Under the hard hat

The roofing industry and broader construction sector carry a disproportionate share of suicides and drug overdoses relative to workforce size.

In 2021, the Centers for Disease Control and Prevention reported male workers in construction had a suicide rate of 56 per 100,000, well above the 32 per 100,000 rate for all men of working age.

CPWR—The Center for Construction Research and Training also reported in 2021 that more than 80,000 people in the U.S. died from opioid overdoses with more than one in six of those deaths being construction workers. In 2022, there were 17,967 overdoses and 1,092 fatal injuries among construction workers.

Recent data from CPWR highlights progress and ongoing challenges when addressing suicide and overdose deaths among construction workers. In 2022, the overdose fatality rate for construction was nearly seven times the all-industry average. Encouragingly, preliminary numbers from 2023 to 2024 show a decrease in suicide and overdose deaths in the construction industry.

Deaths by suicide dropped 1.7% according to CPWR, but that still means 5,000 construction workers were lost to suicide in a single year. Drug-related overdose deaths declined nearly 28.8% from 2023 to 2024, but more than 11,000 workers still died from overdoses—a staggering and unacceptable toll. Factors like work-related injuries, chronic pain and occupational stress continue to place construction workers at heightened risk.

These numbers, while moving in the right direction, are a stark reminder that far too many lives are being lost. The modest decreases in suicide and overdose rates cannot be seen as a reason to slow efforts. Instead, they should serve as a call to action for the industry, policymakers and communities alike. Without sustained and expanded prevention, support and intervention initiatives, thousands of preventable deaths will continue each year.

Now is the time to double down on commitments to worker safety, mental health resources and substance use support in construction—every life saved is a step toward a healthier, more resilient workforce.

Total worker well-being

More than half of construction workers who died from an overdose suffered a work-related injury, possibly leading to opioid dependency, according to peer-reviewed research published in the American Journal of Industrial Medicine in 2013.

The construction industry overall has the highest drug overdose death rate of any sector averaging 131 to 163 deaths per 100,000 workers. In the roofing industry, the rate is even higher: 177 per 100,000 workers, according to data published by the CDC in 2023.

Stressors like job insecurity, long hours, injury risk and a poor psychosocial climate have been strongly linked to depression, drug misuse and death by suicide. The total worker well-being approach integrates everything that shapes our work from the physical environment to workplace culture to enhance safety, health and well-being for everyone.

The National Institute for Occupational Safety and Health found organizations that foster total worker well-being not only see their employees thrive, they also realize stronger recruitment, better retention and a more engaged workforce. It’s a practical, evidence-based approach that combines protection from workplace hazards with programs that promote physical and mental health.

NIOSH and CDC materials summarize multiple employer examples showing integrated well-being programs can reduce turnover and improve retention.

For example, retail company L.L. Bean reported a positive return on investment for a comprehensive worker well-being program with savings ranging from $1.70-$5.70 for every dollar invested. Employers in other sectors have documented improved loyalty and reduced absenteeism after introducing flexible work policies and supervisor support.

Total worker well-being may sound terrific, but how do you implement it?

Getting started

NIOSH’s workbook “Fundamentals of Total Worker Health Approaches” and ready-to-use employee surveys such as the Worker Well-Being Questionnaire can be great ways to start a total worker well-being initiative at your company.

The Worker Well-Being Questionnaire survey is designed to ask workers questions to establish a baseline across work experience, workplace policies and culture, physical environment, safety climate, health status, and home and community factors.

Getting started doesn’t require a lot of effort—sometimes the smallest steps are the most effective. Introducing simple changes a roofing crew can implement this week can make well-being a part of daily life. For example, add a two-minute well-being check to your regular safety briefing that addresses sleep, pain and stress alongside fall protection and tool checks. The answers you receive may lead to rotating rest days with crew members to give them opportunities to schedule family time or medical appointments in advance to alleviate stress and sleep issues.

Company leaders who model healthy behaviors can significantly affect your company’s culture

Another approach is to clearly define non-negotiables for your company culture, such as making water breaks and shaded rest areas essential for everyone, which can help reduce heat stress and keep tempers even. Standardizing injury-recovery plans with early outreach, a straightforward return-to-work process and having one point of administrative contact helps keep injured workers from getting lost in paperwork. Consider updating your rules for attendance to make sure people can seek care without worrying about punishment.

Company leaders who model healthy behaviors can significantly affect your company’s culture. Leaders who take breaks, use available resources and openly talk about recovery demonstrate that seeking help is encouraged, making it easier for others to follow their lead. Total worker well-being is more about intention than huge investments.

Once the basics of worker well-being are in place—visible resources, routine discussions and accessible information—the next steps involve scaling practices into systemic change. Advanced total worker well-being strategies move beyond basic supports to reshape the working environment, policies and business systems so worker health is considered when making decisions.

Advanced total worker well-being may include adopting targeted programs that meet your workplace needs such as recovery-ready and financial health practices.

Recovery-ready practices

Recovery-ready practices are especially important in the roofing industry because musculoskeletal injuries and post-injury opioid exposure are common. A recovery-ready workplace establishes early contact after injury, nonpunitive policies for substance use recovery, graduated duty assignments, and coordinated return-to-work plans with medical providers to reduce long absences and the risk of substance misuse. These practices reduce long-term disability and help workers stay connected to employment during recovery.

Recovery-ready workplace policies deliver human and business benefits by addressing workplace drivers of substance use and removing barriers to treatment and sustained employment. Employers that adopt recovery-ready practices report lower absenteeism and turnover. Workers with substance use disorders take nearly 50% more unscheduled leave while employees in recovery typically take about 10% fewer unscheduled days and have a 12% lower turnover rate than the overall workforce, according to the Department of Labor.

Recovery-ready programs also have been shown to reduce overall healthcare and productivity losses. Addressing substance use and related conditions can lower employer liability by decreasing substance-related incidents on the job, according to the Department of Labor.

NIOSH and affiliated research organizations emphasize workplaces that operationalize recovery support experience shorter disability durations, fewer lost-time days and a higher likelihood of sustained employment, all of which reduce turnover drivers in physically demanding trades like roofing. Employers that formalize recovery pathways also report fewer repeat absences and improved retention among workers returning from injury or treatment.

Financial health practices

In the 2024 Columbia University article, “The Link Between Health and Financial Well-Being,” Oscar Jimenez-Solomon, a researcher for the New York State Psychiatric Institute, said “ ... indebtedness creates two experiences that can be fairly lethal. One is a sense of uninterrupted hopelessness, a feeling that there’s no way out and feeling trapped. The other is the shame, which is very isolating.”

Financial stability is a core component of well-being, and roofing employers can make a significant difference by ensuring easy access to financial counseling and related services, typically offered through Employee Assistance Programs. EAPs often provide short-term confidential financial coaching for budgeting, debt management and credit repair, help with tax preparation and benefits navigation, as well as referrals to legal or housing assistance—all practical supports that reduce the day-to-day money worries that can drive stress and risky coping behaviors.

Employers can enhance the reach of EAP services by publicizing them in crew huddles or toolbox talks. Equally important for alleviating financial worries is an understanding of opportunities for advancement. Formalizing pathways from the field to supervision, middle management and beyond can help reduce stress with transparency.

For more than 10 years, The Work Institute has shown a lack of career development is the number one reason employees cite for quitting their jobs. A well-defined career track gives a roadmap for skill development and promotion, which can increase commitment while reducing the impulse to leave for marginally better pay elsewhere.

Other helpful practices

Pilot programs in construction settings show trained peer supporters elevate opportunities for those seeking help by normalizing conversations about stress, pain and substance use while providing immediate, trusted referrals to clinical care or EAPs.

Naloxone, a medication that rapidly reverses an opioid overdose, can be used in training including demonstrations on mannequins if supported by local guidelines and protocols. This could involve the use of non-active or water-filled nasal spray devices for hands-on practice, which increases readiness and confidence when responding to opioid overdoses. Framing these practices as part of a company’s safety program allows employees to see recovery support is a standard operating procedure.

CPWR recommends recruiting respected crew members as peer champions, providing them with training in active listening and crisis referral to resources such as an EAP or supervisor.

Supervisors who receive training in mental health recognition, supportive communication and reasonable suspicion protocols are more likely to identify distressed workers and facilitate timely referrals to care. The CDC and NIOSH emphasize integrating these skills into existing supervisor safety training so mental health checks become routine rather than optional.

In addition, simple, low-cost visibility tools such as hardhat stickers, high-visibility jacket patches, decals and laminated wallet cards that display the national suicide and crisis lifeline numbers signal who on a crew is trained to listen and where to turn in a crisis. NRCA has many of these employer resources available (see “NRCA resources”).

Placing QR codes on job-site signs and foreman clipboards that link directly to crisis lines, EAP intake forms and bilingual information means help is one scan away.

Toolbox talks and crew huddles can be used to point out markers and remind crews that asking for help is a sign of strength not weakness. Visible cues combined with clear pathways to care can catch people in their weakest moments and make it more likely they will reach out for help before a crisis becomes a tragedy.

Mental health awareness and reducing stigma require consistent, visible messaging. Toolbox talks, bilingual posters and short crew huddles that include real stories and clear instructions about how to get help increase familiarity with resources such as 988 and local EAPs, making it easier for workers to seek care without fear of job loss.

No more tragedies

For roofing firms, the benefits of a total worker well-being approach are worth the time and can save lives. This method provides measurable improvements in employee well-being while increasing productivity. It is more than a dashboard of turnover rates, productivity gains or engagement scores; it is a holistic commitment to fixing the underlying causes that have allowed the current suicide crisis and opioid epidemic to foster.

Total worker well-being seeks recovery from mental and physical pain, anxiety and depression rather than merely patching visible damage. When you combine safety, physical health and mental health into daily work routines, crews stay healthier and employers gain the type of resilience that prevents small problems from becoming tragedies.

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