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

Am J Ind Med. 2020 Nov;63(11):1038-1046. doi: 10.1002/ajim.23174. Epub 2020 Sep 3.

Abstract

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.

Keywords: community based participatory research; community health assessment; quality of life; social determinants of health; work and health.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Community-Based Participatory Research
  • Employment / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Public Health / statistics & numerical data
  • Social Determinants of Health*
  • Urban Population / statistics & numerical data*
  • Vulnerable Populations / statistics & numerical data*
  • Work / statistics & numerical data*
  • Young Adult