Access to full health for all requires good occupational health care. Only here: the account is not there yet. The lessons of the Observatoire de la Mutualité Française on health at work reveals the many existing weaknesses in terms of asset protection.
Can do better. According the Observatory Mutualité Française/Harris Interactive on occupational health revealed on February 21, 2023, France is not the best placed in this area. Regarding fatal accidents at work, for example, our country is at the top of the ranking of European countries, with 3.5 fatal accidents at work per 100,000 people. A level twice higher than the European average (1.7 fatal accidents). This figure is one of many data from the Observatory showing that the difficulties related to occupational health are not sufficiently addressed. Moreover, 91% of working people surveyed say they have experienced health difficulties at work: fatigue, stress, loss of motivation, regular physical pain or burnout. And nearly 4 out of 10 working people consider that their work tends to deteriorate their state of health.
A demographic crisis in occupational medicine
What are the causes of these results? The Observatory emphasizes the weakness of the occupational health offer. Like other medical specialties, occupational medicine is experiencing a demographic crisis: more than half of occupational physicians are over 65, but “general practitioners are not sufficiently trained to detect occupational diseases and accidents at work”, underlines Séverine Salgado, general manager of the Mutualité Française. Furthermore, the Observatory observes an uneven distribution of prevention and occupational health (OHS) services across the territory. These worrying trends mean that 61% of private sector employees did not receive a visit from an occupational physician during the year and that 6% have never encountered one. Self-employed workers and business leaders, in particular, constitute the blind spot of health at work: they are 2.8 million who do not benefit from any follow-up in this area. Furthermore, provident insurance contracts do not protect all workers. Employees of large companies, for example, are better covered than civil servants and the self-employed.
Occupational health is a major focus of public health
“The results of this Observatory show that there is a very significant margin for improvement in terms of health at work, underlined Éric Chenut, president of the Mutualité Française, during their presentation to the press. In terms of physical, social, psychological and environmental well-being, the working environment is nevertheless an essential space if we want to make access to full health possible for all. »
Recalling that health at work is a major focus of public health, which is also supported by Virginie Malnoy, director of New Models at Harmonie Mutuelle (see box), Éric Chenut stated thatthere is no fatality in terms of occupational diseases. “Other countries are doing better than us and progress can be achieved by mobilizing the social partners but also by identifying and disseminating good practices,” he says. This is why the Mutualité Française formulates ten proposals around three axes:
- make occupational health an essential part of public health
- improve prevention and health at work
- better take into account the different conditions of exposure to occupational risks.
Proposals to develop prevention
Among its various proposals, the Mutualité Française underlines, for the first axis, the importance of “supporting public and private employers and professional branches in the development of prevention”. She thus suggests promote awareness in the world of work on the determinants of a work environment conducive to health. This would include supporting the sectors of professional activity in the implementation of prevention tools, in particular those impacted by high claims, such as personal assistance services.
The Mutualité Française also proposes to ensure that the prevention passport (a new tool intended to promote risk prevention in companies) goes beyond occupational health and safety training. It could thus integrate the monitoring of awareness-raising actions in terms of prevention of health determinants implemented by the employer (physical activity, fight against addictions, diet, vaccination).
Another suggestion: rely on health and digital data for better prevention of occupational health risks. “The idea is to mobilize and enhance existing data to analyze occupational risks in order to build a more targeted, effective and measurable risk prevention policy,” said Séverine Salgado. This can also be used to better target prevention actions according to the territories. »
Improve the attractiveness of working conditions
For the 2nd axis, the Mutualité Française calls for the establishment of a universal occupational health service in order to allow all assets to benefit from appropriate monitoring. In order to improve the attractiveness and working conditions of occupational health professionals, it proposes to broaden the skills of nurses in advanced practice (IPA) to the diagnosis of certain occupational risks. Concerning the 3rd axis, finally, the Mutualité Française considers that it is necessary to generalize access to provident cover. Among the proposed measures: establish the obligation to inform employees about pensions or guarantee additional pension cover to all civil servants, as part of the implementation of social protection for civil servants. So many proposals intended to promote access to healthcare for all.
3 questions to Virginie Malnoy, Director of New Models at Harmonie Mutuelle
How is occupational health a major focus of public health?
The quality of life at work impacts the physical and mental health of people in employment, who represent more than 30% of the population in France. Dealing with it is therefore a matter of public health. The lessons brought to light by the Observatory on health at work, in particular the fact that almost 4 workers out of 10 consider that their work tends rather to deteriorate, reinforce the importance of working with companies and employees to share diagnoses and implement concrete actions. Telework has brought improvements but has often modified social relations, the practice of physical activity and the relationship to food. Yet these are three strong determinants of health. There are solutions: they must be co-constructed.
Among the proposals that it formulates following the observations of the Observatory, the Mutualité Française suggests in particular better support for employers and professional branches in the development of prevention. What do you think ?
The approach by professional branch allows an analysis of prevention needs and an interesting level of pooling, making actions more accessible to VSE employees. But let’s not neglect the role of the territory as a lever for collective accountability, in concrete action. Combining national approach by branch and territorial support seems necessary to me. To reduce accidents and occupational illnesses, mutualist actors must give themselves certain priorities: share assessments, co-construct preventive actions in a quality social dialogue and remove the obstacles to their application.
How does the mutual contribute to improving occupational health?
Harmonie Mutuelle acts on many axes. We can cite the fight against lack of foresight which allows working people to be more serene about the financial consequences of illness or accident. We can also talk about the social support service for employees who encounter a difficulty (death, divorce, harassment, etc.).
- Photo credit: Getty images
