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Siqueira CE, Gaydos M, Monforton C, Slatin C, Borkowski L, Dooley P, Liebman A, Rosenberg E, Shor G, Keifer M. Effects of social, economic, and labor policies on occupational health disparities. Am J Ind Med 2014; 57:557-72. [PMID: 23606055 DOI: 10.1002/ajim.22186] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2013] [Indexed: 11/10/2022]
Abstract
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.
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Affiliation(s)
- Carlos Eduardo Siqueira
- Mauricio Gastón Institute of Latino Community Development and Public Policy; University of Massachusetts; Boston Massachusetts
| | - Megan Gaydos
- Program on Health, Equity, and Sustainability; San Francisco Department of Public Health; San Francisco California
| | - Celeste Monforton
- Department of Environmental and Occupational Health, School of Public Health and Health Services; George Washington University; Washington District of Columbia
| | - Craig Slatin
- Department of Community Health and Sustainability; University of Massachusetts; Lowell Lowell Massachusetts
| | - Liz Borkowski
- Department of Environmental and Occupational Health, School of Public Health and Health Services; George Washington University; Washington District of Columbia
| | - Peter Dooley
- LaborSafe Health and Safety Consulting; Dexter Michigan
| | - Amy Liebman
- Migrant Clinicians Network; Salisbury Maryland
| | | | - Glenn Shor
- UC Berkeley School of Public Health, Center for Occupational and Environmental Health, Safe Transportation Research and Education Center (SafeTREC); University of California; Berkeley Berkeley, California
| | - Matthew Keifer
- National Farm Medicine Center, Dean Emanuel Endowed Chair and Director; Marshfield Clinic Research Foundation; Marshfield Wisconsin
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Panikkar B, Woodin MA, Brugge D, Hyatt R, Gute DM. Characterizing the low wage immigrant workforce: a comparative analysis of the health disparities among selected occupations in Somerville, Massachusetts. Am J Ind Med 2014; 57:516-26. [PMID: 23840014 DOI: 10.1002/ajim.22181] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study estimates job-related risks among common low wage occupations (cleaning, construction, food service, cashier/baggers, and factory workers) held by predominantly Haitian, El Salvadorian, and Brazilian immigrants living or working in Somerville, Massachusetts. METHODS A community-based cross-sectional survey on immigrant occupational health was conducted between 2006 and 2009 and logistic regression was used to assess the job-related risks among the most common low wage occupations. RESULTS Construction workers reported significantly higher health risks, and lower access to occupational health services than the other occupations. Compared to cashier/baggers, the reference population in this study, cleaners reported significantly lower access to health and safety and work training and no knowledge of workers' compensation. Factory workers reported significantly lower work training compared to cashier/baggers. Food service workers reported the least access to doctors compared to the other occupations. CONCLUSION We found significant variability in risks among different low wage immigrant occupations. The type of occupation independently contributed to varying levels of risks among these jobs. We believe our findings to be conservative and recommend additional inquiry aimed at assuring the representativeness of our findings.
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Affiliation(s)
- Bindu Panikkar
- Department of Civil and Environmental Engineering; Tufts University; Medford Massachusetts
| | - Mark A. Woodin
- Department of Civil and Environmental Engineering; Tufts University; Medford Massachusetts
| | - Doug Brugge
- Department of Public Health and Community Medicine; Tufts University; Boston Massachusetts
| | - Raymond Hyatt
- Department of Public Health and Community Medicine; Tufts University; Boston Massachusetts
| | - David M. Gute
- Department of Civil and Environmental Engineering; Tufts University; Medford Massachusetts
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Liebman AK, Wiggins MF, Fraser C, Levin J, Sidebottom J, Arcury TA. Occupational health policy and immigrant workers in the agriculture, forestry, and fishing sector. Am J Ind Med 2013; 56:975-84. [PMID: 23606108 DOI: 10.1002/ajim.22190] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND Immigrant workers make up an important portion of the hired workforce in the Agricultural, Forestry and Fishing (AgFF) sector, one of the most hazardous industry sectors in the US. Despite the inherent dangers associated with this sector, worker protection is limited. METHODS This article describes the current occupational health and safety policies and regulatory standards in the AgFF sector and underscores the regulatory exceptions and limitations in worker protections. Immigration policies and their effects on worker health and safety are also discussed. Emphasis is placed on policies and practices in the Southeastern US. RESULTS Worker protection in the AgFF sector is limited. Regulatory protections are generally weaker than other industrial sectors and enforcement of existing regulations is woefully inadequate. The vulnerability of the AgFF workforce is magnified by worker immigration status. Agricultural workers in particular are affected by a long history of "exceptionalism" under the law as many regulatory protections specifically exclude this workforce. CONCLUSIONS A vulnerable workforce and high-hazard industries require regulatory protections that, at a minimum, are provided to workers in other industries. A systematic policy approach to strengthen occupational safety and health in the AgFF sector must address both immigration policy and worker protection regulations.
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Affiliation(s)
- Amy K. Liebman
- Migrant Clinicians Network - Maryland Office; Quantico, Maryland
| | | | | | - Jeffrey Levin
- The University of Texas Health Science Center at Tyler; Tyler, Texas
| | - Jill Sidebottom
- Mountain Conifer Integrated Pest Management; North Carolina State University; Mills River, North Carolina
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Panikkar B, Woodin MA, Brugge D, Desmarais AM, Hyatt R, Goldman R, Pirie A, Goldstein-Gelb M, Galvão H, Chianelli M, Vasquez I, McWhinney M, Dalembert F, Gute DM. Occupational health and safety experiences among self-identified immigrant workers living or working in Somerville, MA by ethnicity, years in the US, and English proficiency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:4452-69. [PMID: 23222180 PMCID: PMC3546771 DOI: 10.3390/ijerph9124452] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 11/13/2012] [Accepted: 11/23/2012] [Indexed: 11/16/2022]
Abstract
In this community based research initiative, we employed a survey instrument predominately developed and administered by Teen Educators to assess occupational health risks for Haitian, Salvadoran, and Brazilian immigrants (n = 405) in Somerville, MA, USA. We demonstrate that a combined analysis of ethnicity, years in the US, and English proficiency better characterized the occupational experience of immigrant workers than considering these variables individually. While years in the US (negatively) and English proficiency (positively) explained the occurrence of health risks, the country of origin identified the most vulnerable populations in the community. Brazilians, Salvadorans, and other Hispanic, all of whom who have been in the US varying length of time, with varying proficiency in English language had twice the odds of reporting injuries due to work compared to other immigrants. Although this observation was not significant it indicates that years in the US and English proficiency alone do not predict health risks among this population. We recommend the initiation of larger studies employing c community based participatory research methods to confirm these differences and to further explore work and health issues of immigrant populations. This study is one of the small number of research efforts to utilize a contemporaneous assessment of occupational health problems in three distinct immigrant populations at the community level within a specific Environmental Justice context and social milieu.
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Affiliation(s)
- Bindu Panikkar
- Department of Civil and Environmental Engineering, Tufts University, Medford, MA 02155, USA; E-Mails: (M.A.W.); (A.M.D.); (D.M.G.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-617-776-3153; Fax: +1-617-627-3994
| | - Mark A. Woodin
- Department of Civil and Environmental Engineering, Tufts University, Medford, MA 02155, USA; E-Mails: (M.A.W.); (A.M.D.); (D.M.G.)
- Department of Public Health and Community Medicine, Tufts University, Boston, MA 02111, USA; E-Mails: (D.B.); (R.H.)
| | - Doug Brugge
- Department of Public Health and Community Medicine, Tufts University, Boston, MA 02111, USA; E-Mails: (D.B.); (R.H.)
| | - Anne Marie Desmarais
- Department of Civil and Environmental Engineering, Tufts University, Medford, MA 02155, USA; E-Mails: (M.A.W.); (A.M.D.); (D.M.G.)
| | - Raymond Hyatt
- Department of Public Health and Community Medicine, Tufts University, Boston, MA 02111, USA; E-Mails: (D.B.); (R.H.)
| | - Rose Goldman
- Cambridge Health Alliance, Cambridge, MA 02139, USA; E-Mail:
| | - Alex Pirie
- Immigrant Service Providers Group/Health, Somerville, MA 02143, USA; E-Mail:
| | - Marcy Goldstein-Gelb
- Massachusetts Coalition for Occupational Safety and Health, Dorchester, MA 02122, USA; E-Mail:
| | - Heloisa Galvão
- 697 Cambridge St. Suite 106 Brighton, MA 02135, USA; E-Mails: (H.G.); (M.C.)
| | - Monica Chianelli
- 697 Cambridge St. Suite 106 Brighton, MA 02135, USA; E-Mails: (H.G.); (M.C.)
| | - Ismael Vasquez
- Community Action Agency of Somerville, Somerville, MA 02143, USA; E-Mails: (I.V.); (M.M.)
| | - Melissa McWhinney
- Community Action Agency of Somerville, Somerville, MA 02143, USA; E-Mails: (I.V.); (M.M.)
| | | | - David M. Gute
- Department of Civil and Environmental Engineering, Tufts University, Medford, MA 02155, USA; E-Mails: (M.A.W.); (A.M.D.); (D.M.G.)
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Garcia D, Hopewell J, Liebman AK, Mountain K. The Migrant Clinicians Network: Connecting Practice to Need and Patients to Care. J Agromedicine 2012; 17:5-14. [DOI: 10.1080/1059924x.2012.632746] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Liebman AK, Augustave W. Agricultural health and safety: incorporating the worker perspective. J Agromedicine 2011; 15:192-9. [PMID: 20665305 DOI: 10.1080/1059924x.2010.486333] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This commentary offers a worker's perspective on agricultural health and safety and describes (1) the historical exemption of agriculture from regulatory oversight and barriers encountered due to lack of regulations and poor enforcement of the existing standards; (2) the effect of immigration status on worker protections; and (3) the basic desire for economic survival and how this impacts worker health and safety. The commentary describes two models to reduce hazards at work that illustrate how workers' perspectives can be incorporated successfully at the policy level and during the intervention development process and puts forth recommendations for employers, researchers, and funding agencies to facilitate the integration of workers' perspectives into occupational health and safety in agriculture. Ultimately, improved worker protection requires systemic policy and regulatory changes as well as strong enforcement of existing regulations. This commentary summarizes the presentation, "Ground View: Perspectives of Hired Workers," at the Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, "Be Safe, Be Profitable: Protecting Workers in Agriculture," January 27-28, 2010, Dallas/Fort Worth, Texas.
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Affiliation(s)
- Amy K Liebman
- Environmental and Occupational Health, Migrant Clinicians Network, Austin, Texas, USA.
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Bonauto DK, Smith CK, Adams DA, Fan ZJ, Silverstein BA, Foley MP. Language preference and non-traumatic low back disorders in Washington State workers' compensation. Am J Ind Med 2010; 53:204-15. [PMID: 19722197 DOI: 10.1002/ajim.20740] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Workers in the United States with limited English proficiency likely perform more hazardous work, experience higher rates of work-related injury and illness, and have worse disability outcomes. METHODS We conducted a descriptive study of employment characteristics, timeliness and utilization of workers' compensation (WC) insurance benefits, cost and occupational health outcomes for Washington State WC state fund, non-traumatic low back disorders (LBD) claimants by language preference. RESULTS A greater proportion of Spanish language preferring (SLP) LBD claims filed were accepted and resulted in lost work time than English language preferring (ELP) LBD claims. There were significant differences in the demographic, employment, and occupational characteristics between the SLP and ELP compensable claimant populations. The SLP LBD compensable claimants had greater time loss duration, greater medical and total claim costs, more use of physical therapy and vocational services than the ELP LBD compensable claimants. With the exception of the timeliness for providing the first time loss payment, the time periods for provision of insurance benefits did not differ between the SLP and ELP populations. SLP compensable claimants received less back surgery and had comparable permanent partial disability payments to the ELP population. Employers were more likely to protest the acceptance of a SLP compensable than one in an ELP LBD compensable claim. CONCLUSION For those injured workers accessing the Washington State WC system, we observed differences based on language preference for pre-injury, and workers compensation outcomes. Further research is needed to explain the observed differences.
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Affiliation(s)
- David K Bonauto
- Safety and Health Assessment and Research for Prevention Program, Washington State Department of Labor & Industries, Olympia, Washington 98504-4330, USA.
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Acosta MSV, Sechrest L, Chen MK. Farmworkers at the border: a bilingual initiative for occupational health and safety. Public Health Rep 2009; 124 Suppl 1:143-51. [PMID: 19618816 DOI: 10.1177/00333549091244s116] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Bilingual and bicultural occupational health and safety interventions for Hispanic farmworkers are extremely rare and, because of language barriers and cultural differences, issues important to their health and safety on the job remain unaddressed. We designed, conducted, and assessed the first bilingual occupational health and safety education program for farmworkers attending High School Equivalency Programs (HEPs). METHODS We took an interdisciplinary participatory approach by integrating educators and researchers with a community advisory board to guide development, evaluation, and implementation of Work Safely-Trabaje con Cuidado Curriculum (Curriculum), a bilingual occupational health and safety curriculum. We created a quasi-experimental design using mixed-method evaluation (quantitative and qualitative elements) via pre- and posttest comparisons, follow-up surveys, and focus groups assessing the Curriculum effect on knowledge, safety risk perception (SRP), and safety behavior. Focus groups and follow-up surveys reflected success and acceptance of the Curriculum among participating farmworkers under the study's logic model. RESULTS Completion of the Curriculum resulted in statistically significant improvements in the combined score of knowledge and SRP at the posttest (p = 0.001) and follow-up survey (p = 0.02) in the intervention group. After completing this study, the Curriculum was permanently adopted by the two high school equivalency sites involved. CONCLUSION The participatory approach resulted in integration of community and applied research partnership. The potential to expand use of this Curriculum by other HEP sites can further assess effectiveness and external validity among underserved minority groups.
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Affiliation(s)
- Martha Soledad Vela Acosta
- Division of Occupational and Environmental Health Sciences, University of Texas-Houston, School of Public Health at Brownsville, Brownsville, TX, USA.
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