HEALTH DISPARITIES AMONG HEALTHCARE WORKERS

描述(摘自调查人员摘要) 社会经济地位(阶级、性别和种族)呈负相关 由于各种情况，有发病和死亡的风险。其中一些 不会立即危及生命，但会对与健康相关的 生活质量，影响一个人的身体和社会功能能力 相当大比例的人口。其中包括肌肉骨骼 各种类型的急性伤害(包括有意和无意的)， 以及精神健康状况。这三件事都与 工作场所的环境条件，这本身就显示出明显的 由于普遍存在的职业隔离，造成了社会经济梯度。这个 调查人员建议将工作环境作为主要调解因素进行检查 社会经济地位对人口健康的影响。这项研究将 涉及定量和定性数据的组合，并将支持 背景分析，设置在更广泛的生态和政治理论中 框架。将使用多个数据源来评估作业要素，例如 体力负荷(如重物搬运)、倒班工作、高心理工作 要求加上较低的决策自主权和人际关系的威胁 暴力，以及设施范围的特点，如适当的 人员配备，管理层对职业健康和安全计划的承诺， 和有关性别、种族歧视和性歧视的政策 骚扰。发病率将通过调查工具进行评估，并从 设施缺勤、工伤和疾病记录，以及 赔偿要求。在一系列的三个小组调查中，调查人员 将寻求最大限度地增加回答不止一次的受试者数量，以 允许纵向分析。一项结果子研究将对员工进行抽样 报告基线上的健康问题；有关其 健康和就业状况将在大约两年后寻求。通过 在多个设施和工作小组中进行这项研究， 可以比较特定工作和个人暴露的影响，如 以及不同管理政策和工作场所气候的影响 有可能确定危险的大小和影响 曝光。这项研究将在医疗行业内进行，该行业 雇用了马萨诸塞州很大比例的工作人口(和 在全国范围内)，并且是一个越来越重要的少数族裔工人的雇主。 这些劳动力在社会经济地位(SES)方面有很大的差异， 性别和种族，并暴露于各种已知的健康和安全 工作中的危险。这一设置有望提供足够的 允许进行有意义的检查的多维因素范围 身体和社会/行为风险及其产生的复杂途径 人口健康状况的差异。

DESCRIPTION (Taken from the Investigators' Abstract) Socioeconomic position (class, gender, and ethnicity) is inversely associated with risk of morbidity and mortality due to various conditions. Some of these are not immediately life-threatening but have a major impact on health-related quality of life, affecting the physical and social functional capacity of a substantial proportion of the population. These include musculoskeletal disorders, various types of acute injury (both intentional and unintentional), and mental health conditions. All three of these have been associated with environmental conditions in the workplace, which themselves show a marked socioeconomic gradient because of widespread occupational segregation. The investigators propose to examine the work environment as a primary mediator of the effect of socioeconomic position on population health. The study will involve a combination of quantitative and qualitative data and will support a contextual analysis, set within a broader ecological and political theoretical framework. Multiple data sources will be used to evaluate job features, such as physical load (e.g., heavy lifting), shift work, high psychological job demands coupled with low decision autonomy, and threat of interpersonal violence, as well as facility-wide characteristics such as adequacy of staffing, management commitment to occupational health and safety programs, and policies concerning gender and racial discrimination and sexual harassment. Morbidity will be assessed by survey instrument as well as from facility records of absenteeism, work-related injury and illness, and compensation claims. In a series of three panel surveys, the investigators will seek to maximize the number of subjects responding more than once, to permit longitudinal analysis. An outcomes sub-study will sample employees reporting health problems at baseline; additional information about their health and employment status will be sought about two years later. By conducting the study in multiple facilities and job groups, it will be possible to compare the effects of job- and individual-specific exposures as well as the effect of different management policies and workplace climates that have the potential to determine the magnitude and impact of hazardous exposures. The study will be conducted within the healthcare industry, which employs a large proportion of the working population in Massachusetts (and nationally) and is an increasingly important employer of minority workers. This workforce has substantial variability in socioeconomic status (SES), gender, and ethnicity and is exposed to a variety of known health and safety hazards at work. This setting will hopefully provide an adequate multidimensional range of factors to permit a meaningful examination of physical and social/behavioral risks and the complex pathways that produce disparities in population health status.