Goal:

To understand the rapidly changing nature of work and its effects on the health of Californians.

Objectives: 

• Spark research to identify and illuminate those trends in the California workplace that hold important implications for health.
• Tie research to action that will improve the working conditions and health of Californians.

Accomplishments:

• Development of research to promote the idea that: “A good job is one of California’s best health promotion strategies.” TCWF took an original step in creating the Work and Health Initiative with a four-program approach promoting health through interventions related to employment. The Future of Work and Health program brought research to bear on how different facets of work and health are connected, and in so doing built a platform of knowledge about work and health used throughout Initiative programs.
• Funding for the “California Work and Health Survey” that illuminated work and health issues important to California. Three years of a longitudinal survey of Californians produced and placed a wealth of information about work and health in California including: 52 newspaper articles, including op-ed pieces and editorials; 20 radio mentions including public affairs shows focused exclusively on survey findings; eight TV stories; four articles published in peer-reviewed journals and three currently under review; 18 conference presentations; seven reports; and three legislative meetings.
• Creation of a network of researchers and practitioners involved in work and health. A series of conferences, meetings, publications and exchanges among the many projects in the Work and Health Initiative have created a loose network of approximately 80 individuals who have played a role of some significance in advancing the field of work and health.
• Exploration of a wide variety of work and health issues. Projects funded under the Future of Work and Health program spanned a broad array of issues in California. These included: issues of older workers; work and health in rural California; implications of the Family and Medical Leave Act; work and health concerns of immigrants; how work and health are affected by the changing demographic composition of California; health effects of discrimination in the workplace; issues of young, temporary workers in Silicon Valley; and community in the workplace.

Challenges:

• False start. This program was originally coordinated by a grantee that, after one year realized that the program was not close enough to its organizational mission and returned the grant. 
• Focus. This program was designed with a broad goal of illuminating connections between work and health in a California context. There was no clear-cut population identified as a focus of the program, no specific audience targeted for the information produced, or concrete action goals identified. As a result, many areas were touched upon lightly, but not a great deal of depth was achieved in any. The lack of focus diluted impact.
• Achieving change. The program design envisioned that knowledge generated from this program would influence policies and employer practices to improve the work and health of Californians. This was much too ambitious. Target policies and practices were identified, but not soon enough in the process or with sufficient concentration of resources to develop and implement changes. 

Lessons Learned: 

• Grants for research need to be carefully focused and appropriately funded. Nine “research, convenings and action” grants were made in this program, averaging about $120,000 over two years. These grants were intended to extend knowledge about connections between work and health and to inform some ongoing efforts to achieve positive change in the work and health of Californians. Although each of these grants made some contribution to extending knowledge and enhancing people’s ability to act knowledgeably, the grants made little cumulative impact. In part this was because in most cases funding from TCWF provided a small increment to a much larger research or action project already underway. To achieve more accumulated impact, it would have been necessary to provide larger grants much more narrowly focused on a well-defined aspect of work and health.
• Operating outside a specific field challenges sustainability. Through its programs, the Work and Health Initiative worked at the intersection of health and economics. During the Initiative, connections between these fields were drawn, and economists and health practitioners identified mutual interests. It is not clear, however, that these conversations and interests will be sustained once the Initiative is over and funding is no longer the motivator.