Global Inequalities at Work: Work’s Impact on the Health of Individuals, Families, and Societies Edited by Jody Heymann Book Overview Section 1 of Global Inequalities at Work (Chapters 1–3) focuses on the effect of labor conditions on the health of individual workers. The section opens with a chapter on chemical and physical exposures. Chapter 1 addresses these risks in the new context of a global economy. As noted in the chapter, the use of some chemicals, such as benzene, has long been restricted in industrialized countries, yet in developing countries their use continues to rise. Likewise, physical hazards that have been banned in the United States and Europe continue to grow in developing countries. Hazardous production is being transferred from wealthier to poorer countries globally. Still, the chemical and physical hazards are not only a problem that developing nations face, since the consequences of chronic exposure, those resulting from the rapid introduction of new substances and the rise of an unprotected informal sector continue to occur in industrialized countries. Chapter 2 provides an important example of biological and social risks in the workplace by examining the case of HIV in Africa. Social and biological experiences at work can both increase and decrease an individual’s risk of contracting HIV. Sexual harassment or coercion at work, low wages that lead to increased economic vulnerability to exposure, and occupational exposure to infected blood products can all increase the risk of a laborer becoming infected with HIV. Social conditions at work can influence not only the likelihood that employees will become infected but the perils they face if they develop AIDS. Workplace response to the condition will influence whether HIV infection results in stigma, discrimination, income or job loss, and thus more rapid health deterioration—or conversely, whether infected individuals will be able to keep their jobs, sustain an adequate income, and access health care. How workplace risks affect individuals’ health depends both on who is exposed and what they are exposed to. Chapter 3 examines child labor and details how the characteristics of those working can influence the health consequences of work. Children are more susceptible to a wide range of occupational hazards. This chapter assesses occupational health risks that range from injuries to illnesses. The chapter both examines risks that all workers face—while examining how the risks and their impact are greater for child workers—and discusses hazards that affect only children. For example, the chapter describes how young children who work full-time and fail to attend school face potentially devastating consequences for their long-term opportunities, income, and health. The second section (Chapters 4—6) of the book provides a detailed analysis of several ways in which working conditions can dramatically influence the health and welfare of the families of those working. Chapter 4 focuses on the ways in which working conditions shape the nature, quality, and amount of time adults can spend caring for children, elderly parents, disabled family members, as well as other family members in need. This chapter provides new research results on how working conditions affect adults’ ability to provide essential care for family members in North America, Latin America, Africa, and Asia. The analysis is global in scope, as well as geography. The effects of working conditions on the ability of parents to care for children, of adults to care for elderly parents, and of workers to care for sick and disabled family members are examined. The impact of working conditions on the health of family members is felt as profoundly in the developing world as in industrialized countries. Chapter 5 discusses a case that is particularly important in poor countries and poor regions of middle-income countries—that of the relationship between work, breastfeeding, and health. Breastfeeding provides important benefits for both infant and maternal health, including lower rates of diarrheal disease, pneumonia, malnutrition and death among infants and lower risks of certain cancers among women. This chapter both reviews the literature and describes a detailed case study from Thailand examining the challenges at home and at work faced by women who seek to combine work and breastfeeding in that industrializing nation. Working conditions that significantly increase the ability of working mothers’ to breastfeed—ranging from adequate paid parental leave to the availability of breastfeeding breaks and child care near workplaces—are explored. Chapter 6 looks at the relationship between parents’ working conditions and children’s nutrition beyond infancy. This chapter reviews the relevant literature and demonstrates that the nature of parents’ working conditions, rather than the mere fact of parents’ employment, is what determines whether the effects of parental work on children’s nutrition will be beneficial or detrimental. As noted in the chapter, characteristics of the parent’s job, such as the wage earned, and the nature of available social supports, such as the quality of alternative child care, all make a critical difference in children’s nutritional status. Section 3 (Chapters 7–9) examines the relationships between work and health at the societal level. This section focuses on two examples: the ways in which working conditions affect income inequalities and health, and the ways in which working conditions influence gender inequalities and health. Chapter 7 examines the effect of work and wage structures on societal levels of poverty and income inequality. It assesses how the poverty and income inequality that result from wage disparities, in turn, significantly undermine social health. Inequalities both across and within countries have been increasing, as the chapter notes, with deeply damaging consequences for health. Conditions of work have had as profound an effect on societies’ gender inequalities as they have had on income inequalities. Chapter 8 examines the relationship between gender inequality at work and health. Trends in Latin American and Caribbean women’s labor force participation over the past two decades are explored in detail, and the positive and negative effects of the associated working conditions are assessed. As noted in the chapter, work itself has been shown to provide many positive health effects, but the lower wages that women receive, the occupational segregation that exists, and the overall worse working conditions that prevail have all led to detrimental health consequences. Chapter 9 examines the health impacts of gender inequality at work in the context of a single country. The chapter examines how state policies in Iran institutionalize gender inequality by restricting women’s work, education, and movement. The chapter details the result: women are often limited in the type of work they can perform and in their ability to seek better work conditions. These limitations result in dire health and welfare consequences. Section 4 (Chapters 10–12) investigates the new challenges to and opportunities for improving the relationship between work and health that are presented by a rapidly globalizing economy. Chapter 10 appraises what is known about the extent to which border industries, the maquilas, bring with them better or worse working conditions than the nations from which the companies originated, as well as better or worse working conditions than in other local industries. The case of Mexico is examined in detail. Chapter 11 begins with the premise that increased competition in the context of a global economy creates incentives for businesses to locate in countries with the worst labor standards. However, the chapter moves rapidly from the recognition of that economic reality to a discussion of what can be done to ensure decent working conditions and healthy economic development. The current policy efforts of the International Labor Organization are detailed. Central to improving working conditions globally is addressing the question of whether it is possible to create global labor standards, as well as whether it is possible to ensure that healthy labor standards will eventually provide the foundation for free trade in the global economy. These issues are the focus of chapter 12. The case is compellingly made that economic strength, free trade, and global labor standards are strongly complementary. Contributors to this volume include: Pavan Baichoo, Mayra Buvinic, Leonor Cedillo, David C. Christiani, Marinel Dall'Agnol, Catalina A. Denman, Kimberly Ann Elliott, Michal Engelman, Luiz A. Facchini, Anaclaudia Fassa, Aron Fischer, Richard B. Freeman, Peju Gbadebo, Parvin Ghorayshi, Antonio Giuffrida, Amanda Glassman, Peter Glick, Siobán Harlow, Jody Heymann, Ichiro Kawachi, Maria de Fátima Maia, Martha Morrow, Stephen Pursey, Alyssa Rayman-Read, S.V. Subramanian, Jukka Takala, Xiao-Rong Wang, and Susanha Yimyam. Back to Work and Health in a Global Economy
		This page is maintained by The Project on Global Working Families. Copyright 2002 by the President and Fellows of Harvard College
	HSPH home