Michael A Flynn, MA, NIOSH; Jacqueline Siv?n, PhD MPH, NIOSH; Andrea Steege, PhD NIOSH; Laura Syron, PhD, NIOSH; Paul Schulte, PhD, NIOSH
The Occupational Health Equity program seeks to identify and eliminate avoidable differences in work-related disease incidence, injury, mental illness, and morbidity and mortality that are closely linked with social, economic, and/or environmental disadvantage.
Not all workers have the same risk of experiencing a work-related health problem, even when they have the same job. The way societies configure social and economic institutions influence workers? exposure to occupational hazards (differential exposure) as well as their ability to cope with adverse consequences of an occupational injury or illness (differential susceptibility). These arrangements are commonly referred to as social determinants of health (SDOH).
Three types of social arrangement particularly salient for the distribution of occupational injury and illness include: social group/identity along axes such as race, class and gender; organizational and industry practices such as competitive bidding, unionization, and sub-contracting; and employment characteristics such as job security, shift work, and pay structures. The Occupational Health Equity program seeks to identify and eliminate avoidable differences in work-related disease incidence, injury, mental illness, and morbidity and mortality that are closely linked with social, economic, and/or environmental disadvantage.
The United States’ workforce is undergoing dramatic demographic and structural shifts. The fastest growing groups in the workforce (such as racial minorities, immigrants, and contingent workers) are also those who are at an increased risk of occupational injuries and illnesses as a result of social, economic, and/or environmental disadvantage. The direct and indirect cost of occupational injury and illness in the United States in 2007 was $250 billion, up from an inflation-adjusted $217 billion in 1992. If the disadvantages that contribute to increased occupational injury and illness are not addressed, the costs to society will increase as workers from these high-risk groups make up an increasing percentage of the workforce. Occupational health equity research and practice is essential if we are to maintain the gains in safety and health of the past half-century.
One of the largest challenges facing occupational health equity is that the same social and economic structures that contribute to higher risks of occupational injury have often also excluded these workers from efforts to understand and prevent workplace illness and injury. As a result, existing surveillance systems often have incomplete information, making the occupational health status of some underserved worker populations unclear. Similarly, research methods that work well for understanding majority populations are often not as effective for working with many racial/ethnic minority groups. Tailored research methods and interventions need to be developed and adopted. Occupational safety and health professionals and organizations need to continue developing the internal capacity and institutional relationships to work effectively with these communities.
The Occupational Health Equity program is working to integrate a social determinants of health approach to occupational safety and health. This work includes: 1. Promote targeted research related to occupational health inequities 2. Integrate social approaches to occupational health 3. Promote ‘work’ as a Social Determinant of Health