The Department of Defense (DoD) has the largest workforce in the United States, with more than 1.4 million active duty service members and about 709,000 civilian employees in 2007 (DoD, 2007i). DoD employees account for approximately 1.3 percent of the total U.S. labor force (DoD, 2007i). As part of its benefits package, DoD provides comprehensive health care to active duty military personnel and their families, retirees and their families, and reservists on active duty.

The current DoD active duty workforce and its health issues differ from the civilian workforce in the United States in ways that might affect the design...

In this chapter, we discuss the goals of the project, the research methods, and sources of information. We also present definitions ofoccupational health, preventive medicine, andintegrated employee health system.

The goal of the project was twofold. First, we aimed to broadly describe SOH policies and organizations within DoD to document the current system. Second, we conducted case studies of employee health programs outside DoD in an effort to gather information and opinions about the implementation process related to, and components of, an integrated employee health system. Our approach entailed (a) reviewing and documenting the policy context of SOH,...

In this chapter, we provide a historical perspective on how SOH programs have evolved in DoD, and we present the results of our review of SOH and health promotion and wellness policy and organization.

This section briefly describes the history of SOH in DoD. A time line of key SOH policies and organizations can be found in Appendix A. This historical perspective is presented to provide a foundation for subsequent discussions of SOH policies and organization in DoD. It was compiled from a variety of sources, such as DoD documents (memoranda, directives and similar policy documents, doctrinal publications, training materials,...

In this chapter, we address information technology (IT) systems in DoD and how they relate to an integrated employee health system. IT systems are considered an essential part of an integrated system because they provide leadership for an organization, with a standard set of information to be used in managing the health of the workforce and the work environment and making related decisions (IOM, 2005). Data and information from an integrated employee health system can serve several purposes, including providing information on program utilization and effectiveness, addressing accountability for the program’s performance, improving the program, and reevaluating following changes in...

In recent years, a number of public and private organizations in the civilian sector have taken steps toward a more integrated approach to SOH. We reviewed civilian models of SOH integration to identify approaches and practices that might be applied to DoD’s employee health system. In this chapter, we describe relevant findings from a literature review and from case studies of three civilian organizations. Most of these findings relate to expanding employee health to include health promotion and wellness programs in addition to traditional SOH. Little information was found related to strengthening the linkages between health promotion activities and an...

The sponsor of this research, DASD C&PP, asked RAND to perform two primary tasks. First, because the DASD (C&PP) recognized that safety and occupational health in DoD is complex and involves multiple policies executed by numerous organizations, we were asked to document the policy background and the organization of the current system as a starting point for changes in policy and organization related to employee health activities. Second, we were asked to conduct case studies of civilian organizations with integrated employee health systems. The goal of both tasks was to create a foundation for a more integrated employee health system...