Recognizing Low Wages as an Occupational Health Hazard

Low wages are detrimental to worker health and should be recognized alongside other occupational health hazards, argue COEH faculty J. Paul Leigh and co-author Roberto De Vogli in an editorial published in the May 2016 issue of the Journal of Occupational & Environmental Medicine. Leigh and De Vogli are professors in the Department of Public Health Sciences at UC Davis.

From asbestos in the sixties to Dibromochloropropane (DBCP) in the seventies to job strain in the nineties, “the history of occupational medicine has been characterized by ever-widening recognition of hazards,” note the authors. They contend “wages are integral characteristics of jobs just as much as toxic physical, chemical, biological, or psychological exposures.”

Roughly 25 percent of the US workforce experiences low-wages, according to the editorial, which offers a definition of low-wage work as an hourly wage for 40 hours per week for one year equivalent to the Federal Poverty Level for a family of four, currently $24,300.

The US Bureau of Labor Statistics states that, in 2015, 78.2 million US workers age 16 and older were paid hourly, representing 58.5 percent of the workforce. Of those, 2.6 million workers received wages at or below the federal minimum level – currently $7.25 an hour.

In an editorial published in the August issue of the American Journal of Public Health, Leigh points out that “American workers affected by an increase in the minimum wage defy stereotypes: the average age is 36; higher percentages are for ages 55 and older (15 percent) than for teenagers (11 percent); and approximately two-thirds are 25 or older.”

In a review of the literature, Leigh explores leading hypotheses that explain the association between wages and health. Mounting evidence suggests low wages are linked to psychological hazards such as “precarious work contracts, job insecurity, long work hours, and job strain.” Researchers have shown low wages negatively affect self-esteem and job satisfaction. In addition to psychological hazards, direct income effects may include living in areas of high crime, air, and water pollution; loss of housing or utilities due to insufficient funds; or forsaking needed health medications in favor of essentials such as food, among others.

Moreover, workers forced to choose between essentials – rent versus food – experience mental strain. The authors report a study published in Science that shows “poverty consumes mental resources so that solving new tasks becomes more difficult for the poor than the non-poor, and this reduction in cognitive capacity results in the poor making non-optimal choices related to the use of preventable health care and compliance with prescription drug regimes.”

Another hypothesis, relative deprivation, argues that as a social species humans value the respect of others. Wages play into that respect as they convey information about position in a social hierarchy, and “persons at the bottom of the hierarchy experience relative deprivation.” Low socioeconomic status is associated with chronic stress, the authors point out, and chronic stress puts your health at risk according to the Mayo Clinic. Increasing low wages while keeping other wages constant, therefore, would decrease distance in the social strata.

In a separate study published in the European Journal of Public Health, lead author Leigh notes low socioeconomic status is associated with hypertension. Based on a longitudinal investigation of 17,295 participants, he found evidence that low wages were a risk factor for hypertension, especially for workers ages 25-44 and women.

The authors call attention to the numerous studies evidencing the cascading effects of increased wages, including reduced absenteeism and increased productivity in the workplace. The implications of a policy decision to increase the national minimum wage would impact 35.1 million workers. “Approximately 28.4 million would be directly affected and 6.7 million indirectly affected through “ripple effects” whereby workers earning just above the minimum would also receive raises,” according to Leigh, who call for future research based on large national data sets to support evidence of the health effects of low wages, while controlling for confounding variables such as other family income and job strain.

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