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社会政治价值观与社会制度:从政治经济学视角研究工作与健康公平性。

Sociopolitical values and social institutions: Studying work and health equity through the lens of political economy.

作者信息

Fujishiro Kaori, Ahonen Emily Q, Gimeno Ruiz de Porras David, Chen I-Chen, Benavides Fernando G

机构信息

Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA.

Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.

出版信息

SSM Popul Health. 2021 Apr 2;14:100787. doi: 10.1016/j.ssmph.2021.100787. eCollection 2021 Jun.

Abstract

Work contributes to health and health inequity in complex ways. The traditional exposure-disease framework used in occupational health research is not equipped to address societal contexts in which work is embedded. The political economy approach to public health directly examines macro-level societal contexts, but the attention to work in this literature is mostly on unemployment. As a result, we have limited understanding of work as a social determinant of health and health inequity. To fill this gap, we propose a conceptual framework that facilitates research on work, health, and health equity in institutional contexts. As an illustration of different social institutions creating different work-related health, we present characteristics of work and health in the United States and the European Union using the 2015 Working Conditions Surveys data. The results also highlight limitations of the traditional exposure-disease approach used in occupational health research. Applying the proposed framework, we discuss how work and health could be investigated from a broader perspective that involves multiple social institutions and the sociopolitical values that underpin them. Such investigations would inform policy interventions that are congruent with existing social institutions and thus have the potential for being adopted and effective. Further, we clarify the role of research in generating knowledge that would contribute to institutional change in support of population health and health equity.

摘要

工作以复杂的方式影响健康和健康不平等。职业健康研究中使用的传统暴露-疾病框架无法应对工作所处的社会环境。公共卫生的政治经济学方法直接审视宏观层面的社会环境,但该文献对工作的关注大多集中在失业方面。因此,我们对工作作为健康和健康不平等的社会决定因素的理解有限。为填补这一空白,我们提出一个概念框架,以促进在机构背景下对工作、健康和健康公平的研究。作为不同社会机构造成不同工作相关健康状况的一个例证,我们利用2015年工作条件调查数据展示了美国和欧盟工作与健康的特点。研究结果还凸显了职业健康研究中传统暴露-疾病方法的局限性。应用所提出的框架,我们讨论了如何从更广泛的视角来研究工作与健康,这一视角涉及多个社会机构以及支撑这些机构的社会政治价值观。此类研究将为与现有社会机构相符、因而有可能被采纳并有效的政策干预提供信息。此外,我们阐明了研究在生成有助于支持人群健康和健康公平的机构变革的知识方面所起的作用。

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