Share Public Health Transcript: Rural Health, You’ve Gotta Care About People

Season 2 Episode 13

Hannah Shultz: Welcome to Share Public Health, the Midwestern Public Health Training Center’s podcast connecting you to public health topics, issues, and colleagues throughout our region and the country highlighting that we all share in public health. Thank you for tuning into this series which focuses on rural health in the midwest. Over 10 episodes, we talk with people in a variety of communities about their experiences and perspectives on rural life, employment, and health. Our aim is to deepen understanding of the complexity of rural life and celebrate rural areas. We’re so happy you’re listening and learning along with us.

Welcome back to the Rural Health series on Share Public Health. I’m Hannah Shultz, your host and producer for this series. Today we’re going to talk about employment and worker safety. Our first guest is Nicole Crain. Nicole is an executive vice president of the Iowa Association of Business and Industry. She tells us a bit about herself.

Nicole Crain: I live in Windsor Heights, Iowa, which is, I guess sort of a suburb of the Des Moines metro area. I’m originally from Blockton, Iowa, which is in Taylor County, a population of 192, so very familiar with rural Iowa. It’s a great place. It really makes up the state and look forward to talking about it today. Just real briefly, if I may, the Association of Business and Industry is a state-wide business organization. A lot of our members are actually in manufacturing. We have members in all industries. We were started in 1903 as a manufacturers association and then expanded in the 80s to include everyone. We represent about 1500 member companies and 330,000 employees in the state of Iowa. That number fluctuates from year to year, but it’s over 300,000 Iowans that are employed by the member companies that join our organization.

Hannah Shultz: Iowa’s workforce is 1.5 to 1.6 million people according to Iowa Workforce Development. At 300,000 employees, Nicole’s organization represents about 20% of people working in Iowa. Nicole shares what she thinks are benefits of living and working in a rural community.

Nicole Crain: It’s hard to just say one thing because I think there are different lenses to look at it through. So from an individual’s perspective, I think the biggest strength is the sense of community. The sense that everyone is watching out for one another. And I also think that is a good way to sum up the lens for an employer or for a farmer. You hear all the time in rural communities that if someone is going through cancer treatments and they have lots of corn to get out in the fall, you’ve got everyone in the area, whether they know that person personally or not, they bring out their semi trucks, they bring out their combines and they are all working together to get the job done and to help that family out. Same thing with rural employers. A lot of our members are actually in rural Iowa. We have a lot of manufacturers. They are some of the largest employers in those communities, in those counties and they are really watching out for one another. It’s a team effort. And you have these employers who have built their companies up, that have been family businesses, some of them have started in the garage. They’ve sometimes had the one employee with them that entire time so you can see how employers and employees work together to make the company better, to make the community better. I think that is the strength of rural Iowa, is the community and the closeness for everyone who lives in the area. There is a lot of dedicated people in rural Iowa, they care about their community, they care about the good work that they do. Thinking, again, specifically to manufacturing – but there’s of different industries in rural Iowa – we talk about community. You see those employees coming to work everyday no matter, in the manufacturing center, what are they making, they take pride in what they are making. They go home and they talk about what they’ve done. Also, I think, for an employer and employee, rural Iowa provides a good work-life balance. You have close travel to work, or even if you have to drive 20 miles, you’re not driving in traffic, you’re driving on an open road with great scenery and so I think the quality of work force in rural Iowa is the one reason, or a very big reason why employers continue to invest and continue to encourage new employees to move to rural Iowa. They don’t want to move outside the state, the economy has changed in the last few years. The economy has changed definitely in the last few decades. I think Iowa has been very fortunate. We have a very robust manufacturing sector and so again, as we talked about earlier, a lot of ABI members in rural areas are those manufacturers. You’ve seen a resurgence in manufacturing, you’ve seen larger manufacturers wanting to support and rely on those smaller suppliers that are close by so you’ve seen the supply chain in rural Iowa and Iowa really work together. We’ve seen increased hiring in those rural areas. We’ve also seen increased challenges with the workforce and hiring because child care issues, just because there is not enough workers for the jobs. These companies have been, again, growing but they need more workers. They need people to come to the area so that is how we’ve seen it change. We’ve seen job growth, we’ve seen workforce challenges with qualified workers and also workers that are able and available to get to work.

Hannah Shultz: There is a collective misconception that there aren’t jobs in rural communities which creates an interesting tension as we simultaneously hear about shortages of doctors, lawyers, nurses, and other professionals in rural areas. Nicole shares her thoughts on this.

Nicole Crain: I wish I had the answer for that one. I think part of it is, you go to rural Iowa… I think there is different definitions of rural. Fairfield, Iowa, I think, the majority of themgeneral population would consider Fairfield, Iowa rural. From where I’m from, Fairfield, Iowa is a big town and so I think that’s something. When you’re thinking of rural Iowa, people shouldn’t just put on the cap of this a town of 150 to 500 people. If you’re thinking of rural Iowa, you need to think of counties or general population centers, Fairfield. Sheffield is a pretty small town. Garner, that’s a town of 3000 people. They have two companies that employ almost 700 people with those two companies. I think maybe part of the misperception is just the definition of rural to some people. I think maybe part of the perception is just what people have said through the years rather than saying, “Oh look, come to Fairfield. Not only do they have a very diverse square with lots of great places to eat and a performing arts center, but they have manufacturing jobs, three shifts, and they also have professional opportunities in those manufacturing jobs. They need engineers. Oh, and they have a hospital. They need doctors, they need nurses.” I think part of it is, Iowans were not always great at telling our story and telling what is out there and marketing it to others. I think that’s part of the challenge with the misperception that there aren’t jobs out there. And maybe it’s not the jobs that some people want, maybe they are not qualified to be the doctor at the Jefferson County Hospital, but that doesn’t mean there aren’t jobs there. I think some of it is communication, it’s marketing. Part of it could just be definitional challenge, but I think that’s a lot of speculation on my part. But if you go to main streets in rural Iowa sometimes you don’t see a lot of activity so then you just assume there isn’t any opportunity there and I think that’s not a fair assumption.

Hannah Shultz: Childcare is a major challenge in rural communities. What happens when someone wants to work but doesn’t have any options for childcare?

Nicole Crain: Childcare is something that’s really hit our organization’s radar in the last few years as unemployment in Iowa, both urban and rural was extremely low. Before the pandemic hit, we were at 2.7% unemployment. That’s virtually full employment and you had lots of job openings. At the time I think there were like 60,000 job openings on the Workforce Development website. Clearly, we needed more people to work and one thing that we kept hearing from members, especially in rural Iowa, is what about childcare? We have people that will work, but we don’t have anywhere for them to send their kids or maybe they only have somewhere for their kids to go part time, especially if they are school-aged children. We started trying to get some more information. What really is going on with childcare in Iowa? ABI is a business organization, but childcare is not really a business that we have represented. The childcare industry and the regulations and everything they go through is a whole new world for us. We reached out to the US Chamber of Commerce Foundation and they actually have a focus on early childhood education and they selected Iowa as one of the four states where they did a study. In February, again, before the pandemic, we had a study that came out in partnership with them, it was called Untapped Potential. In Iowa, there’s $935 million lost annually due to childcare breakdowns and then $781 million is directly due to absences and employee turnover because of their childcare challenges. And then, I think this is especially true in rural Iowa, 69% of Iowans rely on some type of family care to watch their children. If you think of a situation where you may have somebody working the third shift and they are a single parent and they have a five year old, clearly no one is going to be watching their child if they are at work from 11PM to 7AM. So in that situation, you probably do have a lot of family care. You have an individual sending their child to a grandparent or to an aunt or uncle’s house. The children, then, are watched by someone, not a childcare center necessarily. That was pre-pandemic. You look in the urban areas, you have a lot of childcare centers. In rural Iowa, I think you have a lot more in-home, maybe in unregistered childcare homes and so it’s hard to tell how big of an issue this is specifically in rural Iowa, but through this study we had found where employees have turned down promotions at work, employees have quit jobs, employees have been late to work, employees are concerned about what’s going to happen because of their childcare challenges. That’s something we dove into. And then we’ve also been working with the Iowa Women’s Foundation to look into what’s been going on since the pandemic and getting some numbers there, which, again, it’s startling to see that during the pandemic, childcare was still an issue. At one point during this, and this is information that came from the Childcare Resource and Referral, 829 licensed centers closed temporarily and that was as of March 31st, and then it represented a loss of over 50,000 slots across Iowa. If you look at the economy in Iowa, about 80% of Iowa employers or more were considered to be essential businesses during the pandemic which meant most families still needed to go to work and still needed to find somewhere for their children to go. That’s 50,000 slots, when you’re already in the middle of a childcare-challenged area, it’s a big issue. So that’s what we’re seeing with childcare. It is an issue especially in rural Iowa. A couple of other issues that are challenging for rural employers would be transportation to ensure that their employees can get to work on time and also broadband. If you’re talking about companies that want to expand into rural Iowa, they need to have access to connectivity. Also about remote workers, if we have people we want to work remotely in rural Iowa, we need to make sure that we have connectivity for them. And that’s not just a rural issue, that is also an urban issue, but I think those, childcare, housing, and broadband are probably things that you’ve heard in many conversations that you’ve had with people about what’s going on in rural Iowa and what are some of the challenges. Those are the three that we continue to hear from employers, whether they are in northwest Iowa or southeast Iowa.

Hannah Shultz: We’re going to pivot now to talk about workplace safety. I’ll admit to you all that workplace safety is something I know almost nothing about so my first question to Nicole in this part of our conversation is what’s different about safety for rural employers versus urban employers?

Nicole Crain: I think workplace safety is always a priority for employers. It’s the number one priority. Their employees, making sure they are safe and healthy at work, is paramount to the success of the company. I think no matter whether you’re an urban or rural employer, I think you approach that the same way. It does probably depend on what industry you’re in. If you’re in manufacturing, you need to make sure that you have guards on our equipment, you need to make sure you’re doing your safety training. You need to make sure that employees are coming to work, they are well-rested, they are not on something. I think that’s the same in urban areas too. I think that’s the same in an office setting. If people are tired, if people are on medication, if people are coming to work with something in their system, they are not going to be at their best which endangers them, endangers others and also can endanger the employer and the company. I think employers should approach workplace safety the same whether they are in an urban area, rural area, whether they are a trade organization like ABI or whether they are a bank or in manufacturing or in a hospital. Again, if you’re not working in a hospital, you may not need the mask, the face shield, the gown, everything in our pandemic times, but if you are in a manufacturing facility, you’re probably going to need a mask. I think the employers work really hard, especially now in these pandemic times, to stay up to date with regulations. What are the best practices, when do we mask, how do we separate people? How are we making sure, even before pandemic, how are we making sure that people are stretching before they come to work or before they get on the line? All those things. It’s a lot of work for the employer to try to manage and try to keep the company running and keep their employees safe. I do think access to healthcare is something that’s different in a rural workplace than in an urban workplace. I’m thinking specifically of University of Iowa or Cedar Rapids or Des Moines. Where our office sits in Des Moines, we are less than a mile from two hospitals, less than five miles from five hospitals and specialists. That’s not the case in rural Iowa in all situations, in some it is, but there are challenges for access to healthcare. We talked about workplace safety, if there is an injury in the workplace, making sure that that individual can rehab and get back to work. Is there physical therapy that they can.. a lot of larger companies, urban or rural, they have onsite doctors. They have individuals that come in and can do physical therapy right there onsite. Other places, we have a company, 21st Century Rehab, they are physical therapy, they go into rural hospitals and they set up there. That’s how the physical therapy is offered. I’m not in a healthcare field, I know a lot of people that I work with are, so I’m not a healthcare expert, but I do think that is a challenge in rural Iowa is healthcare. And especially for small employers that maybe don’t offer healthcare or individuals who live in rural Iowa that aren’t employed by someone or is self-employed, I think getting health insurance and the affordability of insurance has been a challenge in rural Iowa specifically for quite a few years now.

Hannah Shultz: People do get sick and unfortunately sometimes we get injured. Nicole talked a bit about what impact this has on employers.

Nicole Crain: A couple of things I will say is that what I have noticed in my time working with ABI, whether it be an unfortunate workplace injury, whether it be a healthcare challenge that an employee is facing, employers really offer great benefits in Iowa and one of those being health insurance. I think if you look at, especially small manufacturers, they offer pretty robust health insurance plans and also time-off plans. I think that’s something that employers know and so they try to build into their schedule, into what’s happening there. But like you said, if a doctor’s appointment takes all day as opposed to an hour, that’s something the employer does have to work around. It’s one thing even if an employer has 25 people, it’s another if they have two people and this person was responsible for … let’s say you’re a small plumbing shop and this person was responsible for going on out on five calls today and that was the only person that was licensed to do it. I think employers do a very good job of adapting to a situation, especially if it’s something planned. If it’s an emergency, emergencies come up, there’s not a lot you can do, but something that’s planned, employers want to work with their employees to adapt that situation. We talked about critical access hospitals, I know a lot of times those larger healthcare systems are partners with critical access hospitals to try to bring someone down if it’s for heart, bring down a trailer so you can do your run on the treadmill and your EKG to do your basic heart test if you’ve had heart troubles in the past or cardiac troubles. But that’s not someone there every day in case you have a heart attack. You are kind of limited if someone is at work or someone is at home, what do you do if you’re two hours from Des Moines or two hours from Omaha or Kansas City? It is a challenge and again, I think employers try really hard to be flexible and adapt and that’s the only way they are going to be able to remain successful. I think employers also partner with those local hospitals to bring in specialists. I’ve seen a lot of employers that have helped fund new wings of hospitals or bringing in redevelopment or remodeling hospitals or investing in a hospital in a community where they didn’t have one before. I think employers see the medical community as a partner especially in rural Iowa and want it to be viable and sustainable. We talked about Taylor County. If you need chemo treatment, you need to drive to Creston, which is 35 miles away and then you have to make sure that all your vitals are okay and then you’re sitting there probably for three hours, maybe an hour, I don’t know, depends on what type of treatment you’re getting and then you’re driving back home for three hours. Some people, from the employee perspective, that’s just going to put some people out of the workforce. They are not going to be able to work and if you’re a smaller employer, how do you handle that when, like you said, you need that employee there? And then if you’re the employee, what happens if you don’t have insurance and you received it through your employer? I’ve seen that many times, not from the employer/employee perspective, but I’ve seen that in rural Iowa just from the individual perspective. I think you see that a lot in agriculture communities, I don’t even want to say rural communities. You see that in agriculture communities, just the challenges that provides if someone gets sick, the lack of access to specialty treatment, but also the time consuming nature of getting there and back and what that means for that person. We talked about community in rural Iowa and I still think that is the strength because a lot of times if it is a couple and the spouse is working still, that spouse has to keep their job to be able to help the other spouse and their children, if they have children. So you have a situation where community members are then the ones transporting them. So now, we’re in COVID, how does that work because, first of all, no one can go in with you. And also, if you have a suppressed immune system, don’t want to be driving 35 miles with someone, probably even with masks on, to a chemo treatment or a radium treatment.

Hannah Shultz: I really appreciate how much Nicole cares about the businesses and employees her organization represents.

Nicole Crain: I think the one thing that the public doesn’t always understand or really grasp is how much employers really value their employees. They are not just a number that’s punching in on a time clock. It is a partnership. It is something that employers, I hear stories every day of an employer who is making sure their employee is taken care of, not only at work, but in their home life as well. And so, I think that’s something that maybe gets lost sometimes, but when we talk about workplace safety and health and just everything that’s going on, employers understand that employees aren’t employees, they are people, they are humans, and they want to provide a safe place for them to work. They want people to feel that they have value when they go to work, they want people to feel they have value when they are at home. Employers understand that what’s happening at home and in their personal life does affect what’s going on in the workplace. I think that has been brought to light even more since the pandemic when we are now seeing what actually people’s homes do look like. If you’re not an essential worker, even if you are an essential worker, if you’re able to work remotely, we have Zoom bombers all the time. You see families, you see dogs, and I think that’s been not a bad thing. That’s been a great thing for employers and employees to understand what’s going on in each other’s lives and by continuing to understand that, I think that helps everyone continue working towards that goal of safe workplaces, healthy people and a better Iowa. I’m a really proud Iowan, I’m proud to represent the organization and the employers that I represent. It is something that you hear about, these Iowa family companies and they do, they start in their garage or they start in their shed because something didn’t work on the farm and the next thing you know, they have 300 employees and they are supplying to John Deere and Toro and all the cones on the side of the road are made in Iowa. This is crazy. That’s why I get all cheesy and emotional because I just think they have great stories to tell and they have put so much into their business and to the people who make up their business that it’s hard not to smile and to just want to shout it out from the mountain tops all day long.

Hannah Shultz: Nicole’s enthusiasm is a bit contagious. We’re going to zoom in now and talk with John Grimes from Norfolk, Nebraska. John is retired and spent the last several years of his career working in safety in a food warehouse. He started by giving us some context of where he is.

John Grimes: In Norfolk, we’re about 26,000, our population currently. We’re pretty much the hub for northeast Nebraska, so we have a lot of small towns around us. Actually at the warehouse, where I work safety and security at, we pull folks from 50 plus miles, other small towns around here to come to Norfolk to work at the warehouse and other industry. We do have other industries in our area here. Just a great town, been here right at the 40-year mark and we’re just a good town. I don’t know that I really think of, I’m in a rural area or a non-rural area. I think most folks would probably consider us rural. For us though, we are the larger city with several smaller areas, communities around us. However we’re small enough that we’ve got great shopping, but we’re going to go to the next bigger city, to Sioux City or to Omaha or to Lincoln to shop and for certain things, just to get out of town.

Hannah Shultz: I asked John how someone gets into a career in safety.

John Grimes: I actually started out with food safety. We were a food warehouse and so I started out with food safety and even with that, there was just things I didn’t know and needed to know. Early on, I decided that I wanted to get to know my regulators a little more and to, of course, understand and build relationship with those that were going to be regulating me anyhow and working with me. I found them to be good folks, willing to help and so I did food safety. I was not afraid of the regulations, digging into them, trying to understand them. Through that over the years, my managers, when there was an opening for safety – I actually had been getting into assisting the safety director at the time for a while. So over time it came down to, after a couple of inspections, especially from regulators that, they looked to me and asked if I would interview for the safety manager position. And I said, “Yeah, I would like to do that.” We did and I got to the position and started to rebuild the safety program and get to know my new regulators on the safety wellness side.

Hannah Shultz: John is a people person. He really likes getting to know people and taking care of people. He explains why companies care about safety.

John Grimes: There is so many different reasons why it matters. As an executive, or the financial folks in the company, if I don’t have good safety and I’m having a lot of injuries, God forbid, fatalities, those hit the bottom line pretty hard. Safety is going to affect work comp. Work comp is going to hit that bottom line. Besides that though, that’s the money side of it. On the other hand, just having your employees feel safer and better about where they are coming to work and having someone to go to if they find something or have someone that’s not necessarily working safely, following certain rules. There was just many reasons over the years. When I first got into safety it was more about my numbers and of course trying to stay out of trouble, but over the years you get to learn more about it, at least I did, more of the safety and it’s less about the rules. In a lot of ways, it’s more about understanding people, what makes them tick. How do I get them to do what I need them to do to work safely? The numbers will take care of themselves if I can get my employees on board and get them to work with us and to work safely and to watch out for those around them, make sure they are working safely. I got into the safety in about 2006. I was dabbling in it a few years before that. What’s that, about 14 years or so now. Basically I dabbled in a little bit helping the previous safety person and starting to gather interest for it.

Hannah Shultz: I asked John what’s changed about safety over the years he worked in the field.

John Grimes: Obviously some of the guidance has changed, maybe gotten a little tougher, but I think people, I’m going to say my people probably, I don’t know if they changed too much. You’re still going to run into those and I did, that, I’m sure down deep inside somewhere they do care about safety, but on the outside they didn’t show that they cared that much. I think, for me, it was more me changing and becoming more knowledgeable. With the OSHA rules and their oversight, I really learned a little while into it that I, as the company, we’re going to probably spend a lot more dollars towards work comp than I ever would toward OSHA citations and so it’s not like OSHA is out there every day at the warehouse and they’re picking at every little thing. They have their other places to be and things to do. But they are certainly out there and do the regulations. It was, early on, I just started to learn that I need to figure these guys out at work. I need to be in compliance and it’s going to pay off bigger dividends for the company and employees. We all win in safety if we do it well. And so I just learned if I can prevent injuries of any kind that might end up in my work comp system, then that’s going to be real dollars that we can save on our bottom line. And again, then I don’t have employees that aren’t here to do the work. In the business we were in, our grocery stores put in their desire for groceries everyday and no matter how many were there to help pick those and load them on trucks and then drive them out to the stores, that whole thing needed to be taken care of, all those orders. And so it hurt when we had people not able to come to work that were scheduled. It was so many reasons why we needed to try and prepare and maintain a safe working place, to keep those guys coming in everyday, able to do their jobs. Employee safety, that should be just something that we care about. Not everybody does and again, even the employees themselves don’t always think about their own safety and what’s around them. They are not looking at the big picture when they grab some tool and they go to do something with it. They are just focused in on what’s going on at the time. And so I think it’s important, you’ve got to care about people. That was something else I learned earlier on too, is that you really have to – if you really want to make a difference – you really have to care about the people that you’re working with, above you and below you, the employees and the staff, there’s a lot to care about there. Somebody has to genuinely care to keep workers safe.

Hannah Shultz: It’s obvious that John genuinely cares about his colleagues. He told me a bit about who works in the warehouse.

John Grimes: We were lucky enough that Norfolk, being somewhat of a hub of several smaller towns around the area, we could pull from those other towns. However, there was a time when every year we knew we could find employees out there, good employees, because there was a lot of farmer community around us as well as in Norfolk. So we were going to get these farm kids after they graduated high school each year. They had some common sense, they knew how to run big equipment and had been raised right, as far as we were concerned. I will say that something has changed over the years, is there is less of that. They seem to be less in the fields and running the big equipment and so it became a little harder. Sometimes we couldn’t just rely on common sense of someone coming in, a farm boy coming in to work for us in the city. That was a struggle. But on the other hand, I’ve worked in larger communities with our company in other warehouses that we had and even though we had gobs of folks to pull from, issues we found were drugs. Drug use was higher. We struggled to find employees that could pass a post-offer drug screen when we were trying to hire them. It didn’t matter too much where we were at, we were going to have some struggles whether it was in a larger community or in the smaller communities. In my opinion, I think it was the equipment these days that the farmers, maybe not everyone, but a lot of them have to use, they are in the air conditioned cab now. A lot of GPS in the tractors. Some of them aren’t helping out on the farm as much as they used to have to do with the parents. Just like city kids, they might be playing more video games and things, working on their thumbs, but not so much having that farm experience and working around some of that dangerous equipment and just having a general knowledge when they came in around our forklifts and things as to how to work around equipment like that and to be able to hop on a piece of equipment and have a general understanding of how to raise and lower and go back and forth and things.

Hannah Shultz: John told me how safety is incorporated into new employee onboarding.

John Grimes: We start, of course, with the post-offer screening as far as how strong is their back and shoulders, arms and knees, all of those things, make sure they are able to do the job. We have to have job descriptions and know the limitations. What are the capacities that an employee is going to have to have to lift a maximum lift? What’s their general average pounds of lift? They have to know all that so we start clear back at the hiring process of not just wanting a good employee, and we do that to protect ourselves as a company, but we also want to protect the employee. I shouldn’t put an employee that the physical therapist says or the doctor says really shouldn’t be doing this job. I shouldn’t expose them to that job, I should be honest up front and let them know that, I’m sorry, maybe we’ve got something else, but this job is not good for you because we could hurt you and I don’t want to hurt you. Then once we bring them on, the first few days at least, we’re safety training, just going through policies, our different training programs for safety, how to work safely, covering the building a little bit. There’s a general orientation around the building and how to get there. We were about a million square feet of warehouse and broken up. We built on to the building so many times and so it was easy for new folks to get lost and so we like to take them around and show them things. Of course, you have certain certifications on equipment and things that we had to do for the OSHA guidance, but beyond the OSHA guidance, it really comes down to a person before they operate a heavy piece of equipment and could kill themselves or someone else, you want them to understand the rules and how that machine operates safely. You go through all of that, fall protection, we did have places where they had to maybe get up into the air and do things and so we just had a lot of general safety things that we talked to them of. At one time, it was probably a day and a half of stuff like that that we went through and then even just to put them on their job once we’re done with all of that, we usually spent close to another week; they mirrored someone and worked right with them just to make sure that they understood things and it gave us more time to catch unsafe behaviors if they had those when they came in. You’re used to doing things a certain way and you come into work for a company, even if we teach you the right way to do something, there’s going to be a time where either you’re struggling or something and in your mind, it’s like, you know what, I can do it faster this way even though I’m supposed to do it this way. And so those were things, those unsafe behaviors really became big in making us create a behavioral safety program.

Hannah Shultz: Okay, we’re going to talk about the elephant in the room, COVID-19. We’ve all seen stories about factories that have been hot spots for the virus. I asked John how his warehouse has responded to COVID-19.

John Grimes: I would say it has certainly thrown kinks into things early on more so than later on. Early on, not really totally understanding things yet. But one of the benefits, to a degree it was a hindrance for me sometimes with safety, but on the other hand, it was probably more of a benefit to us during COVID, is that our employees, though we did come together at the beginning of each shift and stretch and warm up and have a short little meeting, pre-shift meeting, to talk about safety before we let them go out and go to work. You watch your spacing during that, but from there, it was pretty much each employee was individually working. They would go down the stairs, they would get on their equipment, their forklift or their double pallet trucks and they’d drive, put on their headsets and they’d say ‘ready’ and an order comes to their headset and then they start heading off individually through the warehouse to pick those pieces for those individual orders. Go to the dock when they are done, drop it off. Say ‘ready’ again so another order comes into their headset and they just continue to go. It wasn’t too much in the warehouse, where most of our employees are, wasn’t too bad for them, too hard for them to social distance, they just were rarely right around each other. They are not handing each other tools and things. They are pretty much on their own. In the office, a lot of them could work from home and so social distancing wasn’t a big issue there either. I think most of them probably didn’t mind working from home.

Hannah Shultz: As I said before, John is a people person and he’s made partnership and collaboration an essential part of his work.

John Grimes: I don’t know about other safety folks, but I am probably more of a relational person, obviously as we talked about, it’s come up many times, but I, again, up front, I just decided I didn’t want to do this alone because I didn’t have all the knowledge that I needed then. I don’t know if we ever do, we should always be lifelong learners. Besides reaching out to my regulators, OSHA, EPA, from there I found other ways to get involved. The local emergency planning committees or LEPCs, every county in America is supposed to be involved or have their own LEPC and that’s making law enforcement, fire and rescue, the hospital, the schools, other agencies around town, anybody that is concerned or has a role in safety. Now, the LEPCs are weighed more heavily towards hazardous materials and so that’s what we try to work with the industries that have those hazardous chemicals and store them and ship them and maybe create them. The LEPCs are a mandate from EPA for these groups to come together. I’ve been chairing our LEPC here in northeast Nebraska. We’re actually currently a six county LEPC with maybe growing, adding a few counties in the near future. We’re coming together quarterly and we’re looking at, not so much employee safety, but safety for the communities that we are in and that are in our counties. We’re working with the companies that have the chemicals and we’re that liaison to the public who may know about what’s in their community and may not know about what’s in their community as far as hazardous chemicals. We try and bring that all together quarterly and make sure we have plans in case a hazmat incident happens. From there, the state emergency response commission that I’m in, that is just at more of a state level so I’m working with the NDEE, which was the Department of Environmental Quality in Nebraska, now they’ve brought in energy with them and the state fire marshal and all the state different offices that are involved in those same things and hazardous materials. I just made a lot of great friends and know a lot of folks around the country actually through those things, but I like to stay pretty involved with the safety council then. I chair the board currently, but doing some adjunct training for them. So when I retired, I didn’t want to stop, I don’t think you ever stop being a safety person. It has to become something that’s in your heart, in your mind, and that you just do. It’s part of you and so I wanted to be able to continue to help others. Any safety training I can help with or just consulting, just make myself available, but staying involved is really important.

Hannah Shultz: I asked John what other people like me who know very little about workplace safety would be surprised to hear about.

John Grimes: My leaders, at least, used to think more on, maybe an incentive program. We’re just going to focus this incentive program on the warehouse people because they are the ones really at risk out there for injury. What’s the office person got to worry about? There’s plenty in the office that could go wrong and I’ve seen it. I don’t know how many injuries that I’ve had with office employees. So things that we maybe had to change the way we were doing something or these days, ergonomics is big, especially for those working at home this last year and maybe still continually. Ergonomically, I can just about picture how some of their computer stations look and they are not very ergonomic, probably, and so I’m wondering will employers start to see work comp issues in the near future, if they haven’t already from just office setups at home. Maybe they didn’t take the time to make sure that they were following good ergonomic rules and taking care of themselves.

Hannah Shultz: When I think of workplace injuries, my mind immediately jumps to really, really bad scenarios. John confirmed that this is not the majority of work injuries.

John Grimes: Pretty commonly, what I found, it didn’t matter the job you’re doing, how much you’re lifting, but it would still fall into the strains and sprains category. That was going to be most of my injuries. They weren’t the serious, real serious injuries, a smashing, crushing injury, ran over, something like that or loss of a body part. They were just strains. Whether it was in the warehouse and someone was lifting improperly and so they ended up straining a back or a shoulder or something like that. Since that was what most of my work comp dollars went to, was these strains, was we’ve got to focusing more on actually understanding how do strains happen and how can they be prevented because they can be prevented. And then working with my employees in further training as to how to do that. And then behavioral safety audits, where my supervisors would help watch folks throughout the day and see how they are lifting and if they put themself at risk by lifting something improperly. We didn’t pound on them, but we had a quick, short little meeting with them as to, “Hey, you did all these things right, but you reached to lift.” It doesn’t matter always what the weight of it is, it could be a pencil on the desk and somebody reaches or twists wrong and I’ve got a strain injury. Even though ergonomic type injuries, like carpel tunnel are by OSHA considered more an illness because they come on over time, it’s still an injury, it’s going to hit my work comp and so just helping folks, again, learn. Because they don’t think about it, that they may end up with some carpel tunnel or strain when they sit down to work on their laptop. I’m not the greatest at it when I’m at home either. I have pretty good posture here in my office, but otherwise, I do think about it and I will correct myself now and then, but it’s not the first thing I think about when I sit down with my laptop on my lap and on the bed or something. Strains, primarily, it doesn’t matter what field you’re in, what you do and how much you’re lifting. They are just a possibility for anybody and we all need to stay in condition as much as we can and just think about things before we act and how we’re doing them.

Hannah Shultz: John brings up some interesting questions here. As more people are working from home, what’s the employer’s responsibility if someone gets injured while working? One of the things that has come out of both of these conversations is that safety is safety. It doesn’t matter if you’re in a town of 47 or a city of a million. Thank you both for your commitment to rural employers and employees and for sharing your experiences with us.

Thank you for tuning into this episode of Share Public Health. Thank you to the Injury Prevention Research Center, Iowa Center for Agricultural Safety and Health, the Healthier Workforce Center of the Midwest, the Heartland Center for Occupational Health and Safety, the Great Plains Center for Agricultural Health, the Midwestern Public Health Training Center, the Prevention Research Center for Rural Health and the Rural Policy Research Institute. The theme song for this series is Walk Along John. It’s performed by Al Murphy on fiddle, Mark Janssen on mandolin, Brandy Janssen on banjo, Warren Hamlin on guitar and Aletta Murphy on bass. Al learned these songs from a Fiddler named Albert Spray, who is from Kahoka, Missouri. A transcript, evaluation and discussion guide for this episode are available at mphtc.org and in the podcast notes.

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