Health Disparities Among Health Care Workers (original) (raw)
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Few if any sectors are as critical to society and as dynamic in the arena of work and employment as health care. From a purely economic perspective, the united states spends more than 9,500perpersonperyearoninsurancepremiums,out−of−pocketcosts,hospitalandphysiciancare,andprescriptiondrugs—9,500 per person per year on insurance premiums, out-of-pocket costs, hospital and physician care, and prescription drugs—9,500perpersonperyearoninsurancepremiums,out−of−pocketcosts,hospitalandphysiciancare,andprescriptiondrugs—3 trillion in 2014—exhausting 17.5% of GDP. Almost half of these costs are borne by federal, state, and local governments, and thus taxpayers, and another 28% falls directly upon American households. Furthermore , despite White House–led health care reform and a shared goal among policymakers to reduce the projected rate of increase in per capita health care spending—that is, to " bend the cost curve " —health care expenditures in the united states are still expected to grow faster than the rest of the economy over the next two decades, further increasing their overall share of GDP and the resulting burden on the economy (cms 2015). Rather alarmingly, this sizeable investment does not seem to drive quality of patient care. The united states spends 50% more per capita on health care than does the next closest country while experiencing above-average rates of medical errors and infant mortality and below-average life expectancies—not to mention the largest uninsured population of any
Occupations and Health Disparities: The National Health Interview Survey 1997-2004 Monograph
The National Health Interview Survey (NHIS) is a multipurpose household survey of the US civilian non-institutionalized population conducted annually since 1957. From 1997From -2004,393 US workers age 18 years and older (representing an estimated 126,637,406 US workers annually) participated in a probability sampling of the entire non-institutionalized US population; variables collected included a range of measures of health disparities.
Effects of Social Economic and Labor Policies on Occupational Health Disparities
Background This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States. Methods We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities. Results Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker’s compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities. Conclusions There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all.
2008
Objective-To examine whether health status and obesity prevalence differ by race or ethnicity and health care workforce category. Methods-Data representing US health care workers aged 20 to 64 between 1982 and 2004 were retrieved from the Integrated Health Interview Series. Trends, as well as disparities, in health status and obesity are examined by workforce category using logistic regression. Results-Self-reported health status of health care workers has declined over time and the prevalence of obesity is rising. Moreover, there is a clear social gradient across workforce categories, which is widening over time. Within workforce categories, there are significant racial disparities in health status and prevalence of obesity. Conclusions-Health of health care workers needs to be taken into account when setting policies intended to increase access to health care and create a healthy diverse workforce. Substantial health disparities have been documented for the general US population, with numerous studies showing racial or ethnic disparities in health status, health behaviors, and mortality. 1-7 Yet there is a dearth of research on health disparities among health care providers. One recent study calculated morbidity rankings for over 200 occupations. The authors found that several of the more prestigious health professions (eg, physicians, dentists, pharmacists) were among the lowest in morbidity ranking, whereas nurse aids and licensed practical nurses were among the 10 highest morbidity rankings. 8 However, little is known about racial disparities in health within the health care workforce. Given the importance of the health care workforce to a healthy population, there may be additional cause for concern if health disparities among health care workers mirror that of the general population. Changes in technology, increasingly complicated disease management, and an aging population have all contributed to a significant growth in the demand for health care services. 9-11 This rapid and persistent rise in the demand for health services has outpaced the supply of health care workers, leading to a significant health care workforce shortage. Moreover, these unfilled positions have resulted in an increase in the current health care workers' workload. For example, Bhargavan and Sunshine 12 found that the average radiologist's annual clinical workload has increased by around 13% from 1995-1996 to
International Journal of Health Services, 2010
Although the conditions and power relations of employment are known to be crucial health determinants for workers and their families, the nature of these relations and their effects on health have yet to be fully researched. Several types of employment-precarious employment in developed countries; informal sectors, child labor, slavery, and bonded labor in developing countries-expose workers to risky working conditions. Hazardous work and occupation-related diseases kill approximately 1,500 workers, globally, every day. Growing scientific evidence suggests that particular employment conditions, such as job insecurity and precarious employment, create adverse health effects; yet the limited number of studies and the poor quality of their methods prevent our understanding, globally, the complexity of employeremployee power relations, working conditions, levels of social protections, and the reality of employment-related health inequalities. This article introduces a special section on employment-related health inequalities, derived from the EMCONET approach, which focuses on (1) describing major methods and sources of information; (2) presenting theoretical models at the micro and macro levels; (3) presenting a typology of labor markets and welfare states worldwide; (4) describing the main findings in employment policies, including four key points for implementing strategies; and (5) suggesting new research developments, a policy agenda, and recommendations. This introduction includes a glossary of terms in the emerging area of employment conditions and health inequalities.
Health Equity and a Paradigm Shift in Occupational Safety and Health
International Journal of Environmental Research and Public Health, 2021
Despite significant improvements in occupational safety and health (OSH) over the past 50 years, there remain persistent inequities in the burden of injuries and illnesses. In this commentary, the authors assert that addressing these inequities, along with challenges associated with the fundamental reorganization of work, will require a more holistic approach that accounts for the social contexts within which occupational injuries and illnesses occur. A biopsychosocial approach explores the dynamic, multidirectional interactions between biological phenomena, psychological factors, and social contexts, and can be a tool for both deeper understanding of the social determinants of health and advancing health equity. This commentary suggests that reducing inequities will require OSH to adopt the biopsychosocial paradigm. Practices in at least three key areas will need to adopt this shift. Research that explicitly examines occupational health inequities should do more to elucidate the ef...
Occupational health disparities: Improving the well-being of ethnic and racial minority workers
Occupational health disparities: Improving the well-being of ethnic and racial minority workers., 2017
For several decades, the National Institute for Occupational Safety and Health (NIOSH) has recognized that some workers groups have suffered disproportionate rates of disease, injury, and fatality compared with the population in general. NIOSH prioritized research investigating the causes, impacts, and possible solutions to these disparities in its National Occupational Research Agenda (NORA). The populations most frequently studied were women workers, aging workers, young workers, and workers from particular racial/ethnic backgrounds. These research efforts yielded a wealth of descriptive information about the individual groups studied. However, it became clear that general methodological approaches for successfully conducting intervention research with majority populations were not well suited to working with many racial/ ethnic minority groups. Traditional methodological approaches were particularly ineffective with Latino immigrant workers as they did not account for INTROduCTION
An Approach to Studying Social Disparities in Health and Health Care
American Journal of Public Health, 2004
Objective. We explored methods and potential applications of a systematic approach to studying and monitoring social disparities in health and health care. Methods. Using delayed or no prenatal care as an example indicator, we (1) categorized women into groups with different levels of underlying social advantage; (2) described and graphically displayed rates of the indicator and relative group size for each social group; (3) identified and measured disparities, calculating relative risks and rate differences to compare each group with its a priori most-advantaged counterpart; (4) examined changes in rates and disparities over time; and (5) conducted multivariate analyses for the overall sample and "atrisk" groups to identify particular factors warranting attention. Results. We identified at-risk groups and relevant factors and suggest ways to direct efforts for reducing prenatal care disparities. Conclusions. This systematic approach should be useful for studying and monitoring disparities in other indicators of health and health care.
PsycEXTRA Dataset, 2013
The current paper aims to advance research on occupational health disparities among racial and ethnic minorities. We review the historical context and development of the field of occupational health disparities, and review a diverse set of national research frameworks. Our work is based on the Diversified Portfolio Model (DPM) of adaptability (Chandra and Leong 2016) which maintains that diversification promotes greater adaptability. Since diversification bestows adaptive advantages in multiple arenas of human endeavor, we proposed that an analysis of diverse theoretical models for studying occupational health disparities would also benefit the field of Occupational Health Science. The theoretical frameworks reviewed include: (a) The National Institute of Aging's (NIA) health disparities framework, (b) An Epidemiological Framework, (c) The Transformation for Health Framework, and (d) The Cultural Adaptations Framework. We summarize lessons and highlight the need for incorporating change perspectives, prevention-oriented approaches, and mixed-methods approaches to address occupational health disparities. Keywords Occupational health disparities. Racial and ethnic minorities. Diversified Portfolio Model Racial and ethnic minority groups have a disproportionate share of disease, disability, and premature death compared to the general population (Leong et al. 2017). Such disparate impact has been observed across different fields ranging from health to education and various explanations for these effects have been posited (