Global Inequalities at Work: Work's Impact on the Health of Individuals, Families, and Societies - Hardcover

Jody Heymann

Hardcover

ISBN 10: 0195150864 ISBN 13: 9780195150865

Publisher: Oxford University Press, 2003

Synopsis

A map of the relationship between work and health that is truly global--both geographically and in its coverage of the impact of work on the health of individuals, families, and societies, has not previously been drawn. Global Inequalities at Work is the first book to fill in the map. Drawing from studies done around the world, it critically examines the many ways in which work is affecting health around the world. The first section covers the wide range of risks--physical, chemical, and social--tot he health of employees in agricultural, industrial, and post-industrial workplaces. Part II provides a detailed analysis of how working conditions can dramatically influence the health and welfare of family members--including children, elderly parents, and the disabled--in both the developing and industrial world. Part III examines the relationships between work and health at the societal level by focusing on two examples: the ways in which working conditions affect income inequalities and health, and the ways in which working conditions influence gender inequalities and health. Part IV investigates the new challenges to and opportunities for improving the relationship between work and health that are presented by a rapidly globalizing economy.
Global Inequalities at Work addresses these issues at a time when globalization is both markedly changing the impact of work on the health of individuals, families, and societies, and radically revising what can be done about it. Leaders from universities, international organizations, and nongovernmental organizations bring to this edited volume expertise from six continents.

About this title

About the Author

Jody Heymann is at Harvard Medical School.

From The New England Journal of Medicine

The global workplace is rapidly evolving. In formerly "developing" but now highly industrialized countries, migration from rural to urban areas and employment in burgeoning industrial zones are fragmenting social networks. Though the settings vary widely, most of the sources of stress are familiar to us all: loss of extended-family supports, double duty for mothers, inadequate child-care options, and conflicts between meeting job responsibilities and caring for frail parents. Less familiar is the issue of child labor on a massive scale. The effect of these factors is magnified in countries in which wages are much lower and choices are fewer than they are in postindustrial societies. (Figure) As they review the effects of work on health, the book's 27 authors (from five continents) look beyond toxic and ergonomic hazards to examine infant health, nutrition, child development, and elder care. Changes in the workplace are influenced not only by local employers but also by government policies that encourage foreign investment -- a move that gives international companies substantial autonomy within the host nation. Although employment can have broad health benefits for individual workers and their families, we are shown how poor working conditions can endanger both health and welfare in a multitude of ways. Editor Jody Heymann gives the example of Laura, the widowed working mother of a toddler. Laura works 15-hour shifts, seven days per week, in a foreign-owned factory and with her $13 weekly wage cannot afford child care. She must choose between asking her 10-year-old niece to drop out of school to care for her toddler and (as many of her neighbors do) leaving the child alone at home. In this book, social scientists, economists, and health experts from international nongovernmental organizations and universities review a large and growing literature of empirical research on the relationship between the workplace and health. To explain broad patterns, they often draw on econometrics and epidemiology. An x-y plot shows, for example, how a small increase in income markedly improves life expectancy for workers at the lowest income levels, an effect that reaches an asymptote at the highest income levels. This graph dramatically demonstrates how a fixed number of dollars provides a greater health benefit to the poor than it does to the rich. Similarly, though women's wages are usually lower than men's, an increase in the wages of a working mother has greater health benefits for her children than does the same increase in the wages of a working father. Another analysis shows that the lack of facilities for expressing and storing breast milk in the workplace leads to early termination of nursing. Many of the countries included in this analysis are those in which, because of the poor quality of drinking water, the health benefits of breast-feeding are greatest. The authors illustrate these broad trends with their own regionally based research. In 70 countries, industrial zones have been created near national borders for the processing of exports in order to reduce manufacturing costs. The breaking down of barriers to foreign investment can force poor countries into a "race to the bottom" as they compete for jobs by accepting the lowest wages. At the same time, foreign ownership of some of these industries offers the opportunity to introduce better labor and occupational health standards than those of the host country. The analysis of maquiladoras (factories) in northern Mexico illustrates some of these tensions. Maquiladoras employ a high proportion of women whose only other option may be labor in agriculture. In many cases the maquiladoras provide training in workplace health and safety. But women in these factories may have lower wages, higher rates of exposure to toxic materials, and more musculoskeletal problems, and they may bear infants with lower birth weights than women who do not work in the maquiladoras. With their research-based perspectives from many parts of the world, the authors also introduce us to important international events. The slow integration of Iranian women into the workplace was largely erased after the 1979 revolution by government policies that discouraged women from working in formal employment settings and restricted them to home-based and agricultural labor, a condition that is linked to poorer health status. This trend has been reversed to some degree with the liberalization of these policies since 1990. The book's two concluding chapters predict that instituting a system of uniform international labor standards will have beneficial effects in improving health status at the many levels discussed throughout the book. If standards are uniformly enforced in all countries, the authors write, companies will be unable to gain a competitive advantage by investing in countries with lax labor standards. Such a system could prevent the "race to the bottom." These proposed solutions to global inequalities at work should be of great interest to international health planners and to managers of businesses in industrializing nations. William S. Beckett, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About this edition

• Publisher: Oxford University Press
• Publication date: 2003
• ISBN 10: 0195150864
• ISBN 13: 9780195150865
• Binding: Hardcover
• Edition number: 1
• Number of pages: 368