Bad Jobs, Bad Health? How Work and Working Conditions Contribute to Health Disparities

Our plain-English summary of Bad Jobs, Bad Health? How Work and Working Conditions Contribute to Health Disparities, by S.A. Burgard, K.Y. Lin (The American Behavioral Scientist, 2013).

The study

• Authors: S.A. Burgard, K.Y. Lin
• Journal: The American Behavioral Scientist
• Published: 2013;57(8)
• Cited by: 191 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

In this review, we touch on a broad array of ways that work is linked to health and health disparities for individuals and societies. First focusing on the health of individuals, we discuss the health differences between those who do and do not work for pay, and review key positive and negative exposures that can generate health disparities among the employed. These include both psychosocial factors like the benefits of a high status job or the burden of perceived job insecurity, as well as physical exposures to dangerous working conditions like asbestos or rotating shift work. We also provide a discussion of the ways differential exposure to these aspects of work contributes to social disparities in health within and across generations. Analytic complexities in assessing the link between work and health for individuals, such as health selection, are also discussed. We then touch on several contextual level associations between work and the health of populations, discussing the importance of the occupational structure in a given society, the policy environment that prevails there, and the oscillations of the macroeconomy for generating societal disparities in health. We close with a discussion of four areas and associated recommendations that draw on this corpus of knowledge but would push the research on work, health and inequality toward even greater scholarly and policy relevance.

In plain English

This article was a narrative review, not a new study. It reviewed published research, mainly on paid work by adults in postindustrial economies, about how work and working conditions are linked to health and to health differences between social groups. The authors discussed health differences between people who do and do not work for pay. They also covered psychosocial stressors such as job strain and job insecurity, and physical hazards such as crystalline silica, asbestos and rotating shift work. Asbestos came up only briefly. The authors cited one earlier study (Yano and colleagues, 2001, whose title refers to chrysotile asbestos) for the statement that asbestos exposure increases the risk of lung cancer. They also described asbestos exposure as an objectively measurable risk factor. The review presented no new data on asbestos. It also discussed health selection, unequal exposure to dangerous work across social groups, and how occupational structure, policy and the economy relate to population health. The authors closed with four suggestions for future research. They noted that they gave only minimal attention to informal or unpaid work.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of published research on work, working conditions and health disparities; no new data were collected
• Who was studied: Published studies, mainly of adults doing paid work (wages or salary) in postindustrial economies; informal, inconsistent or unpaid work received only minimal attention
• Exposure: A broad range of work-related factors: employment versus non-employment, occupational status, psychosocial stressors (job strain, job insecurity, work-family spillover), and physical hazards including crystalline silica, asbestos, noise, repetitive work and rotating or nonstandard shift work
• Main results:
  • The review cited an earlier study (Yano et al., 2001) for the statement that asbestos exposure increases the risk of lung cancer. This is another study's finding, not new data from this review.
  • In the reference list, the title of the cited Yano et al. (2001) study refers to cancer mortality among workers exposed to amphibole-free chrysotile asbestos.
  • The authors contrasted psychosocial stressors, which depend on workers' own reports, with objectively measurable risk factors such as asbestos exposure.
  • The review summarized prior research showing that people who do not work for pay or are unemployed are less healthy than those in the paid labor force.
  • The review summarized prior evidence that less advantaged workers are more likely to be exposed to physically dangerous work.
  • The authors discussed 'health selection', in which existing health shapes a person's work, as an alternative explanation for links between work and health.
• The authors' conclusion: The authors closed with four suggestions for future research: better measurement of working conditions (including examining more than one condition at a time), multilevel studies, comparisons across societies and over time, and learning from good jobs and workplaces. They noted that occupational epidemiology tends to focus on measuring a single type of exposure, such as asbestos.
• Limitations the authors state:
  • The authors stated that the review gave only minimal attention to workers whose labor is informal, inconsistent or unpaid.

Related studies

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• A narrative review of the health disparities associated with malignant pleural mesothelioma — D.C. Freudenberger, R.D. Shah (2021)
• Health effects of working in pulp and paper mills: malignant diseases — K. Torén, B. Persson, et al. (1996)
• Working with asbestos and the possible health risks — D. Sen (2015)
• Evaluation of asbestos exposure in the working environment. Recommendation of subcommittee on asbestosis of the permanent commission and international association on occupational health — (1972)
• Environmental pollution and extreme weather conditions: insights into the effect on mental health — M. Tota, J. Karska, et al. (2024)

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