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EmploymEnT, woRk, and hEalTh inEqualiTiEs - a global perspective
9
9.1. The need for a poliTical perspecTive
There are a number of problems with the way in which many scientific
studies view and understand the political issues that shape health
policy. Broadly speaking, one of the main problems is a lack of
attention to politics. The result is that the political roots of public
health policy are very often reduced to financial or technical value-free
processes. This approach ignores the influence of political ideology,
beliefs, and values, in addition to the power of governments, unions,
employers, corporations and scientific experts, among other actors
(levenstein & Wooding, 1997; labonte, schrecker, & Gupta, 2005).
These social forces need to be considered in order to understand how
political decision-making creates a balance between minimising the
risk to workers and facilitating the profitability of firms. it turns out
that, very often, meeting the definition of "acceptable risk" does not
necessarily ensure a safe work environment. There are two distinct
reasons for this outcome and both stem from a fundamental
imbalance of power between employers and workers.
first, the distribution of political and economic power between
capital and labour is structurally skewed in favour of the former.
While it is commonly assumed that workers and employers share an
interest and responsibility in maintaining a healthy working
environment, the reality is quite different. in fact, there is a conflict
of interest, because only the employer controls the means of
production (i.e., technology) and at the same time she or he has a
permanent goal of maximizing profit (Muntaner & lynch, 1999;
Muntaner, eaton, diala, Kessler, & sorlie, 1998; Milgate, innes, &
o'loughlin, 2002). This means that, while employers may have a
long-term interest in reducing the economic costs of occupational
diseases and injuries, the immediate investment required can be
high and returns could take years to come in (Walters, 1985). This is
how the distribution of political and economic power has a profound
influence on workplace health and safety in capitalist economies.
This plays out in the administration of firms in two ways. first, at
the whim of the prevailing economic conditions and the need to stay
competitive, important decisions about occupational health, such as
what constitutes a "satisfactory level of worker's health and safety",
are often left to the employers, superceding health professional
assessments. for multinational corporations, this also entails
decisions about where to operate and what kind of standards will apply
in different locations (fustukian, sethi, & Zwi, 2001). Moreover,
employers faced with the choice between an unsafe working
environment and a low level of profit often use economic incentives to
lure workers into dangerous occupations, instead of spending money
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