Our Institute and the Oregon Healthy Workforce Center staff have spent time learning more about the connection between work and social determinants of health, relying on experts both among us and beyond our walls. Social determinants of health, as defined by the World Health Organization (WHO), “are the conditions in which people are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life.”

An important article on this topic was recently published by Brad Wipfli, Ph.D., faculty member of the OHSU/PSU School of Public Health and Principal Investigator with the Oregon Healthy Workforce Center. Appearing in the Journal of Occupational and Environmental Medicine, it is titled Work As a Social Determinant of Health: A Necessary Foundation for Occupational Health and Safety. The publication enriches the ever-growing available literature, and is particularly important reading for those in occupational health and safety. It is important for occupational health and safety professionals to consider the context of social determinants of health in order to impact the systems that affect these inequities.

We encourage you to access and read the entire journal article. Here are a few highlights:

• “Work is a social determinant of health in several ways. Social factors like racism and classism have a huge influence over where a person has the opportunity to work, which creates, maintains, and deepens inequities.

• The workplace also drives health inequities through characteristics like job demands, benefits, compensation, access to healthcare, power/prestige, social networks, exposure to hazards, and more. Occupational risks and benefits interact and accumulate over time.

• The experience of work among U.S. adults is strongly patterned by how identities and individual-level factors including race, ethnicity, immigration status, gender, socioeconomic position, sexual orientation, and more, intersect with structural and social factors. These patterns occur not because identities and positionalities relate to skills or capacities, but because society structures access to opportunity based on them.

• Work is a place in which structures and policies can be modified in ways that reduce health inequities. The ways in which work impacts these inequities should be a foundational consideration in all occupational health and safety research and practice.”

In the article, Dr. Wipfli and co-authors Sara Wild, Dr. Dawn Richardson, and Dr. Leslie Hammer, provide a case study example using data from the Oregon Healthy Workforce Center funded Active Workplace Study. Data were collected among the call workers participating in this study during both the pandemic and severe local and regional wildfires, and, although participants were highly sedentary during this time period, the type and organization of work protected them from harmful effects of smoke (as compared to outdoor workers) and from workplace COVID-19 exposure as they worked from home. Other workers, including higher numbers of Black/African and Hispanic/Latino populations are more likely to work in jobs requiring them to be in-person or work outdoors. These jobs are also less likely to provide health insurance or paid time off. Agricultural workers experienced the impacts of wildfire smoke in distinct and substantial ways.

Dr. Wipfli and team  suggest “using a few equity focused and antiracist approaches to incorporate this framework into occupational health and safety research and practice, including the Racism as a Root Cause approach, intersectional approaches that examine how different identities and personal characteristics form work experiences, using a life course perspective that examines work and health over time, and studying the impact of policies and system-level trends on work and health inequities.”

We thank Dr. Wipfli and his research team and collaborators for sharing this article with us. Learn more about Dr. Wipfli and about the Active Workplace Study.

Other resources from our Institute:
Fall 2020 Symposium recordings: Worker Health: Work as a Social Determinant of Health
Fall 2021 Symposium recordings: Work Life Challenges and Integration in the Context of COVID