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Construction workers face some of the most dangerous conditions of any American workforce — not just physically, but mentally. A new leadership toolkit, developed by researchers from the Centers of Health, Work & Environment at the Colorado School of Public Health, is changing how job sites approach safety from the ground up, putting the tools for change directly in workers' hands.
Construction work is a high-hazard, high-intensity workplace. According to the Bureau of Labor Statistics, more than 1,000 construction workers were fatally injured on the job in 2024 (Bureau of Labor Statistics, 2026). Most injuries were due to slips and falls; however, the construction industry has also seen a decrease in mental health. That same year, Bureau data shows 263 suicides among workers and 410 drug and alcohol overdoses (Bureau of Labor Statistics, 2026). Introduced last year by the Centers for Health, Work, and Environment and the Center for Promotion of Health in New England, Built to Last: A Leadership Toolkit™ seeks to lower the risk of injury for construction workers while engaging on-site leadership and workers to identify and implement solutions that support safety and mental health.
Associate professor, Natalie Schwatka, PhD, MS, leads the Built to Last project, and while in health and safety leadership, Schwatka found a deep interest in combining leadership with workforce engagement. The complex, fast-paced work environment of construction quickly became her focus. Influenced by the Total Worker Health® model, Built to Last was founded on a set of principles, including safe working conditions and leadership at both the employer and employee levels.
To build the toolkit, Schwatka partnered with Program and Outreach Director at CHWE, Lili Tenney, DrPH, MPH, and Olivia Zarella, DrPH, MPH, Research Associate for Implementation Science, alongside Jenn Cavallari, ScD, CIH, Suzanne Nobrega, PhD, and Serena Rice, MS, from the Center for the Promotion of Health in New England.
“It’s not telling construction workers what to do, it’s giving them the tools to know what to do and do it effectively,” said Schwatka.
Using practical leadership skills through a design sprint method to quickly identify and implement on-site controls for safety and mental health concerns, the toolkit empowers workers and site supervisors/managers to go beyond standard safety protocols. “The first step is leadership – none of the staff on site are going to be successful if the foreman doesn’t know how to lead successfully,” Schwatka explained.
“People are excited about the opportunity to find root causes of mental health in the community.” Said Schwatka. The team is currently involved in an implementation study with six large contractors: Four subcontractors on a single site and a small roofing company. The goal is to better understand fidelity and adaptations prior to a large-scale study of Built to Last’s effectiveness at improving jobsite outcomes.
Built to Last is only in its second year of a five-year grant, but Schwatka has big plans for the model’s future. The team will continue its implementation study, tracking years three and four to establish a larger study this time with a focus on outcome and accessibility. The future of Built to Last will include other industries and partners beyond construction.
Funding for Built to Last: A Leadership Toolkit™ is provided by CPWR: The Center for Construction Research and Training via a cooperative agreement with CDC/NIOSH. The project is also supported by an advisory board, and the team would like to acknowledge the contractors and employees who are testing the toolkit.
Want to learn more about Built to Last? Check out the toolkit's website or contact the project coordinator, Olivia Zarella, at Olivia.Zarella@cuanschutz.edu.
