Work, Neighborhood, Commuting, and Occupational Health Disparities

Details

• Personal Author:
  Barbeau, Elizabeth M. ; Chen JT ; Krieger N
• Description:
  Reducing occupational health disparities is a priority of NIOSH's National Occupational Research. Recognizing that workers' susceptibility to occupational and social hazards in the workplace is further shaped by their social and environmental context beyond work, we undertook this study to enrich the United For Health study (UFH; R01 OHO7366-01; PI: Barbeau) of occupational and social hazards among a working class population with contextual data on workers' residential neighborhoods and workers' commuting time and distance. We were able to geocode 93% of study subjects' residential addresses to the census tract level with high accuracy, with the remaining 7% geocoded based on ZIP code centroid. We calculated commuting distance and time for each participant based on an analysis of the street network, and found that measures calculated using a variety of algorithms yielded very similar results (r>0.95). Individual socioeconomic position (SEP) and area-based socioeconomic measures (ABSMs) were mildly correlated, with substantial variability of ABSMs within categories of individual SEP. Black participants were more likely to live in socioeconomically disadvantaged neighborhoods and to have longer commutes. While we observed significant gradients by individual SEP for selected health outcomes (self-rated health, smoking, systolic blood pressure, and asthma and wheeze), most gradients by ABSM were not significant, although point estimates suggested a pattern of worse health outcomes with increasing socioeconomic deprivation. Longer commutes were associated with a lower odds of wheeze in the full cohort and lower systolic blood pressures for Black and Latino participants. We also evaluated the area-based measure CT % below poverty as a potential confounder and/or effect modifier of relationships between social and occupational hazards and selected health outcomes. Observed associations with workplace abuse (associated with self-rated health, smoking, asthma, and wheeze), sexual harassment (associated with systolic blood pressure), racial discrimination (associated with smoking and asthma), and occupational hazards (associated with wheeze) were not reduced by controlling for CT poverty or commuting distance, and in a few cases, were strengthened. While the observed associations with social and occupational hazards varied by racial/ethnic group, interaction models did not yield significant evidence of effect modification by CT poverty, although in some cases, point estimates suggested that the effect of social hazards was greater among residents of more impoverished neighborhoods. Our study demonstrates the feasibility of using geocoding and area-based measures to broaden frameworks for analyzing occupational health disparities. Racial/ethnic and socioeconomic disparities in exposure to social hazards (such as sexual harassment, workplace abuse, and racial discrimination) and occupational hazards, can be conceptualized within the framework of the inverse hazard law, by which the accumulation of health hazards tends to vary inversely with the power and resources of the populations affected. Policies and interventions to address occupational health disparities should thus consider how racial/ethnic minorities and socioeconomically disadvantaged workers are multiply disadvantaged by the clustering of adverse socioeconomic circumstances and social and occupational hazards. This perspective can inform occupational health and environmental health practitioners, regulators, and advocates, urban planners, community based groups, and worker organizations about ways to create healthier communities and jobs. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Environmental Exposure Environmental Pollution Healthcare Disparities Minority Health Occupational Health Race Factors Safety Violence
• Keywords:
  Abuse Blood Pressure Environmental Hazards Health Disparities Minority Health Occupations Racial Factors Sociological Factors
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-48
• NIOSHTIC Number:
  nn:20059552
• NTIS Accession Number:
  PB2021-100141
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R03-OH-009338, 2012 Aug; :1-48
• Contact Point Address:
  Jarvis T. Chen, ScD, Harvard School of Public Health, Department of Society, Human Development, and Health, 401 Park Drive Rm 403-N, Boston, MA 02215
• Email:
  arvis@hsph.harvard.edu
• Federal Fiscal Year:
  2012
• NORA Priority Area:
  Manufacturing ; Services
• Performing Organization:
  Harvard University School of Public Health
• Peer Reviewed:
  False
• Start Date:
  20080901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20110831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0ba7ebc324ba5c6f2852ec7502be008135dbb43d89caecd3bf72188d7f05d887c9625a2fa50b714d380bbb4c7056261a4bcf5ae03fd5f858ec2e3eff666fba4f
• Download URL:
  https://stacks.cdc.gov/view/cdc/218981/cdc_218981_DS1.pdf
• File Type:
  [PDF - 1.48 MB ]