International Journal of Environmental Research and Public Health

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4 pages, 263 KiB

Open AccessEditorial

Work, Health, and the Ongoing Pursuit of Health Equity

by Emily Q. Ahonen, Megan R. Winkler and Anjum Hajat

Int. J. Environ. Res. Public Health 2022, 19(21), 14047; https://doi.org/10.3390/ijerph192114047 - 28 Oct 2022

Cited by 3 | Viewed by 1414

Abstract

The many facets of work, including employment relationships and attendant employment quality, the day-to-day conditions experienced in any given job, and the evolution of one’s working circumstances over time can support or detract from health, and combine in myriad ways to impact worker [...] Read more.

The many facets of work, including employment relationships and attendant employment quality, the day-to-day conditions experienced in any given job, and the evolution of one’s working circumstances over time can support or detract from health, and combine in myriad ways to impact worker well-being [...] Full article

(This article belongs to the Special Issue Work, Health, and Equity)

Research

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17 pages, 774 KiB

Open AccessArticle

Employment Quality and Mental and Self-Reported Health Inequities among Latinx Housecleaners: The Safe and Just Cleaners Study

by Sherry Baron, Isabel Cuervo, Gary Winkel, Deysi Flores, Ana Gonzalez and Homero Harari

Int. J. Environ. Res. Public Health 2022, 19(23), 15973; https://doi.org/10.3390/ijerph192315973 - 30 Nov 2022

Cited by 3 | Viewed by 1750

Abstract

Precarious employment, such as housecleaning, is one important structural contributor to health inequities. We used an employment quality (EQ) framework to characterize the impact of employment conditions on mental and self-reported ill-health among Latinx housecleaners in the New York City metropolitan area. Using [...] Read more.

Precarious employment, such as housecleaning, is one important structural contributor to health inequities. We used an employment quality (EQ) framework to characterize the impact of employment conditions on mental and self-reported ill-health among Latinx housecleaners in the New York City metropolitan area. Using a community-based participatory research approach, we collected cross-sectional survey data from 402 housecleaners between August 2019 and February 2020 to characterize housecleaners’ EQ and its association with depression, perceived stress, and self-reported health. We also measured work-related irritant eye, skin, and respiratory symptoms, which have been shown in previous research to be associated with housecleaners’ exposure to chemical components of cleaning products. Our housecleaner cohort was largely female and immigrant and most had worked at least five years. Survey items capturing the EQ dimensions of unbalanced interpersonal relations, low material resources, and violations of workers’ rights were associated with increased odds of depression, perceived stress, and self-reported ill-health. Work-related irritant eye, skin, and respiratory symptoms were also independently associated with mental and self-reported ill-health and some of the effects of EQ on health were potentially partially mediated through their association with work-related irritant symptoms. Findings can inform directions for community-based educational and policy initiatives to improve housecleaners’ employment quality. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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12 pages, 1939 KiB

Open AccessArticle

Evaluating the Effect of San Francisco’s Paid Parental Leave Ordinance on Birth Outcomes

by Deborah Karasek, Sarah Raifman, William H. Dow, Rita Hamad and Julia M. Goodman

Int. J. Environ. Res. Public Health 2022, 19(19), 11962; https://doi.org/10.3390/ijerph191911962 - 22 Sep 2022

Cited by 2 | Viewed by 2300

Abstract

Since 2017, San Francisco’s Paid Parental Leave Ordinance (PPLO) has allowed parents who work for private-sector employers to take 6 weeks of fully paid postnatal parental leave. Previous studies have linked paid parental leave with health improvements for birthing people and babies, although [...] Read more.

Since 2017, San Francisco’s Paid Parental Leave Ordinance (PPLO) has allowed parents who work for private-sector employers to take 6 weeks of fully paid postnatal parental leave. Previous studies have linked paid parental leave with health improvements for birthing people and babies, although evidence for birth outcomes is limited. We hypothesized that the PPLO may have improved birth outcomes via reduced stress during pregnancy due to anticipation of increased financial security and postnatal leave. We used linked California birth certificate and hospital discharge records from January 2013 to December 2018 (n = 1,420,781). We used quasi-experimental difference-in-difference (DD) models to compare outcomes among SF births before and after PPLO to outcomes among births in control counties. Births from January 2017 through December 2018 among working San Francisco (SF) people were considered “exposed” to PPLO; births during this time among working people outside of SF, as well as all births before 2017, served as controls. We conducted subgroup analyses by race/ethnicity, education and Medicaid coverage at delivery. Overall analyses adjusting for covariates and indicators for time and seasonality indicated no association between PPLO and birth outcomes. Our results indicate that PPLO may not have affected the birth outcomes we examined among marginalized groups who, due to structural racism, are at heightened risk of poor outcomes. We speculate that this result is due to the PPLO’s design and focus on postnatal leave. Future work should examine the policy’s effects on other outcomes. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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18 pages, 643 KiB

Open AccessArticle

Do Different Patterns of Employment Quality Contribute to Gender Health Inequities in the U.S.? A Cross-Sectional Mediation Analysis

by Trevor Peckham, Noah Seixas, A. B. de Castro and Anjum Hajat

Int. J. Environ. Res. Public Health 2022, 19(18), 11237; https://doi.org/10.3390/ijerph191811237 - 7 Sep 2022

Cited by 7 | Viewed by 2209

Abstract

Compared to recent generations, workers today generally experience poorer quality employment across both contractual (e.g., wages, hours) and relational (e.g., participation in decision-making, power dynamics) dimensions within the worker–employer relationship. Recent research shows that women are more likely to experience poor-quality employment and [...] Read more.

Compared to recent generations, workers today generally experience poorer quality employment across both contractual (e.g., wages, hours) and relational (e.g., participation in decision-making, power dynamics) dimensions within the worker–employer relationship. Recent research shows that women are more likely to experience poor-quality employment and that these conditions are associated with adverse health effects, suggesting employment relations may contribute to gender inequities in health. We analyzed data from the General Social Survey (2002–2018) to explore whether the multidimensional construct of employment quality (EQ) mediates the relationship between gender and health among a representative, cross-sectional sample of U.S. wage earners. Using a counterfactually-based causal mediation framework, we found that EQ plays a meaningful role in a gender–health relationship, and that if the distribution of EQ among women was equal to that observed in men, the probability of reporting poor self-reported health and frequent mental distress among women would be lower by 1.5% (95% Confidence Interval: 0.5–2.8%) and 2.6% (95% CI: 0.6–4.6%), respectively. Our use of a multidimensional, typological measure of EQ allowed our analysis to better account for substantial heterogeneity in the configuration of contemporary employment arrangements. Additionally, this study is one of the first mediation analyses with a nominal mediator within the epidemiologic literature. Our results highlight EQ as a potential target for intervention to reduce gender inequities in health. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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24 pages, 1098 KiB

Open AccessArticle

Cohort Profile: The Assessing Economic Transitions (ASSET) Study—A Community-Based Mixed-Methods Study of Economic Engagement among Inner-City Residents

by Lindsey Richardson, Anita Minh, Deb McCormack, Allison Laing, Skye Barbic, Kanna Hayashi, M.-J. Milloy, Kimberly R. Huyser, Kathleen Leahy and Johanna Li

Int. J. Environ. Res. Public Health 2022, 19(16), 10456; https://doi.org/10.3390/ijerph191610456 - 22 Aug 2022

Cited by 2 | Viewed by 2666

Abstract

The Assessing Economic Transitions (ASSET) study was established to identify relationships between economic engagement, health and well-being in inner-city populations given that research in this area is currently underdeveloped. This paper describes the objectives, design, and characteristics of the ASSET study cohort, an [...] Read more.

The Assessing Economic Transitions (ASSET) study was established to identify relationships between economic engagement, health and well-being in inner-city populations given that research in this area is currently underdeveloped. This paper describes the objectives, design, and characteristics of the ASSET study cohort, an open prospective cohort which aims to provide data on opportunities for addressing economic engagement in an inner-city drug-using population in Vancouver, Canada. Participants complete interviewer-administered surveys quarterly. A subset of participants complete nested semi-structured qualitative interviews semi-annually. Between April 2019 and May 2022, the study enrolled 257 participants ages 19 years or older (median age: 51; 40% Indigenous, 11.6% non-Indigenous people of colour; 39% cis-gender women, 3.9% transgender, genderqueer, or two-spirit) and 41 qualitative participants. At baseline, all participants reported past daily drug use, with 27% currently using opioids daily, and 20% currently using stimulants daily. In the three months prior to baseline, more participants undertook informal income generation (75%) than formal employment (50%). Employed participants largely had casual jobs (42%) or jobs with part-time/varied hours (35%). Nested qualitative studies will focus on how inner-city populations experience economic engagement. The resulting evidence will inform policy and programmatic initiatives to address socioeconomic drivers of health and well-being. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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16 pages, 620 KiB

Open AccessArticle

Investigating Employment Quality for Population Health and Health Equity: A Perspective of Power

by Kaori Fujishiro, Emily Q. Ahonen and Megan Winkler

Int. J. Environ. Res. Public Health 2022, 19(16), 9991; https://doi.org/10.3390/ijerph19169991 - 13 Aug 2022

Cited by 14 | Viewed by 3482

Abstract

Employment quality (EQ) has gained increasing attention as a determinant of health, but the debate among occupational health researchers over the measurement of EQ poses a challenge to advancing the literature. This is especially problematic when the concept is used across social, cultural, [...] Read more.

Employment quality (EQ) has gained increasing attention as a determinant of health, but the debate among occupational health researchers over the measurement of EQ poses a challenge to advancing the literature. This is especially problematic when the concept is used across social, cultural, and national borders, as EQ is shaped by power dynamics within sociopolitical and economic contexts that are specific to each society. Investigating EQ in context could help develop a clearer understanding as to why EQ is configured in certain ways, how best EQ could be measured, how EQ impacts health, and ultimately how EQ could be improved. In this paper, we propose that attention to social context—and in particular power—may help advance the research on EQ and health. We present an allegory, or a visual description, that articulates the power balance in the employer–worker relation as well as in the sociopolitical context in which the employer–worker relation takes place. We end by proposing specific approaches for occupational health researchers to incorporate a perspective of power in EQ research that may clarify the concept and measurement of EQ. A clearer recognition of EQ as a product of power in social context aligns with the research approach of addressing work as a social structural determinant of health. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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14 pages, 393 KiB

Open AccessArticle

Association between Precarious Employment and Chronic Stress: Effect of Gender, Stress Measurement and Precariousness Dimensions—A Cross-Sectional Study

by Mireia Julià, Fabrizio Méndez-Rivero, Álex Gómez-Gómez, Óscar J. Pozo and Mireia Bolíbar

Int. J. Environ. Res. Public Health 2022, 19(15), 9099; https://doi.org/10.3390/ijerph19159099 - 26 Jul 2022

Cited by 13 | Viewed by 2527

Abstract

Precarious employment has been highlighted as a social determinant of health, given, among others, to its alleged association with chronic stress. However, few studies have been conducted analyzing such association, using both perceived stress indicators and biological markers. Accordingly, the present study analyzed [...] Read more.

Precarious employment has been highlighted as a social determinant of health, given, among others, to its alleged association with chronic stress. However, few studies have been conducted analyzing such association, using both perceived stress indicators and biological markers. Accordingly, the present study analyzed the association of multidimensional (6 dimensions) precarious employment scale with perceived stress and 23 markers of adrenal and gonadal hormone production, including cortisol. The sample consisted of 255 salaried workers from Barcelona (125 men, 130 women) aged 25–60. OLS regression models stratified by sex were conducted. Results demonstrated that precarious employment increased the probabilities of having perceived stress in both sexes. In addition, the production of adrenal hormones among men is associated with precarious wages and among women with precarious contracts (“Temporariness”, “Disempowerment”, and “Rights” dimensions). Therefore, precarious employment could be embodied by workers, altering their perceived well-being and physiological characteristics. Differences between men and women in the physiological effect of precarious employment could express not just the biochemical differences inherent to biological sex, but also the social construction of gender identities, positions and roles in society and family, as well as gender inequalities in the labour market. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

19 pages, 1080 KiB

Open AccessArticle

Understanding Migrant Farmworkers’ Health and Well-Being during the Global COVID-19 Pandemic in Canada: Toward a Transnational Conceptualization of Employment Strain

by Leah F. Vosko, Tanya Basok, Cynthia Spring, Guillermo Candiz and Glynis George

Int. J. Environ. Res. Public Health 2022, 19(14), 8574; https://doi.org/10.3390/ijerph19148574 - 14 Jul 2022

Cited by 15 | Viewed by 3105

Abstract

During the COVID-19 pandemic, Canada imposed certain international travel bans and work-from-home orders, yet migrant farmworkers, declared essential to national food security, were exempt from such measures. In this context, farm worksites proved to be particularly prone to COVID-19 outbreaks. To apprehend this [...] Read more.

During the COVID-19 pandemic, Canada imposed certain international travel bans and work-from-home orders, yet migrant farmworkers, declared essential to national food security, were exempt from such measures. In this context, farm worksites proved to be particularly prone to COVID-19 outbreaks. To apprehend this trend, we engaged an expanded and transnational employment strain framework that identified the employment demands and resources understood from a transnational perspective, as well as the immigration, labour, and public health policies and practices contributing to and/or buffering employment demands during and after the COVID-19 pandemic. We applied mixed methods to analyze administrative data, immigration, labour, and public health policy, as well as qualitative interviews with thirty migrant farmworkers employed in Ontario and Quebec. We concluded that the deleterious outcomes of the pandemic for this group were rooted in the deplorable pre-pandemic conditions they endured. Consequently, the band-aid solutions adopted by federal and provincial governments to address these conditions before and during the pandemic were limited in their efficacy because they failed to account for the transnational employment strains among precarious status workers labouring on temporary employer-tied work permits. Such findings underscore the need for transformative policies to better support health equity among migrant farmworkers in Canada. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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26 pages, 655 KiB

Open AccessArticle

Employment Industry and Occupational Class in Relation to Serious Psychological Distress in the United States

by Lauren R. Gullett, Dana M. Alhasan, W. Braxton Jackson II and Chandra L. Jackson

Int. J. Environ. Res. Public Health 2022, 19(14), 8376; https://doi.org/10.3390/ijerph19148376 - 8 Jul 2022

Cited by 4 | Viewed by 2625

Abstract

Occupational characteristics may influence serious psychological distress (SPD) and contribute to health inequities; yet, few studies have examined multiple employment industries and occupational classes in a large, racially diverse sample of the United States. Using data from the National Health Interview Survey, we [...] Read more.

Occupational characteristics may influence serious psychological distress (SPD) and contribute to health inequities; yet, few studies have examined multiple employment industries and occupational classes in a large, racially diverse sample of the United States. Using data from the National Health Interview Survey, we investigated employment industry and occupational class in relation to SPD in the overall population and by race/ethnicity, gender, age, household income, and health status. We created eight employment industry categories: professional/administrative/management, agricultural/manufacturing/construction, retail trade, finance/information/real estate, educational services, health care/social assistance, accommodation/food services, and public administration/arts/other services. We also created three occupational class categories: professional/management, support services, and laborers. SPD was measured using the Kessler Psychological Distress Scale and scores ≥13 indicated SPD. We adjusted for confounders and used Poisson regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). Among the 245,038 participants, the mean age was 41.7 ± 0.1 years, 73% were Non-Hispanic (NH)-White, and 1.5% were categorized as having SPD. Compared to the professional/administrative/management industry, working in other industries (e.g., manufacturing/construction (PR = 0.82 [95% CI: 0.70–0.95]) and educational services (PR = 0.79 [95% CI: 0.66–0.94])) was associated with lower SPD. Working in support services and laborer versus professional/management positions were both associated with 19% higher prevalence of SPD (95% CI: 1.04–1.35; 95% CI: 1.04–1.38, respectively). Furthermore, working in a support services or laborer versus professional/management position was associated with higher SPD in most employment industries. Industry-specific workplace interventions to equitably improve mental health are warranted. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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27 pages, 2169 KiB

Open AccessArticle

Non-Standard Employment and Unemployment during the COVID-19 Crisis: Economic and Health Findings from a Six-Country Survey Study

by Virginia Gunn, Alejandra Vives, Alessandro Zaupa, Julio C. Hernando-Rodriguez, Mireia Julià, Signild Kvart, Wayne Lewchuk, Eva Padrosa, Mattias Philippe Vos, Emily Q. Ahonen, Sherry Baron, Kim Bosmans, Letitia Davis, Ignacio Díaz, Nuria Matilla-Santander, Carles Muntaner, Patricia O’Campo, Per-Olof Östergren, Christophe Vanroelen, Emilia F. Vignola and Theo Bodin Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2022, 19(10), 5865; https://doi.org/10.3390/ijerph19105865 - 11 May 2022

Cited by 15 | Viewed by 5557

Abstract

The COVID-19 crisis is a global event that has created and amplified social inequalities, including an already existing and steadily increasing problem of employment and income insecurity and erosion of workplace rights, affecting workers globally. The aim of this exploratory study was to [...] Read more.

The COVID-19 crisis is a global event that has created and amplified social inequalities, including an already existing and steadily increasing problem of employment and income insecurity and erosion of workplace rights, affecting workers globally. The aim of this exploratory study was to review employment-related determinants of health and health protection during the pandemic, or more specifically, to examine several links between non-standard employment, unemployment, economic, health, and safety outcomes during the COVID-19 pandemic in Sweden, Belgium, Spain, Canada, the United States, and Chile, based on an online survey conducted from November 2020 to June 2021. The study focused on both non-standard workers and unemployed workers and examined worker outcomes in the context of current type and duration of employment arrangements, as well as employment transitions triggered by the COVID-19 crisis. The results suggest that COVID-19-related changes in non-standard worker employment arrangements, or unemployment, are related to changes in work hours, income, and benefits, as well as the self-reported prevalence of suffering from severe to extreme anxiety or depression. The results also suggest a link between worker type, duration of employment arrangements, or unemployment, and the ability to cover regular expenses during the pandemic. Additionally, the findings indicate that the type and duration of employment arrangements are related to the provision of personal protective equipment or other COVID-19 protection measures. This study provides additional evidence that workers in non-standard employment and the unemployed have experienced numerous and complex adverse effects of the pandemic and require additional protection through tailored pandemic responses and recovery strategies. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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16 pages, 656 KiB

Open AccessArticle

Expanding the Conceptualization of Support in Low-Wage Carework: The Case of Home Care Aides and Client Death

by Emma K. Tsui, Marita LaMonica, Maryam Hyder, Paul Landsbergis, Jennifer Zelnick and Sherry Baron

Int. J. Environ. Res. Public Health 2022, 19(1), 367; https://doi.org/10.3390/ijerph19010367 - 30 Dec 2021

Cited by 7 | Viewed by 2984

Abstract

Home care aides are a rapidly growing, non-standard workforce who face numerous health risks and stressors on the job. While research shows that aides receive limited support from their agency employers, few studies have explored the wider range of support that aides use [...] Read more.

Home care aides are a rapidly growing, non-standard workforce who face numerous health risks and stressors on the job. While research shows that aides receive limited support from their agency employers, few studies have explored the wider range of support that aides use when navigating work stress and considered the implications of these arrangements. To investigate this question, we conducted 47 in-depth interviews with 29 home care aides in New York City, focused specifically on aides’ use of support after client death. Theories of work stress, the social ecological framework, and feminist theories of care informed our research. Our analysis demonstrates aides’ extensive reliance on personal sources of support and explores the challenges this can create in their lives and work, and, potentially, for their communities. We also document aides’ efforts to cultivate support stemming from their home-based work environments. Home care aides’ work stress thus emerges as both an occupational health and a community health issue. While employers should carry responsibility for preventing and mitigating work stress, moving toward health equity for marginalized careworkers requires investing in policy-level and community-level supports to bolster employer efforts, particularly as the home care industry becomes increasingly fragmented and non-standard. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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12 pages, 947 KiB

Open AccessArticle

Health Inequalities in the Diverse World of Self-Employment: A Swedish National Cohort Study

by Karl Gauffin and Andrea Dunlavy

Int. J. Environ. Res. Public Health 2021, 18(23), 12301; https://doi.org/10.3390/ijerph182312301 - 23 Nov 2021

Cited by 6 | Viewed by 1746

Abstract

With labor being a central social determinant of health, there is an increasing need to investigate health inequalities within the heterogenous and growing population in self-employment. This study aimed to longitudinally investigate the relationship between income level, self-employment status and multiple work-related health [...] Read more.

With labor being a central social determinant of health, there is an increasing need to investigate health inequalities within the heterogenous and growing population in self-employment. This study aimed to longitudinally investigate the relationship between income level, self-employment status and multiple work-related health indicators in a Swedish national cohort (n = 3,530,309). The study investigated the relationship between self-employment status and health outcomes later in life. All poor health outcomes, with the exception of alcohol-related disorders, were more common in the self-employed population, compared to the group in regular employment. The income gradient, however, was more pronounced in the group with regular employment than the groups in self-employment. The study found clear connections between low income and poor health in all employment groups, but the gradient was more pronounced in the group in regular employment. This suggests that income has a weaker connection to other types of health promoting resources in the self-employed population. Potentially, lacking social and public support could make it difficult for unhealthy individuals to maintain low-income self-employment over a longer time period. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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16 pages, 371 KiB

Open AccessArticle

Differences in Work Disability Duration for Immigrants and Canadian-Born Workers in British Columbia, Canada

by Sonja Senthanar, Mieke Koehoorn, Lillian Tamburic, Stephanie Premji, Ute Bültmann and Christopher B. McLeod

Int. J. Environ. Res. Public Health 2021, 18(22), 11794; https://doi.org/10.3390/ijerph182211794 - 10 Nov 2021

Cited by 6 | Viewed by 2660

Abstract

This study aimed to investigate differences in work disability duration among immigrants (categorized as economic, family member or refugee/other classification upon arrival to Canada) compared to Canadian-born workers with a work-related injury in British Columbia. Immigrants and Canadian-born workers were identified from linked [...] Read more.

This study aimed to investigate differences in work disability duration among immigrants (categorized as economic, family member or refugee/other classification upon arrival to Canada) compared to Canadian-born workers with a work-related injury in British Columbia. Immigrants and Canadian-born workers were identified from linked immigration records with workers’ compensation claims for work-related back strain, connective tissue, concussion and fracture injuries requiring at least one paid day of work disability benefits between 2009 to 2015. Quantile regression investigated the relationship between immigration classification and predicted work disability days (defined from injury date to end of compensation claim, up to 365 days) and modeled at the 25th, 50th and 75th percentile of the distribution of the disability days. With a few exceptions, immigrants experienced greater predicted disability days compared to Canadian-born workers within the same injury cohort. The largest differences were observed for family and refugee/other immigrant classification workers, and, in particular, for women within these classifications, compared to Canadian-born workers. For example, at the 50th percentile of the distribution of disability days, we observed a difference of 34.1 days longer for refugee/other women in the concussion cohort and a difference of 27.5 days longer for family classification women in the fracture cohort. Economic immigrants had comparable disability days with Canadian-born workers, especially at the 25th and 50th percentiles of the distribution. Immigrant workers’ longer disability durations may be a result of more severe injuries or challenges navigating the workers’ compensation system with delays in seeking disability benefits and rehabilitation services. Differences by immigrant classification speak to vulnerabilities or inequities upon arrival in Canada that persist after entry to the workforce and warrant further investigation for early mitigation strategies. Full article

(This article belongs to the Special Issue Work, Health, and Equity)

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