Employmentweb_low

EMploYMEnt, work, And hEAlth inEquAlitiEs - a global perspective
in the Chureca dump in Managua
(nicaragua), boys and girls work in worse
conditions than adults.
source: antonio rosa (2005)
While each risk factor may lead to different health outcomes
through various mechanisms, some main points need to be
emphasised here. First, axes such as social class, gender, and
ethnicity/race are key relational mechanisms that explain why
workers, and often their families, are exposed to multiple risks. For
example, there is a growing body of scientific evidence showing that
workers are more exposed to physical and chemical hazards
compared to owners or managers. Second, three of the key specific
social mechanisms underlying class, gender, and ethnicity/race are
exploitation, domination, and discrimination (Muntaner, 1999;
Muntaner, Benach, Hadden, Gimeno, & Benavides, 2006; Krieger,
2000). And third, those cross-cutting axes (i.e., social class, gender,
and ethnicity/race but also other related aspects such as age,
migrant status, or geographical location) may be linked to multiple
disease outcomes through different risk-factor mechanisms. These
key axes generating work-related health inequalities can influence
disease even though the profile of risk factors may vary dramatically
(Link & Phelan, 1996).
Material deprivation and economic inequalities (e.g., nutrition,
poverty, housing, income, etc.), exposures which are closely related
to employment conditions, may also have an important effect on
chronic diseases and mental health via several life-style behaviours,
physio-pathological changes, and health-related outcomes. For
example, the length of time children have been working may have an
effect on growth and academic performance, probably caused by a
lack of adequate nutrition (Hawamdeh & Spencer, 2003). In addition
to the key role played by these material factors, proponents of
psychosocial theories have emphasised the central importance
played by one's position in a hierarchy, that is, where one stands in
relation to others. There are two models that analyse the role of the
psychosocial work environment in explaining health inequalities.
The first is the popular demand-control model (Karasek, 1979)
based on the balance between quantitative demand and low control
(i.e., limited decision latitude and lack of skill discretion). The
second is the effort-reward imbalance model, which claims that
high efforts spent at work that are not met by adequate rewards
(money, esteem, promotion prospects, job security) elicit recurrent
stressful experiences (Siegrist & Theorell, 2006).
Nevertheless, although discussion of material versus
psychosocial factors may be important for research purposes as
well as for the type of interventions to be considered, it has been
argued that the dichotomy between both theories has been
overblown (Muntaner, 2004; Macleod & Smith, 2003). The
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