Chantarat Tongtan, Enns Eva A, Hardeman Rachel R, McGovern Patricia M, Myers Samuel L, Dill Janette
Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA.
Center for Antiracism Research for Health Equity, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA.
J Econ Race Policy. 2022;5(4):267-282. doi: 10.1007/s41996-022-00098-5. Epub 2022 Mar 22.
In the United States (US), Black-particularly Black female-healthcare workers are more likely to hold occupations with high job demand, low job control with limited support from supervisors or coworkers and are more vulnerable to job loss than their white counterparts. These work-related factors increase the risk of hypertension. This study examines the extent to which occupational segregation explains the persistent racial inequity in hypertension in the healthcare workforce and the potential health impact of workforce desegregation policies. We simulated a US healthcare workforce with four occupational classes: health diagnosing professionals (i.e., highest status), health treating professionals, healthcare technicians, and healthcare aides (i.e., lowest status). We simulated occupational segregation by allocating 25-year-old workers to occupational classes with the race- and gender-specific probabilities estimated from the American Community Survey data. Our model used occupational class attributes and workers' health behaviors to predict hypertension over a 40-year career. We tracked the hypertension prevalence and the Black-white prevalence gap among the simulated workers under the staus quo condition (occupational segregation) and the experimental conditions in which occupational segregation was eliminated. We found that the Black-white hypertension prevalence gap became approximately one percentage point smaller in the experimental than in the status quo conditions. These findings suggest that policies designed to desegregate the healthcare workforce may reduce racial health inequities in this population. Our microsimulation may be used in future research to compare various desegregation policies as they may affect workers' health differently.
The online version contains supplementary material available at 10.1007/s41996-022-00098-5.
在美国，黑人尤其是黑人女性医护人员更有可能从事工作要求高、工作控制低且主管或同事支持有限的职业，并且比白人同行更容易失业。这些与工作相关的因素会增加患高血压的风险。本研究考察职业隔离在多大程度上解释了医护人员中高血压方面持续存在的种族不平等现象，以及劳动力去隔离政策对健康的潜在影响。我们模拟了一个美国医护人员群体，分为四个职业类别：健康诊断专业人员（即地位最高）、健康治疗专业人员、医疗技术人员和医疗辅助人员（即地位最低）。我们通过根据美国社区调查数据估计的特定种族和性别的概率，将25岁的工人分配到不同职业类别来模拟职业隔离。我们的模型使用职业类别属性和工人的健康行为来预测40年职业生涯中的高血压情况。我们追踪了在现状条件（职业隔离）和消除职业隔离的实验条件下，模拟工人中的高血压患病率以及黑人和白人之间的患病率差距。我们发现，与现状条件相比，实验条件下黑人和白人之间的高血压患病率差距缩小了约一个百分点。这些发现表明，旨在使医护人员群体去隔离的政策可能会减少该人群中的种族健康不平等现象。我们的微观模拟可用于未来的研究，以比较各种去隔离政策，因为它们可能对工人健康产生不同影响。
在线版本包含可在10.1007/s41996-022-00098-5获取的补充材料。
