Visual Representation of Work as a Social Determinant of Health: Augmenting Silver et al., Employment Status, Unemployment Duration, and Health-Related Metrics among US Adults of Prime Working Age

Details

• Journal Article:
  American Journal of Industrial Medicine
• Personal Author:
  Silver, Sharon R. ; Li, Jia ; Quay, Brian
• Description:
  To the Editor: We write to augment a discussion point from our article recently published in AJIM, "Employment Status, Unemployment Duration, and Health-Related Metrics among U.S. Adults of Prime Working Age: Behavioral Risk Factor Surveillance System, 2018-2019." In that discussion, we noted that "Decoupling these observed associations [between unemployment and the elevated prevalence of multiple adverse health outcomes] will require addressing 1) social and economic factors contributing to unemployment; 2) job and income insecurity; and 3) healthcare access, which in the U.S. is related to employment both directly (through employer-based coverage) and indirectly (through income)." We have developed a visual representation of selected pathways through which work functions as a key social determinant of health (SDOH) in the United States. While the article focused on employment status, SDOH such as housing and education often also constrain the type of work a person can obtain. For example, we noted that "residential segregation [affects] access to high-quality primary and secondary education, and thus higher education, which in turn influences employment options, and attendant wages and stability." In addition, employment status and type of work affect health conditions and outcomes both directly, through working conditions, and indirectly, through compensation (salary/wages, health insurance coverage, etc.). As shown, multiple feedback loops reinforce these relations. The diagram is high-level and not comprehensive: only selected SDOH are shown; many other inputs constraining education, housing, and employment choices (including other institutionalized modes of discrimination) are not shown; lesser directional indicators are omitted in the interest of legibility; and numerous pertinent characteristics of work are omitted. However, unlike most pictorial representations of SDOH, this diagram highlights the centrality of work as a SDOH and the mutually-reinforcing pathways that complicate the path to health equity. [Description provided by NIOSH]
• Subjects:
  Education Employment Healthcare Disparities Health Status Occupational Health Safety Social Class Social Determinants Of Health Socioeconomic Factors Surveys And Questionnaires Unemployment

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• Keywords:
  Worker health; Work intervals; Unemployment; Health surveys; Surveillance; Education; Socioeconomics; Health disparities
• Source:
  Am J Ind Med 2022 Aug; 65(8):697-698
• ISSN:
  0271-3586
• Pubmed ID:
  35612358
• Pubmed Central ID:
  PMC9283259
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering ; OD - Office of the Director
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  3 pdf pages
• Volume:
  65
• Issue:
  8
• NIOSHTIC Number:
  nn:20065306
• Contact Point Address:
  Sharon Silver, MS, MA, National Institute for Occupational Safetyand Health, Division of Field Studies and Engineering, MS R-17, 1150 Tusculum Ave. Cincinnati, OH 45226, USA
• Email:
  ssilver@cdc.gov
• Federal Fiscal Year:
  2022
• Peer Reviewed:
  False
• Collection(s):
  National Institute for Occupational Safety and Health CDC Public Access
• Main Document Checksum:
  urn:sha-512:0425449377a950eec24a9ac4c7d23796036882cb76ad941be6b6b4db82048bba61481daa2a197603a4e69b1f76f15b2a5a7d02aa7b2279872c9e6e1ec54af5e3
• Download URL:
  https://stacks.cdc.gov/view/cdc/119393/cdc_119393_DS1.pdf
• File Type:
  [PDF - 139.81 KB ]