HEALTH DISPARITIES AMONG HEALTHCARE WORKERS

描述（摘自研究者摘要） 社会经济地位（阶级、性别和种族）与 具有由于各种状况而发病和死亡的风险。 其中一些 不会立即危及生命，但对健康相关的 生活质量，影响身体和社会功能的能力， 占人口的很大一部分。 其中包括肌肉骨骼 疾病，各种类型的急性损伤（有意和无意）， 和心理健康状况。 所有这三个都与 工作场所的环境条件，这些条件本身显示出明显的 社会经济梯度，因为广泛的职业隔离。 的 调查人员建议将工作环境作为主要的调解人， 社会经济地位对人群健康的影响。 这项研究将 涉及定量和定性数据的结合，并将支持 背景分析，设置在一个更广泛的生态和政治理论 框架. 多个数据源将用于评估工作功能，例如 作为物理负载（例如，举重），轮班工作，高心理工作 要求加上低决策自主性，以及人际威胁 暴力，以及设施范围内的特点，如适当的 人员配备、管理层对职业健康和安全计划的承诺， 性别和种族歧视以及性别歧视和 骚扰 将通过调查工具以及 工厂的缺勤、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， 将寻求最大限度地增加不止一次回答的受试者数量， 进行纵向分析。 结果子研究将对员工进行抽样调查， 报告基线时的健康问题;关于其 健康和就业状况将在大约两年后进行调查。 通过 在多个设施和工作组进行研究， 可以比较工作和个人特定暴露的影响， 以及不同的管理政策和工作环境的影响 有可能确定危险的程度和影响的 暴露。 该研究将在医疗保健行业内进行， 雇用了马萨诸塞州大部分的工作人口（和 在全国范围内），是少数民族工人越来越重要的雇主。 这些劳动力在社会经济地位（SES）上有很大的差异， 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 这一设置将有望提供一个充分的 多层面的因素，以允许有意义的审查 身体和社会/行为风险以及产生这些风险的复杂途径 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.