Black Jobs Matter: Racial Inequalities in Conditions of Employment and Subsequent Health Outcomes

Abstract

African-Americans shoulder an excessive burden of unemployment, precarious employment, and low paying jobs in the United States, which may help explain why they experience some of the worst health outcomes among U.S. citizens. This paper presents a conceptual framework describing this phenomenon. The social determinants of health as described by this framework include racism, social and public policy formation, socioeconomic status, and conditions of employment. The intermediate determinants of health, which include the ability to afford health behavior, depression and addiction, environmental exposures, and access to primary care, are informed by conditions of employment, which leads to poor health outcomes for African-Americans. This paper will explore in detail these relationships.

Racial–Ethnic Differences in Turnover Intent Among Home Health Aides

“…Bureau of Labor Statistics (2017), Blacks experience an excessive burden of low-paying jobs and unemployment. Blacks make up 11% of all employed workers in the United States but comprise 25% of lower pay occupation workers (Doede, 2016; Kalleberg, Reskin, & Hudson, 2000). In addition, low-wage earners often do not receive benefits such as health insurance, paid sick leave, or vacation time.…”

“…In addition, low-wage earners often do not receive benefits such as health insurance, paid sick leave, or vacation time. Lack of health insurance leads to poor health outcomes due to reduced access to primary care (Doede, 2016). Poor health may impact HHAs’ ability to work and decrease continuity of care for patients.…”

“…Results from this study suggest that home health agencies must first address any inequality in pay and advancement practices as it relates to Black HHAs. In addition, organizational leaders should consider Doede’s (2016) advocacy for workers to be paid livable wages. Covington-Ward (2017) suggests that if higher salaries are constrained by Medicaid funding, then signing bonuses should be provided.…”

“…Higher retention also means agencies can lower their costs of recruiting, hiring, and training new HHAs. Other recommendations for agencies to implement include stronger worker protections and comprehensive worker benefits such as health insurance, paid leave, mileage reimbursement, and retirement (Doede, 2016). HHAs may benefit from the ACA’s requirement that more agencies offer health insurance for full-time employees (Nisbet & Morgan, 2017).…”

Racial, Ethnic, and Gender Disparities in Health Care Access and Use Among U.S. Adults With Serious Psychological Distress

“…In states that expanded Medicaid under the ACA, black adults have made tremendous gains in access to care (24). Advancements in coverage, particularly among groups disproportionately affected by economic recessions, suggest that the Medicaid expansion offers an appropriate safety net to preserve access to health care (35).…”