Background: The welfare state has a long history of uncertain future. Nonetheless, health indicators of people living in countries with a more universal and generous welfare state remain better than those living under less generous and more individualist welfare regimes. In this essay, we reflect on how occupational health, as part of public health, can contribute to the sustainability of the welfare state. Methods: Over the course of the political and social transformations of the State, from single guarantor of security to assuming civil and social rights, the practice of public health has added, to its original objectives related to the control of epidemics of contagious diseases, the promotion of health and the reduction of inequalities...