Work as a social determinant of health; a landscape assessment of employers in two historically disinvested urban communities.

BACKGROUND

Work is considered a structural determinant of health, yet specific determinants that could be targeted at the community level have not been elaborated. The aim of this research is to develop a methodology for incorporating employers and employment into community health assessment.

METHODS

As part of a community based participatory research (CBPR) collaboration, we inventoried and characterized businesses in two neighborhoods using multiple data sources and walk-around surveys. Community and academic researchers planned, executed, discussed, and debated the methodology, the findings, and the potential for incorporating "work" in community health considerations.

RESULTS

In two contiguous communities with a total population of roughly 100,000, we identified 1,127 employers: 85% were small employers; almost 70% of businesses were in retail, service, financial/business services, and food/accommodations sectors. Cash economy, hidden employment, and phantom businesses were uncovered.

CONCLUSION

We developed a CBPR approach to incorporating local businesses and employment sectors into community health assessment in economically and socially disadvantaged communities. Knowing about "work" in a community will form the basis for including business owners into CBPR partnerships and incorporating work-related health and economic factors into community health improvement and quality of life plans.