Occupational Health Equity

Burden, Need and Impact

NIOSH strives to maximize its impact in occupational safety and health. The Occupational Health Equity program identifies priorities to guide investments, and base those priorities on the evidence of burden, need and impact. Below are the priority areas for the Occupational Health Equity program.

Burden

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. ¹ If the disadvantages that contribute to increased occupational injury and illness are not addressed, the costs to society will increase as workers from these 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.

Need

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 .² 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.³ 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:

 

1. Improving surveillance and research methods to more precisely identify which social, economic, and/or environmental disadvantages contribute to higher rates of occupational injury and illness in which industries.
2. Conducting research that explains how barriers to safety and health related to these factors occur at the worksite and how they can be overcome.
3. Developing and evaluating tailored occupational safety and health programs, policies or other changes that directly address these barriers either by themselves or in combination (Overlapping Vulnerabilities)
4. Improved institutional infrastructure to address these risk factors through internal capacity building and partnership development.^4,5

 

 

Impact

The Occupational Health Equity program generates knowledge about how work arrangements (e.g. contingent work), socio-demographic characteristics (e.g. age, language, sex), and organizational factors (e.g. business size) affect worker well-being.

Some recent accomplishments include:

• A NIOSH study which found that about 30% of the higher rate of death among blacks compared with whites was because blacks experience on average lower levels of job complexity (i.e., their jobs do not allow problem solving, decision making, inductive and deductive reasoning, or information synthesis).⁶
• NIOSH conducted site visits across the US with three tribes, two tribal corporations and six tribal-serving organizations to develop partnerships and plan for American Indian/Alaska Native (AI/AN) worker safety and health activities with accompanying NIOSH Science Blog post support for the new AI/AN initiative.
• NIOSH distributed a series of multi-media products called Protéjase en el trabajo (Protect yourself at work) to immigrant workers through Mexican consulates which serve approximately 1.5 million people per year.
• A follow-up survey to the Overlapping Vulnerabilities report found deficits in workplace safety and health training provided to immigrants working in smaller construction firms, compared to those working in larger firms.

 

References

¹ Leigh J [2011]. Economic burden of occupational injury and illness in the United States. The Milbank Quarterly. 89(4):728-72.

² Souza K, Steege AL, Baron SL [2010]. Surveillance of occupational health disparities: challenges and opportunities. Am J of Ind Med. 53(2):84-94.

³ Flynn MA, Eggerth D [2014]. Occupational Health Research with Immigrant Workers. In: Schenker MB, Castañeda X, Rodriguez-Lainz A, eds. Migration and Health Research Methodologies: A Handbook for the Study of Migrant Populations, Chapter: Occupational Health Research with Immigrant Workers. Oakland, CA: University of California Press.

⁴ Flynn MA, Check P, Eggerth DE, Tonda J [2013]. Improving occupational safety and health among Mexican immigrant workers: A binational collaboration. Public Health Reports. 128(6_suppl3):33-8.

⁵ Sinclair RC, Cunningham TR, Schulte PA [2013]. A model for occupational safety and health intervention diffusion to small businesses. Am J Ind Med 56(12):1442-51.

⁶ Fujishiro K, Hajat A, Landsbergis PA, Meyer JD, Schreiner PJ, Kaufman JD [2017]. Explaining racial/ethnic differences in all-cause mortality in the Multi-Ethnic Study of Atherosclerosis (MESA): substantive complexity and hazardous working conditions as mediating factors. SSM Popul Health 3:497-505