White Paper Descriptions

Paper 1: Work Organization

This paper will address the impact of work organization on occupational health disparities, especially the effects of contingent (also referred to as precarious) work, forced overtime, downsizing, contracting out, and other issues leading to increased job insecurity and job instability. These pressures result in both physical and mental health concerns for workers in general, but may have an even greater impact on those segments of the workforce known to have occupational health disparities. Work organization hazards can include job insecurity, work intensity, lean production, long work hours, job strain, job efforts greater than rewards, social isolation and lack of union representation. The organization of work may also reduce access to such positive or protective job attributes as control, support, respect, schedule flexibility, substantive complexity, and opportunities for promotion and for development of skills.

Paper 2: Workplace Injustice: Discrimination, Abuse, and Harassment

The white paper will present and discuss the state of the evidence for relationships between work-related injustices (including discrimination, bullying, and harassment) and health outcomes. The paper will explore how these relationships may lead to health disparities in different worker groups. Workplace discrimination based on race, national origin, language/accent, gender, age, religion, disability, or sexual orientation, can take many forms, including preferential hiring, firing, or job placement, as well as coworker or supervisor hostility, all of which can cause job stress and chronic physical and mental health problems.

Paper 3: Approaches to Education and Training

Education and training interventions that aim to reduce occupational health disparities face a number of challenges. Structural barriers often discourage worker-initiated action to advocate for improved safety and health conditions in workplaces even when workers have adequate knowledge of risks. Many employers, in particular smaller employers, may lack resources and knowledge to address worker training needs or to implement health and safety measures based on training. Cultural differences also need to be considered in the design and implementation of education and training interventions. The paper will focus on effective and promising solutions to meeting the unique challenges of conducting education and training with populations that experience occupational health disparities.

Paper 4: The Health of the Low-income Workforce: Integrating Public Health and Occupational Health Approaches

Workers' health, and especially low-income workers' health, was among the central concerns of the social reform movement to improve public health in the early 20th century. Today, the work environment is rarely considered in public health research or intervention programs targeting low-income populations. Conversely, few workplace safety and health programs, especially where low-income workers are employed, effectively address the broader range of public health problems impacting workers' health (including smoking, availability of exercise facilities and good nutrition, and preventive health checkups). This paper will examine the barriers, successes, and opportunities for better integrating occupational health concerns into the mainstream public health infrastructure and public health into the mainstream occupational health infrastructure, with a focus on programs that target low-income communities and workplaces.

Paper 5: The Effects of Social, Economic, and Labor Policies on Occupational Health Disparities

Federal, state, and local policies can have important consequences for mitigating or exacerbating Occupational Health Disparities. Labor laws and approaches to enforcement and compliance are perhaps the most obvious types of policies that affect occupational health disparities. In addition to policies that explicitly address workplaces, other social and economic policies can also create conditions for health and safety equity among working populations. For example, access to paid time off, affordable child- or elder-care, and health insurance are examples of employer-based programs that form part of the "social safety net" that helps buffer the social and economic impact of disease and disability on all, but especially on at-risk working populations, their families, and their communities. Macro-level policies such as federal laws on healthcare, immigration, and tax incentives for businesses, can also affect health equity among working populations. This paper will explore the breadth of policies (social, economic, or labor) that influence occupational health disparities, develop case studies focusing on the effects of specific policies on health inequities for workers as well as on small employers or other employer groups that might disproportionately employ at-risk working populations, and offer examples of how policies could be modernized to reflect the realities of today's workforce and the way work is organized.