UIC experts awarded $7 million grant to improve the health of low-wage workers

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Reviewed by Emily Henderson, B.Sc.Jan 10 2022

Public health experts at the University of Illinois Chicago will continue efforts to improve the health of low-wage workers, thanks to a five-year, $7 million grant from the National Institute for Occupational Safety and Health.

The UIC Center for Healthy Work, which is part of the School of Public Health, was first launched in 2016. The anticipated new funds will support the center, a Center of Excellence for Total Worker Health, and its ongoing projects through 2026 to reduce the health disparities and barriers to health experienced by workers who earn a low wage or who are in other precarious employment circumstances.

Precarious employment refers to work that is poorly paid, unprotected, or insecure and individuals in these circumstances generally do not have the same benefits as those in more secure or permanent positions -; like employer-sponsored health insurance or medical leave. Examples include street vendors, crafters, domestic care providers, and people in temporary or unsafe working conditions, like those in manufacturing and warehouses.

Rates of precarious employment are increasing, and our social structures and policies are lagging behind in providing basic protections for many workers. We hope that through collaborative, participatory action research we can create positive changes that better protect and promote worker health."

Lorraine Conroy, center director and UIC professor of environmental and occupational health sciences

Conroy said that these rates were increasing before the COVID-19 pandemic and workers in precarious employment, who don't have work-from-home flexibility or who have been unable to retain work due to illness or fear of contracting the virus, have experienced significant barriers to health during the pandemic. Lower-income communities have also experienced a disproportionate share of COVID-19 cases and deaths.

UIC Center for Healthy Work researchers have conducted extensive outreach and engaged hundreds of community members from Chicago's Lawndale neighborhood and throughout Illinois in research to understand the nature and prevalence of low-wage and precarious work.

With the renewed funding, center researchers will advance this work with community members and expand efforts to empower workers.

A new project includes collaborating with a large employer to develop and implement a process that uses data to identify the factors that prevent worker well-being -; like social determinants of health or diversity, equity and inclusion factors. The goal is to improve worker health through a method for organizational decision-making that fosters healthy work initiatives as a sustainable business strategy.

The center will also expand collaborations across systems-level partners, like those in public health agencies and worker advocacy groups.

"To make changes that are sustainable, our research needs to be actionable and stakeholders at all levels need to be engaged. There is no ivory tower with answers. Workers need a seat at the table and public health and governmental agencies need to listen. We need better solutions to protect workers, or we will all suffer," said Elizabeth Fisher, deputy director of the center and research specialist at the School of Public Health. "Among the many things COVID-19 has revealed about our society, it has shown us very clearly that worker health is public health. We hope the work of the center will make this issue more visible."

Through research and broad dissemination of data and findings, the UIC team hopes to draw attention to the impact of low-wage and precarious work on health in local communities and provide policymakers with the information needed to drive impactful change. In addition, to make sure that workers know their rights and can find resources.

"So much of what we hear from people is a sense that, whatever the circumstances, they have to take it. That even though they can't sleep, are not treated fairly, or don't have access to affordable care when they get sick, it's better than not having a job," said Ronaldo Favela, research associate and outreach coordinator for the center. "Part of our challenge is that unhealthy work is normalized, by everyone."

"Improving worker health is not about one company offering one or even a few health services. It's about social and political changes that prevent an entire class of workers, a growing class of workers, from being excluded from basic opportunities to maintain or achieve health," Conroy said.

To date, key outputs from UIC Center for Healthy Work researchers include:

Establishment of the Healthy Communities through Healthy Work initiative and the Healthy Work Collaborative, a training series that included public health, health care, labor, government, nonprofit and advocacy organizations. During the events, center researchers helped public health and health care practitioners develop an understanding of precarious work and explore how policy, systems and environmental change initiatives can create pathways to healthier work.

Establishment of the Greater Lawndale Healthy Work Project to identify community-based solutions to promote worker health in the Lawndale and Little Village neighborhoods, which have a higher proportion of employment in low-wage jobs and lower individual and household earnings reported, compared to the rest of Chicago.

Analysis of census and labor data to create a profile of work in the Lawndale area. Analysis revealed that residents of Lawndale are mostly employed in retail trade, health care, and social assistance; residents of Little Village are mainly employed in manufacturing, accommodation and food services, administrative support, and waste management. The researchers also found that 80% of these jobs are in the private sector, more than 20% do not have any health insurance coverage, and the highest level of education for 29% of residents is a high school degree or similar. These findings and others are described in the research brief, "A Systematic Analysis of Census and Labor Data to Create a Community Profile of Work."

Identification of three major areas of concern for residents in the Lawndale area: systematic marginalization from opportunities to access healthy work situations; contextual and structural hostility to sustain healthy work; and violations in the rights, agency, and autonomy of resident workers. These findings are outlined in "Community Resident Perceptions of and Experiences with Precarious Work at the Neighborhood Level: The Greater Lawndale Healthy Work Project," a study published in the International Journal of Environmental Research and Public Health.

Identification of residents' perceptions of healthy and unhealthy work opportunities. Healthy work was described as including flexible work hours, decent wages and supportive co-workers and management. Unhealthy work was described as including systemic inequities and exploitation. Physical and psychological stress was also shown to be pervasive and described as an exposure, outcome, and a cause of unhealthy work. These findings are reported in the American Journal of Industrial Medicine, "Impact of precarious work on neighborhood health: Concept mapping by a community/academic partnership."

Providing critical data analysis support to county officials in advance of a 2019 Boone County Board vote (11-1) to support the county health department's vision of achieving a healthy workforce and ensuring a safe and healthy work environment for its residents.