And especially when people come, uh, not only with the problem but different solutions. It, um, it really makes a huge difference and. You know, most policy makers will say, we didn’t know that this was an issue. Right. And I think sometimes we assume that, um, you know, everyone knows, you know, what’s going on in our workplace and that they just don’t care.

That might be the case sometimes, but I think more often than not, um, people do care and they will work towards a solution, but if they don’t know about it, then you, you know, you don’t know what you don’t know. Right.

Christine: This has been so helpful. Um, I wanna thank you Shannon and, and our listeners. If you are, you know, an HR leader.

You wanna be sure, I mean, we packed a lot into this episode, but you wanna [00:31:00] probably listen to this a couple times because I think it’s important to really think about how to support all, um, people in your workforce and, um, think about the occupational health equity aspect as well. So I do hope this conversation further helps organizations really think about their full.

Holistically, um, their whole workforce. So I have actually one more question for you, Shannon. I ask all of our guests and um, I’m just gonna throw it right at you. So are you ready?

Shannon: I’m ready. Let’s do it. Okay.

Christine: Okay. What’s one small shift, personally or professionally that Dr. Shannon has made the biggest difference in your own wellbeing?

Shannon: Having a friend to work out with that for me has, um, been huge. Just that accountability. Um, but also the fun. It [00:32:00] makes it more fun. There’s more laughter, um, and our friendship is stronger outside of that. And. What usually happens is a group, you know, effects starts to take place and all of us start to become healthier and drink less alcohol, eat healthier foods together when we’re out.

But, um, just that one thing, making sure that you have one person who you’re accountable to, um, but that also you have fun with and can, can go work out together. That’s been really huge for me.

Christine: I love it. I mean, we definitely need to have a workout buddy, as I call it. And it’s funny you should say that ’cause my workout buddy, my worker, my walker friend, I should say, she just reached out to me today.

It’s finally some getting warmer on the east coast and she’s like, we gotta go for a walk. I’m like, yes, I miss it.

Shannon: Yeah.

Christine: Accountability getting you out there when you’re like, oh, I don’t feel like it today. But she calls. So yes. And then you have that person that you can be [00:33:00] nice to while you’re working out, even though you might be a little frustrated again, along the lines of our theme to be nice to people.

Well, I wanna thank you so much, Dr. Shannon for being my guest today, and thank you everyone for listening to this episode of the HR Scoop.

Shannon: Thank you.

How can employers better understand the systems that shape employee health and turn that insight into safer, more equitable workplaces? 

When only half of health outcomes are tied to medical care, employers play a far greater role than they may realize. 

“We don’t leave home and then come to work different people.” 

This conversation covers: 

• • Why paid sick leave policies have ripple effects on families, finances and long-term health.
  • The connection between psychological safety, trust and injury reporting.
  • Why total worker health requires both culture change and policy change.
  • How employee voice can influence not just company policy, but public policy as well.