Labor Day and Public Health

Abstract

The cover image of farmworkers walking a picket line in Watsonville, Calif, in 1997 marks Labor Day and worker health. Workers and their families constitute the overwhelming majority of the public. Research classifications based on gender, race/ethnicity, country of origin, or sexual orientation usually contain a predominance of workers in each group. Egregious disparities in health are evident between those who own businesses and those who work for wages, with little or no control over the conditions under which they labor. Most of the members of this association and the readers of this journal are themselves public health workers and health care providers. Public health research, policy, practice, and education devoted to workers and their families belong in the Journal, and a broad discussion of worker health is warranted. Public health and worker safety share historical roots. This month's Images of Health, titled “Night Shift in a Glass Factory,” depicts child exploitation nearly a century ago. Socialists, labor leaders, Progressive reformers, and public health workers joined together to address “the bitter cry of the children.” Strong alliances among groups such as these are needed today. Bernardini Ramazzini's classic text Diseases of Workers was published in 1700. The excerpt reprinted here underscores the fact that certain links between working conditions and poor health have been known for quite some time. Such is the case with repetitive tasks and stress injuries. Years of effort and struggle to arrive collectively at needed workplace safeguards were obliterated in March 2001 when the US Congress and the Bush administration voted to undo the Occupational Safety and Health Administration's landmark ergonomics standards. Political will is needed to repair this damage and protect the health of large numbers of workers. Workers' health goes beyond occupational health. Rajiv Bhatia and Michael Katz demonstrate that better wages equals better health in their article, “Estimation of Health Benefits From a Local Living Wage Ordinance.” Earlier this year, students at Harvard University aligned with campus unions and staged a 21-day sit-in to demand a living wage of at least $10 an hour for all university employees. Collective action is effective in bringing attention to labor concerns. The largest public health programs in the United States, Medicare and Medicaid, were initiated through the political pressure of organized labor. Trade unions have historically defined the most pressing health concerns of workers. They are also effective partners in ensuring essential health coverage and programs, as Elizabeth Barbeau and her colleagues found (see “Coverage of Smoking Cessation Treatment by Union Health and Welfare Funds”). The farmworkers featured on the cover won, on March 22, 2001, their 4-year struggle to be represented by the United Farmworkers Union. In doing so, they gained wage increases, paid holidays, job security, life insurance, a seniority system, a grievance procedure, and a company-paid medical and dental plan. The medical and dental plan covers not only the farmworkers themselves, but their families as well, both in the United States and in Mexico. Improving the health of workers also advances the health of the majority of the public.