Work as a Social Determinant of Health: A Necessary Foundation for Occupational Health and Safety

Details

• Personal Author:
  Hammer L ; Richardson DM ; Wild S ; Wipfli B
• Description:
  Social determinants of health "are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life" (1). Though historically not considered as such in occupational health and safety research or practice (2), work is a social determinant of health (3-5). Where a person has the opportunity to work is highly influenced by how their individual level characteristics (e.g., race, ethnicity, gender, income, education level, etc.) intersect with structural level factors (e.g., racism, classism, access to opportunity, etc.). For example, structural and institutionalized racism - manifest in schools, neighborhoods, and workplaces - has created deep and pervasive inequities in access to economic mobility, in large part due to where one can work. The workplace also drives health inequities through characteristics like job demands, benefits, compensation, access to healthcare, power/prestige, social networks, exposure to hazards, and more (3). Occupational risks and benefits interact and accumulate over time, resulting in deep and pervasive health inequities (6). Work is therefore a driver, marker, and outcome of inequity. If occupational health and safety researchers and practitioners do not consider the larger social context and fail to recognize work as a social determinant of health, we effectively uphold systems and structures of inequity (7). The purpose of this paper is therefore to amplify and add to previous calls to consider work as a social determinant of health (e.g., 3- 5,8), and to encourage researchers and practitioners to employ equity-focused strategies. This paper adds to previous research by presenting a case study of how characteristics of work intersected with environmental factors to impact worker health, and situating this example within the larger context of work as a social determinant of health. This case study represents a snapshot of a particular time and place in society. Participants in this case study experienced this time and place in one way, while other workers experienced it differently, which highlights several ways in which work functions as a social determinant of health. [Description provided by NIOSH]
• Subjects:
  Healthcare Disparities Health Promotion Occupational Health Safety Workplace
• Keywords:
  Health Care Health Disparities Health Programs SDOH Social Determinants Of Health Total Worker Health TWH Workplace Studies
• ISSN:
  1076-2752
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Oregon ; OSHA Region 10
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  63
• Issue:
  11
• NIOSHTIC Number:
  nn:20063397
• Citation:
  J Occup Environ Med 2021 Nov; 63(11):e830
• Contact Point Address:
  Sara Wild, MPH, 3222 SW Research Dr., Portland, OR 97239, Mail code L606
• Email:
  wilsa@ohsu.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  Oregon Health & Science University, Portland
• Peer Reviewed:
  False
• Start Date:
  20110901
• Source Full Name:
  Journal of Occupational and Environmental Medicine
• End Date:
  20260831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:02ff5eb67f876bb21e5d5f5dd3a8f09f98df12ee8c655682ede83ccb1c2630663ad4586b0755e5079c376284caabf805b19309444d1b794e9828959066f1f600
• Download URL:
  https://stacks.cdc.gov/view/cdc/226466/cdc_226466_DS1.pdf
• File Type:
  [PDF - 197.94 KB ]