Promoting integrated approaches to reducing health inequities among low‐income workers: Applying a social ecological framework

Abstract

Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity. We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations. An example of successful approaches to developing integrated programs in each of these settings is described. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed.

Does workplace health promotion reach shift workers?

“…Workplaces have been suggested as suitable arenas for health promotion with the aim of reaching large groups of individuals with similar needs and opportunities to change their health behavior. However, health behaviors may also be affected by circumstances in the working environment, and health promotion is increasingly being suggested to be an integrated part of occupational health activities (15).…”

“…Previously, it has been argued that irregular working hours and shift work may limit the success (15), feasibility and sustainability (16) of workplace health promotion. Therefore, we suggest a fourth pathway from shift work to poor health, as we posit that workplace interventions aimed at improving the employees' health and health behaviors (ie, workplace health promotion) do not reach shift workers to the same extent as day workers.…”

Workplace health and safety intervention for child care staff: Rationale, design, and baseline results from the CARE cluster randomized control trial

“…First, child care settings offer an important opportunity to provide access to health promotion programs for these low-income workers. Workplace health promotion programs have been identified as an important strategy for addressing disparities in health and chronic disease among low-wage workers [90,91]. Recent calls to action for child care settings to be a part of health promotion efforts for children [92–94] might provide some needed momentum.…”

Recognition of the Relationship Between Patients’ Work and Health

“…These findings point to the need not only for the types of occupational medicine-related Knowledge Resources reported in the accompanying articles and assessed in this study, but also for other forms of collaboration between PCPs and occupational physicians such as those piloted by the Migrant Clinicians Network for farmworkers. 23,24 …”