This paper synthesizes research on the contribution of workplace injustices – discrimination, harassment, abuse and bullying – to occupational health disparities. A conceptual framework is presented to illustrate the pathways through which injustices at the interpersonal and institutional level lead to differential risk of vulnerable workers to adverse occupational health outcomes. Members of demographic minority groups are more likely to be victims of workplace injustice and suffer more adverse outcomes when exposed to workplace injustice compared to demographic majority groups. A growing body of research links workplace injustice to poor psychological and physical health, and a smaller body of evidence links workplace injustice to unhealthy behaviors. Although not as well studied, studies also show that workplace injustice can influence workers’ health through effects on workers’ family life and job-related outcomes. Lastly, this paper discusses methodological limitations in research linking injustices and occupational health disparities and makes recommendations to improve the state of research.
In this qualitative study, the authors describe work organization factors, problems workers encounter on the job, consequences of these problems, and actions taken to deal with them. Study participants were immigrant workers seeking assistance at the Chicago Interfaith Workers' Rights Center. Using a grounded theory approach, the investigators coded narratives from 455 records describing workers' problems. Emerged sequences of events were then integrated into a model. Data show that workers' rights are systematically violated and problems are rooted in how jobs are designed and managed. Work organization factors are associated with occupational injury/illness, job loss, and worker actions. Employer responses included indifference and various forms of retaliation. This model provides insight into the work-related troubles immigrants face and informs hypothesis generation and action initiatives.
A robust socioeconomic gradient in health is well-documented, with higher socioeconomic status (SES) associated with better health across the SES spectrum. However, recent studies of U.S. racial/ethnic minorities and immigrants show complex SES-health patterns (e.g., flat gradients), with individuals of low SES having similar or better health than their richer, U.S.-born and more acculturated counterparts, a so-called “epidemiological paradox” or “immigrant health paradox”. To examine whether this exists among Asian Americans, we investigate how nativity and occupational class (white-collar, blue-collar, service, unemployed) are associated with subjective health (self-rated physical health, self-rated mental health) and 12-month DSM-IV mental disorders (any mental disorder, anxiety, depression). We analyzed data from 1530 Asian respondents to the 2002–2003 National Latino and Asian American Study in the labor force using hierarchical multivariate logistic regression models controlling for confounders, subjective social status (SSS), material and psychosocial factors theorized to explain health inequalities. Compared to U.S.-born Asians, immigrants had worse socioeconomic profiles, and controlling for age and gender, increased odds for reporting fair/poor mental health and decreased odds for any DSM-IV mental disorder and anxiety. No strong occupational class-health gradients were found. The foreign-born health-protective effect persisted after controlling for SSS but became nonsignificant after controlling for material and psychosocial factors. Speaking fair/poor English was strongly associated with all outcomes. Material and psychosocial factors were associated with some outcomes – perceived financial need with subjective health, uninsurance with self-rated mental health and depression, social support, discrimination and acculturative stress with all or most DSM-IV outcomes. Our findings caution against using terms like “immigrant health paradox” which oversimplify complex patterns and mask negative outcomes among underserved sub-groups (e.g., speaking fair/poor English, experiencing acculturative stress). We discuss implications for better measurement of SES and health given the absence of a gradient and seemingly contradictory finding of nativity-related differences in self-rated health and DSM-IV mental disorders.
Socioeconomic position is often operationalized as education, occupation, and income. However, these measures may not fully capture the process of socioeconomic disadvantage that may be related to morbidity. Economic opportunity, subjective social status, and financial strain may also place individuals at risk for poor health outcomes. Data come from the Asian subsample of the 2003 National Latino and Asian American Study (n = 2095). Regression models were used to examine the associations between economic opportunity, subjective social status, and financial strain and the outcomes of self-rated health, body mass index, and smoking status. Education, occupation, and income were also investigated as correlates of these outcomes. Low correlations were observed between all measures of socioeconomic status. Economic opportunity was robustly negatively associated with poor self-rated health, higher body mass index, and smoking, followed by financial strain, then subjective social status. Findings show that markers of socioeconomic position beyond education, occupation, and income are related to morbidity among Asian Americans. This suggests that potential contributions of social disadvantage to poor health may be understated if only conventional measures are considered among immigrant and minority populations.
Racial discrimination in the workplace was positively associated with poor health among Filipino Americans after we controlled for reports of everyday discrimination and general concerns about one's job. This finding shows the importance of considering the work setting as a source of discrimination and its effect on morbidity among racial minorities.
Background Nurses often endure working irregular day, night and evening shifts as well as mandatory overtime (i.e. employer-imposed work time in excess of one's assigned schedule). While these work characteristics are examined as potential risks for nurses' safety and health, it is not clear whether negative health impacts occur simply because of working long hours or in combination with other mechanisms. Aim This study investigates how these work characteristics are associated with nurses' work-related injury and illness over and above long work hours. Methods In this cross-sectional study, questionnaire data were collected from a sample of 655 registered nurses in the Philippines. Multiple logistic regression was used to assess associations of shift work and mandatory overtime with four work-related health outcomes. Results After weekly work hours, shift length and demographic variables were accounted for, non-day shifts were associated with work-related injury [odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.07, 2.24] and work-related illness (OR = 1.48; 95% CI: 1.02, 2.16). Also, frequency of working mandatory overtime was associated with work-related injury (OR = 1.22; 95% CI: 1.06, 1.41), work-related illness (OR = 1.19; 95% CI: 1.04, 1.37) and missing more than 2 days of work because of a work-related injury or illness (OR = 1.25; 95% CI: 1.08, 1.44). Conclusions These findings suggest that non-day shifts and mandatory overtime may negatively impact nurses' health independent of working long hours. Mechanisms through which these work characteristics affect health, such as circadian rhythm disturbance, nurse-to-patient ratios and work–family conflict, should be examined in future studies.
Objectives-We investigate how duration in the US impacts the relationship between job-related stress and health conditions among Filipino immigrants.Methods-Using data from the Filipino American Community Epidemiologic Study, a crosssectional sample of 1,381 immigrant Filipinos was obtained. Negative binomial regression was used to examine the interaction between years residing in the US and job concerns on number of selfreported health conditions.Results-Job concern is positively associated with health conditions for all immigrants no matter what length of time they have spent in the US. This association is strongest for recent immigrants and the strength of the association weakened with increasing time spent in the US.Conclusions-Findings suggest that job-related stressors are associated with adverse health outcomes among Filipino immigrants and that this relationship is strongest for newer immigrants. New immigrants should be recognized as a vulnerable group with regard to the impact of work on their well-being.
In response to the significant number and severity of work-related back injuries and other musculoskeletal disorders among nurses, the American Nurses Association (ANA) has launched the Handle With Care campaign. The campaign seeks to build a health care industry-wide effort to prevent back and other musculoskeletal injuries. This is being done through developing partnerships and coalitions, education and training, increasing use of assistive equipment and patient-handling devices, reshaping nursing education to incorporate safe patient-handling, and pursuing federal and state ergonomics policy by highlighting technologyoriented safe-patient handling benefits for patients and nurses. In the absence of national-or state-level ergonomics regulations that protect health care workers, the ANA has taken on alternative approaches to encourage a movement toward controling ergonomic hazards in the health care workplace and preventing back injuries among the nation's nursing workforce.
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