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policies and interventions Figure 26. policy entry points in the micro-theoretical framework.. eMployMenT Employment Conditions - Full-time Permanent Employment - Unemployment - Precarious Employment - Informal Employment - Child Labour - Slavery and Bonded Labour b WorK orGanisaTion Working conditions Exposures, Hazards and Risk Factors: - Physical - Chemical - Biological - Ergonomic - Psychosocial Material Deprivation and Economic Inequalities c Health-related Behaviours Health-related Outcomes Physio-pathological Changes c Health Inequalities D Health Systems policy entry point a refers to any change in the power relations between the main political and economic actors in society. political power is understood here, in a broad sense, as not limited to traditional political actors (such as political parties) but also including any actor essential to the understanding of a country’s social context. for example, in contemporary societies, political actors include political parties, trade unions, corporations, transnational companies, banks, employer associations, and civil society organisations. policy entry point B refers specifically to modifications of employment conditions which reduce exposure and vulnerability to health-damaging factors. These policy initiatives could include, for example, regulating temporary work to promote safety and health in the workplace and during working hours. policy entry point C relates to actions modifying working conditions, such as health-related material hazards in the workplace, behaviour changes and psychosocial factors present in the workplace or living situation. policy entry point d relates to different types of interventions which may reduce the unequal social consequences produced by poor health and psychopathological change. Social and Family Networks modEl oF dynamiC liFE-CouRsE inTERaCTions country / regional / locally influenced by social class, gender, ethnicity, age, migrant status source: prepared by the authors demonstration by informal sector workers through the streets of managua (nicaragua). source: antonio rosa (2004) 307
EmploymEnT, woRk, and hEalTh inEqualiTiEs - a global perspective These points of entry illustrate the variety of ways of implementing policies targeting health inequalities related to employment conditions. The prevailing policy emphasis, however, does not address the broader social issues that create pervasive patterns of health inequality. instead of targeting welfare state provisions, most health policy, in accordance with neo-liberal recommendations, pertains to the workplace, which does not influence the wider problem of a lack of worker protection (lynn skillen, 1996). These usually ineffective policy frameworks fol<strong>low</strong> three perspectives. first, from the biomedical perspective, the “lifestyle approach” converts the social problems of work into private, individual problems. second, the environmental European demonstration organized by the perspective emphasises acceptable exposure limits for European Trade union Confederation in biological, chemical, ergonomic and physical hazards. This Barcelona (spain). ignores psychosocial hazards and the organisational context source: antonio rosa (2002) (addley, 1999). a third perspective, the classic epidemiological approach, emphasises the surveillance of hazard outcomes (diseases and injuries) but not surveillance of the organisational factors underlying exposure to hazards. The problem is that none of these three perspectives consider how power differentials determine hazardous exposures and worker vulnerability, how workers’ consent to exposure is negotiated or how the labour force is segmented by gender, class, or race, thus ignoring institutional factors (e.g., weakened regulatory processes and public policy). Many of the same limitations apply to micro-credit schemes and the voluntarist notions of corporate social responsibility that are promoted to improve health in poor countries. These perspectives only partially respond to changes in society at large. To address this shortcoming, we provide an outline with examples of the policy entry points that we have identified according to our theoretical framework. in this framework the greatest emphasis is on structural policies and interventions. These are public health interventions that promote health by altering the structural context within which health and health inequities are produced and reproduced (Blankenship, friedman, dworkin, & Mantell, 2006). They are more effective because they are related to the production and reproduction of hazards from employment and working conditions, tackling the systemic problem rather than individual cases. 308
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EmploymEnt, Work and HEaltH InEqual
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CORE GROUP* Carlos H. Alvarado, Fra
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EMplOyMENt, wOrk, aNd hEalth iNEQua
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EMploYMEnt, work, And hEAlth inEquA
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A Bozo fisherman at the break of da
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A group of women carrying cotton af
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the adobe house construction has be
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Labour markets and welfare states:
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labour Markets and welfare states:
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Employment relations and health ine
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Epilogue: the economic crisis 10
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epilogue: the econoMic crisis this
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epilogue: the econoMic crisis all o
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epilogue: the econoMic crisis and t
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epilogue: the econoMic crisis group
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epilogue: the econoMic crisis Case
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epilogue: the econoMic crisis group
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epilogue: the econoMic crisis feedi
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epilogue: the econoMic crisis short
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epilogue: the econoMic crisis commu
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epilogue: the econoMic crisis Refer
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Conclusions & recommendations 11 "I
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conclusions and recommendations sho
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conclusions and recommendations The
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conclusions and recommendations wor
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conclusions and recommendations Eff
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conclusions and recommendations •
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Appendix
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AppeNdIx recommendation no. 190 and
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AppeNdIx employment conditions. emp
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AppeNdIx Forced labour. Although th
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AppeNdIx Job discrimination. this t
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AppeNdIx in: muntaner, c., Benach,
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AppeNdIx in: Bartley, m., & Ferrie,
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AppeNdIx work intensification. work
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AppeNdIx Bank's Atlas method (adjus
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AppeNdIx table a2. descriptive stat
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AppeNdIx table a3. labour market fa
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AppeNdIx CorE sEmi-pEriphEry pEriph
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AppeNdIx Country clusters table A5
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AppeNdIx semi-peripheral countries
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AppeNdIx Figure a6. Health indicato
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RefeRences RefeRences 1. IntroductI
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arrangements and precariousness in
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International Labour Organization.
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Benach (Eds.), Desigualtats en salu
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Instituto Nacional de Estadística
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desde América Latina y el Caribe.
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Woldehanna, T., Guta, F., & Ferede,
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unemployment Chan, W. S., Yip, P. S
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International Labour Organization.
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Clarke, S., Sloane, D., & Aiken, L.
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among residents in the Trent region
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Sales, E. C., & Santana, V. S. (200
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Parent-Thirion, A., Fernandez, M. E
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Unemployment and mental health: Und
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Tytherleigh, M. Y., Jacobs, P. A.,
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Chilcoat, E. (2008). Pinkie promise
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Africa. Perspective of Global Devel
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freight transport and distribution
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Índex LIST OF FIGURES 2. Fair empl
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Table A5. Country clusters by labou
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Case study 43. Sexual orientation,
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acronyms and abrevIatures AIDS - Ac
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autHors and contrIbutors CORE GROUP
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Maria da Graça Luderitz Hoefel. Ho
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Maria da Graça Luderitz Hoefel. Ho
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INSTITUTIONS AND ASSOCIATIONS THAT
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