HEALTH DISPARITIES AMONG HEALTHCARE WORKERS

描述（摘自《研究者摘要》）

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.