Workers are people too: societal aspects of occupational health disparities--an ecosocial perspective.
Workers are people too. What else is new? This seemingly self-evident proposition, however, takes on new meaning when considering the challenging and deeply important issue of occupational health disparities--the topic that is the focus of 12 articles in this special issue of the American Journal of Industrial Medicine. In this commentary, I highlight some of the myriad ways that societal determinants of health intertwine with each and every aspect of occupation-related health inequities, as analyzed from an ecosocial perspective. The engagement extends from basic surveillance to etiologic research, from conceptualization and measurement of variables to analysis and interpretation of data, from causal inference to preventive action, and from the political economy of work to the political economy of health. A basic point is that who is employed (or not) in what kinds of jobs, with what kinds of exposures, what kinds of treatment, and what kinds of job stability, benefits, and pay-as well as what evidence exists about these conditions and what action is taken to address them-depends on societal context. At issue are diverse aspects of people's social location within their societies, in relation to their jointly experienced-and embodied-realities of socioeconomic position, race/ethnicity, nationality, nativity, immigration and citizen status, age, gender, and sexuality, among others. Reviewing the papers' findings, I discuss the scientific and real-world action challenges they pose. Recommendations include better conceptualization and measurement of socioeconomic position and race/ethnicity and also use of the health and human rights framework to further the public health mission of ensuring the conditions that enable people-including workers-to live healthy and dignified lives.
Krieger
Nancy
N
Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts 02115, USA. nkrieger@hsph.harvard.edu
D000062:Accidents, Occupational / Q000517:prevention & control / Q000706:statistics & numerical data; D017753:Ecosystem; D015340:Epidemiologic Research Design; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006806:Human Rights; D006801:Humans; D016272:Occupational Health / Q000706:statistics & numerical data*; D012935:Social Justice; D012959:Socioeconomic Factors