Friday, September 7, 2012

Deteriorating Working Conditions in the United States

By Peter Schnall and Erin Wigger

During the past year we have devoted a number of blogs to discussing working conditions, as they currently exist in China, specifically at the Foxconn plant used to manufacture several Apple products. We’d now like to turn our attention to the rapidly deteriorating working conditions in the United States; first by enumerating briefly what we’ve already learned are contributing factors to unhealthy work in the U.S. and second by contrasting, combining, and complementing this knowledge with what is currently going on – for better or worse – in different workplaces across America.

So, what do we know contributes to or constitutes an unhealthy workplace?

For a very long time (over a hundred years now) chemical and physical exposures (e.g. heat, cold, dangerous working conditions) have been recognized as risk factors to the health of working people. This recognition resulted in a societal consensus in the passage of the OSHA Act in 1970 which regulates safety standards in U.S. workplaces and also marked the creation of our National Institute for Occupational Safety and Health which funds research into working conditions.

Despite efforts to improve the work environment from legislation like OSHA, illnesses and disability at work from many causes are on the rise. Part of this is due to the processes of globalization - the steadily increasing inter-dependency of world economics, production, trade, technology and culture – which is having an enormous impact on work, work organization and the health of working people (we have been discussing these issues in our reporting on Foxconn in earlier blogs). There is now increasing competition among nations and between corporations, as resources grow scarcer. The ongoing need for corporate profitability drives globalization, technology and changes in workplace organization resulting in more competition, restructuring and downsizing, outsourcing, more precarious labor and increased job insecurity, as well as increased time pressure and intensification of work (1).

These changes in work organization, in turn, give rise to psychosocial stressors such as job strain, effort-reward imbalance, emotional labor, threat-avoidant-vigilant work, organizational injustice, as well as increased demands in the form of long work hours, contingent work, shift work which increase stress and can lead to chronic illnesses, including mental and physical health problems. Psychosocial stressors play an important role in promoting CVD risk factors, such as obesity and hypertension. Many of these work stressors are especially prevalent among drivers (bus, taxi, and truck) as well as health workers who are exposed to noxious combinations of long work hours, intensification of work, inadequate training, lack of support and emotional labor leaving them prone to anxiety, burnout, depression and hypertension.

The psychosocial work environment has only recently begun to be acknowledged as a serious risk to worker’s health. The psychosocial work environment refers to the interaction between the individual worker and various aspects of the work environment. The primary way researchers have looked into this subject has been to examine the way work is organized – e.g., how hard one has to work (i.e., the workload), the amount of control a person has over how their work gets done, whether a person experiences injustice or unfair treatment at their workplace, has employment security, works long hours or in shifts, etc. When a worker perceives threats at work this can create a stress response which, over time research has found, can cause increasingly deleterious effects on one’s health.

For instance, Karasek’s Job Strain Model posits that employees in jobs that are high in demands and low in control (high strain) are likely to experience stress which results in deleterious health. Research has shown that jobs characterized as “high strain” over time put a physiological strain (e.g. increased blood pressure) on workers that can result in a range of serious and chronic physical health conditions such as musculoskeletal disorders, hypertension, chronic back pain, heart disease, stroke, Type II diabetes, and even death are just a few of these (3).

Other posited psychosocial models present us with a related but different picture. There appear to be a number of pathways through which the organization of work creates stress and illness in workers. While Karasek’s model referenced above has received the most research, a great deal of evidence also supports Johannes Siegrist’s Effort-Reward Imbalance model which describes the unhealthy relationship between workers and the work environment as springing from a “mismatch between high workload (high demand) and low control over long-term rewards” [58, p. 1128] (2).

Researchers have also begun to look at the affects of work involving having to maintain a high level of vigilance in order to avoid (usually life-threatening) disasters. This is referred to as Threat-Avoidant Vigilant work and is common among drivers as well as airplane pilots and air traffic controllers. There is also mounting evidence as to the noxious affects of Emotional Labor on worker health. Simply stated, emotional labor involves work that requires a person to interact emotionally with customers/others by having to suppress their true emotions or fake appropriate ones. Organizational injustice and low social support have also been shown to be of great importance to worker health (4).

These psychosocial stressors listed above are by no means a comprehensive list and for those readers as yet unacquainted with research on these very important topics, we urge you to look into it further at our website: where numerous articles can be found on these topics. There is also links to a number of related websites. Another excellent source for information on work exposures and psychosocial stressors is our new book, available for purchase here at Baywood Publishing, called Unhealthy Work: Causes, Consequences, Cures.

In subsequent blogs we will report on recent research findings and news stories that highlight the increasingly unhealthy working conditions in the U.S.


1. Schnall PL, Dobson M, Rosskam E, Editors Unhealthy Work: Causes, Consequences, Cures. Moutsatsos C. Chapter 2: Economic Globalization and It’s Effects on Labor, Baywood Publishing, 2009, pgs 26-34.

(For further discussion of Globalization read Chapter 2)

2. Schnall PL, Landsbergis PA, Baker D. Job Strain and Cardiovascular Disease. Annual Review of Public Health; 15:381-411,1994. Schnall PL, Landsbergis PA, Schwartz JE, Pickering TG. Job Strain and Hypertension.

3. Karasek RA, Theorell T. 1990. Healthy Work. New York: Basic Books

4. Schnall PL, Dobson M, Rosskam E, Editors Unhealthy Work: Causes, Consequences, Cures. Chapter 6: The Workplace and Cardiovascular Disease, Baywood Publishing, 2009, pgs 89-101.


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