NIMHD Workshop Explores Effects of Work on Health Disparities
The National Institute on Minority Health and Health Disparities recently hosted a 2-day online workshop—the Role of Work in Health Disparities in the United States—to understand and address the role of work as a social determinant that contributes to health disparities.
The multidisciplinary workshop convened experts from the fields of health disparities, population sciences, labor economics, occupational health, epidemiology and organizational sociology and psychology to consider work as a social determinant and to identify priority research areas, potential mechanisms and interventions to address the role of work in health disparities.
Workshop co-chairs Dr. Rada Dagher, scientific program director in clinical and health services research at NIMHD, and Dr. Nancy Jones, scientific program director in community health and population sciences at NIMHD, took turns leading the meeting.
The first day provided an overview of current knowledge and conceptual grounding of research on work and health disparities, addressing theoretical foundations; concepts, measures, indicators and analytical approaches; and the challenges of operationalizing the concept of work. Day two addressed key mechanisms such as occupational segregation, worksite segregation, life course and intergenerational transmission; and systemic-level influences and pathways.
For U.S. adults, the experience of work is strongly influenced by their social identities, such as race/ethnicity, immigrant status, socioeconomic status, gender, sexual minority status and rural/urban residence. All these factors are associated with health disparities. However, most occupational disparities research to date has focused on hazardous exposures in the workplace. Meanwhile, health disparities research has seldom studied the role of work in explaining health disparities.
Dagher said that studying the contribution of work to health disparities can help tackle a number of disparities underlying current health crises in the United States, such as Covid-19, maternal mortality and opioid use disorders.
NIMHD director Dr. Eliseo Pérez-Stable began the workshop by saying, “We acknowledge that work and occupation are primary social determinants of health. One of the questions I want to see discussed in this workshop is, how does this differ from what we already get from socioeconomic status, race, ethnicity and place?”
Dr. Sarah Burgard of the University of Michigan gave the keynote address, “The State of the Science for Research on Work and Health Disparities.” She explained that work had not been studied as a social determinant of health as much as, for instance, education because it is challenging to measure the effects of work on health across the lifespan; most influences appear over time and can be connected to the complex paths of many different aspects of work.
Prominent epidemiological sociologist Dr. Bruce Link of the University of California, Riverside, presented “The Importance of Work in Fundamental Cause Theory,” in which he discussed how work structures major health-relevant aspects of our lives as a source of flexible resources such as money, knowledge, prestige, power and beneficial social connections, as well as a source of exposures and an important place where racism/discrimination occurs.
Organizers, speakers, and discussants agreed that the workshop was a success, sparking groundbreaking discussion of new approaches and interdisciplinary synergies to the underexplored effects of work on health disparities.
A complete videocast of the workshop is available at https://nimhd.nih.gov/news-events/conferences-events/hd-workshop.html.