The neglect of organized labor in industrial and organizational (I-O) psychology can be attributed not only to historical circumstances and managerialist values (Lefkowitz et al., Reference Lefkowitz, Zickar, Cascio and Kochan2026) but also to the field’s theoretical and methodological orientations. We argue that the lack of a robust framework for examining unions’ multilevel effects, combined with I-O psychology’s emphasis on job performance rather than worker well-being as the ultimate criterion (Tay et al., Reference Tay, Batz-Barbarich, Yang and Wiese2023), drives this dearth of research. In response, we propose the public health model (e.g., Tetrick & Quick, Reference Tetrick, Quick, Quick and Tetrick2011) as an organizing framework to remedy this oversight. This approach focuses on both individual and organizational/structural changes (LaMontagne et al., Reference LaMontagne, Martin, Page, Reavley, Noblet, Milner, Keegel and Smith2014; Tetrick & Winslow, Reference Tetrick and Winslow2015) and prioritizes worker well-being.
The public health model distinguishes among primary interventions (preventing harm by modifying stressors at their source), secondary interventions (equipping individuals to manage unavoidable stressors), and tertiary interventions (supporting recovery after harm has occurred). We argue that unions’ multilevel nature—as institutions that can function as primary, secondary, and tertiary interventions—has complicated their study within I-O psychology. We therefore propose conceptualizing unions as integrated interventions, similar to initiatives that address both promotion and prevention (e.g., Safety and Health Involvement For Truckers, Olson et al., Reference Olson, Anger, Elliot, Wipfli and Gray2009; Wellworks-2, Sorensen et al., Reference Sorensen, Stoddard, LaMontagne, Emmons, Hunt, Youngstrom, McLellan and Christiani2002). This framing moves beyond the dichotomous treatment of union presence in prior research (e.g., Macky & Boxall, Reference Macky and Boxall2009; Sundari et al., Reference Sundari, Pertiwi and Nugroho2025; Ulacia et al., Reference Ulacia, Smith-Etxeberria and Beldarrain-Durandegui2025). Specifically, like the systems approaches Anger et al. (Reference Anger, Elliot, Bodner, Olson, Rohlman, Truxillo, Kuehl, Hammer and Montgomery2015) describe, unions integrate primary interventions, secondary interventions (e.g., negotiating for personal protective equipment, employee assistance programs), and tertiary interventions (e.g., disability benefits, return-to-work accommodations). Below, we examine unions’ potential impacts at each level of the public health model, with the goal of fostering richer theory and opening new directions for research. We include research questions at each intervention level that may significantly contribute to the I-O literature.
Unions as primary interventions
Primary interventions are “the least studied [workplace well-being intervention] to date” (Tetrick & Winslow, Reference Tetrick and Winslow2015, p. 587), requiring significant resource investment, organizational approval, and substantial time to demonstrate effects (Anger et al., Reference Anger, Elliot, Bodner, Olson, Rohlman, Truxillo, Kuehl, Hammer and Montgomery2015). Unions align with this definition, as they seek to modify working conditions for all by negotiating for safer workplaces, reasonable workloads, fair scheduling practices, and improved wages and benefits.
The perspective of unions as primary interventions has shaped research on unions in I-O psychology, where unions are typically operationalized dichotomously (present vs. absent; e.g., Macky & Boxall, Reference Macky and Boxall2009). Although this binary treatment is a useful first step for evaluating primary intervention efficacy, it obscures meaningful variation within unions. Research rarely specifies the mechanisms through which unions influence worker well-being or the conditions under which these effects emerge. I-O psychology has given limited attention to how variation in union governance, priorities, leadership, and member engagement shapes relationships between union presence and worker well-being or organizational outcomes. For instance, Hammer et al. (Reference Hammer, Bayazit and Wazeter2009) found that union members’ beliefs about, and attitudes toward, their union depend on the union president’s leadership approach, with these effects further shaped by internal leadership structures. Similarly, unions’ influence on downstream outcomes such as safety climate (Sinclair et al., Reference Sinclair, Martin and Sears2010), access to healthcare, or perceptions of power has been underexamined, arguably because of this perspective. Treating unions as static or binary institutional features limits understanding of how they shape worker well-being and organizational outcomes.
Sample “unions as primary interventions” research questions
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• What union-based mechanisms (e.g., justice, voice, contracts) impact work- and organization-related attitudes (e.g., job insecurity, work engagement, organizational commitment) during organizational, economic, or societal change?
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• What features of union-based structural arrangements and negotiated contracts (e.g., collective bargaining, work councils, worker board representation) are most effective at preventing workplace harm and promoting worker well-being, and do these differ by organizational or industry context?
Unions as secondary interventions
Secondary interventions equip at-risk individuals with knowledge and resources to manage existing demands/hazards (Tetrick & Quick, Reference Tetrick, Quick, Quick and Tetrick2011), including activities such as safety training, stress and fatigue awareness education, and reporting mechanisms (Hagedorn et al., Reference Hagedorn, Paras, Greenwich and Hagopian2016; Leigh & Chakalov, Reference Leigh and Chakalov2021). Whereas viewing unions as a primary intervention highlights their prevention role and the benefits they provide for all employees (e.g., higher wages, greater job security; Bennett & Kaufman, Reference Bennett and Kaufman2004), viewing unions as a secondary intervention highlights novel and underexplored insights.
Unions may serve as a source of social support (e.g., Goeddeke & Kammeyer-Mueller, Reference Goeddeke and Kammeyer-Mueller2009)—an often-studied secondary intervention—particularly for individuals in stressful workplace circumstances. Unions provide opportunities for employees to engage in social exchange relationships where they receive assistance with workplace problems, have their voices heard, and experience demonstrated care for their well-being and job satisfaction (Goeddeke & Kammeyer-Mueller, Reference Goeddeke and Kammeyer-Mueller2009). However, the impact of social support is contingent on the employee’s identification with the support source (Sonnentag et al., Reference Sonnentag, Tay and Shoshan2023), suggesting union identification warrants further study.
Unions also provide safety training (e.g., Kurtz et al., Reference Kurtz, Robins and Schork1997) and resources. Through occupational health and safety training programs using peer trainers and professional staff, unions provide members with knowledge and skills to recognize and prevent workplace hazards (Kurtz et al., Reference Kurtz, Robins and Schork1997). Additionally, unions may facilitate access to health screenings in occupations at particularly high risk of certain health outcomes (e.g., lung cancer for firefighters; Shah et al., Reference Shah, Kim, Khan, Krishnan, Lally, Shah, Alex, Seder, Liptay and Geissen2024).
Beyond support and training, unions provide protected channels for worker voice, allowing workers exposed to stressors to express concern without fear of retaliation. Robinson and Smallman (Reference Robinson and Smallman2013) found that workplaces where management and unions aligned on consultative or negotiated approaches to occupational health and safety reported fewer workplace injuries than workplaces with lower levels of participation or misaligned perceptions of voice between parties, demonstrating that union voice mechanisms contribute to improved safety outcomes.
Sample “unions as secondary interventions” research questions
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• What organizational and union-based features impact the perceptions of social support within unions and within the organization broadly? How do these dual sources of support shape employee attitudes, well-being, and voice across organizational contexts?
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• Which union members benefit most from union-led interventions (e.g., safety training, health screenings, hazard reporting), and how is efficacy shaped by power dynamics, contract features, and industry context?
Unions as tertiary interventions
Tertiary interventions address harm after it has occurred by supporting recovery, accommodation, and continued participation in work. Although unions routinely operate in this domain, this role has received little attention in I-O psychology. This omission is surprising, given that labor unions frequently negotiate for protections and standards when risks cannot be eliminated (Brown, Reference Brown2006).
Union-negotiated benefits often include provisions that support workers following illness, injury, or burnout, such as healthcare access, disability accommodations, job protection during medical leave, and retraining opportunities for workers who can no longer perform their original roles (Hickox, Reference Hickox2016). These provisions are not preventive; they assume harm has already occurred and serve to address its consequences. Nevertheless, they may determine whether a worker exits the labor force permanently or is able to return (Choi et al., Reference Choi, Bahk, Lee and Kim2021).
Career sustainability is a key outcome when viewing union membership, presence, or density as a tertiary intervention. Union members may be able to work longer, not because their jobs are less demanding but because they have resources that allow them to recover when work demands take a toll (VanHeuvelen et al., Reference VanHeuvelen, Han and VanHeuvelen2024). This perspective is particularly relevant in physically demanding or high-burnout occupations where attrition is a persistent concern. Unions may also advocate for resources for workers and their families who experience downstream physical symptoms attributable to the workplace, even when not linked to a single event. For example, firefighters face higher than average risks of cancer, and through union-led efforts (along with partnerships with National Institute of Occupational Safety and Health and researchers), a range of cancers have been identified as occupation-based, resulting in financial benefits for families of firefighters who die from these identified cancers (IAFF, 2025). In this way, unions not only facilitate the career sustainability of members but also the sustainability of union members’ families and, arguably, communities.
In addition to physical health support, unions may also provide access to mental health resources to address psychological symptoms of workplace exposures. Feder (Reference Feder1997) describes a union-based victim support program for members experiencing in-school crime, which included short-term psychological counseling post-incident as well as ongoing services and support. As the program expanded, its role evolved to include advocacy and coordination, helping members navigate restrictions within external health organizations. This illustrates how unions can serve as critical intermediaries ensuring continued access to care.
Sample “unions as tertiary interventions” research questions
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• What symptoms, illnesses, or disabilities are best supported by union activities, and how does union presence impact the sustainability of workers and their family members? Does this differ based on industry or features of the union?
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• How does union membership interact with organizational resources (e.g., employee assistance programs, return-to-work programs, and disability accommodations) to facilitate improved career sustainability? How do union structures (e.g., steward networks, collective agreements, and grievance procedures) facilitate or inhibit access to these supports?
Conclusion
Moving beyond I-O psychology’s documented neglect of unions requires attending to the varied features and activities through which unions shape worker well-being. The public health model offers I-O psychology a framework for doing so. By reframing unions as primary, secondary, and tertiary interventions, we seek to redirect attention toward union-related research questions that are theoretically meaningful and feasible to study. By also focusing on well-being (Tay et al., Reference Tay, Batz-Barbarich, Yang and Wiese2023), future research can help reframe labor-management relations from conflict to cooperation.
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