Workers are people too: Societal aspects of occupational health disparities—an ecosocial perspective

Abstract

Workers are people too. What else is new? This seemingly self-evident proposition, however, takes on new meaning when considering the challenging and deeply important issue of occupational health disparities--the topic that is the focus of 12 articles in this special issue of the American Journal of Industrial Medicine. In this commentary, I highlight some of the myriad ways that societal determinants of health intertwine with each and every aspect of occupation-related health inequities, as analyzed from an ecosocial perspective. The engagement extends from basic surveillance to etiologic research, from conceptualization and measurement of variables to analysis and interpretation of data, from causal inference to preventive action, and from the political economy of work to the political economy of health. A basic point is that who is employed (or not) in what kinds of jobs, with what kinds of exposures, what kinds of treatment, and what kinds of job stability, benefits, and pay-as well as what evidence exists about these conditions and what action is taken to address them-depends on societal context. At issue are diverse aspects of people's social location within their societies, in relation to their jointly experienced-and embodied-realities of socioeconomic position, race/ethnicity, nationality, nativity, immigration and citizen status, age, gender, and sexuality, among others. Reviewing the papers' findings, I discuss the scientific and real-world action challenges they pose. Recommendations include better conceptualization and measurement of socioeconomic position and race/ethnicity and also use of the health and human rights framework to further the public health mission of ensuring the conditions that enable people-including workers-to live healthy and dignified lives.

Disparities by ethnicity, language, and immigrant status in occupational health experiences among Las Vegas hotel room cleaners

“…Workers were assigned to the category ''English as first language'' (EFL) or ''English as second language'' (ESL). Immigrants were defined as workers who checked that they were ''Born outside the U.S.A.'' while nonimmigrants checked that they were ''Born in the U.S.A.'' Despite overlap between Hispanics, ESL individuals, and immigrants, we considered all three classifications (ethnic origin, language, and immigrant status) for analysis since these socio-demographic characteristics imply different mechanisms regarding the genesis of disparities [Premji, 2008;Krieger, 2009] and can produce different results [Premji et al, 2010]. It should be noted that Hispanics, ESL individuals, and immigrants are minorities in the context of the U.S. workforce but constitute the majority of workers within our population of Las Vegas room cleaners.…”

Quelle(s) épidémiologie(s) pour la santé au travail ? Réflexions à partir des cancers professionnels

“…Cette nouvelle approche vise ainsi à rompre avec l'aspect vertical et échelonné des précédents courants, et se présente plutôt comme une sphère compréhensive de différents aspects (aussi bien macro que micro) de la distribution des maladies (Krieger, 2001). Cette approche présente de nombreux défis en santé au travail où sa mise en oeuvre reste encore à faire (Krieger, 2010). Geoffrey Rose rappelait dans une perspective similaire que la distribution d'un risque donné dans une population varie sur un continuum.…”

Leveraging health capital at the workplace: An examination of health reporting behavior among Latino immigrant restaurant workers in the United States

“…Sick and injured workers are also sick and injured consumers, whose purchasing power can be limited by their ailments (ROC-NY, 2006). They are also more likely to risk reinjury and recurring illness if they are not provided with proper medical attention and conditions for recovery (Krieger, 2010). Our comprehension of how workers respond to workplace illness and injury must be considered if we are to craft viable policies for promoting workers' health and the health of their families and communities.…”