Research into disparities in occupational health by social and economic factors has a long history [Ramazzini, 1913; Hamilton, 1943]. Driven in part by changes in the workforce and economy, recent years have seen a renewed attention to disparities in work-related health outcomes and the experience of worker groups who are at increased risk in the workplace [Murray, 2003; Lipscomb et al., 2006]. In 1996, the National Institute for Occupational Safety and Health (NIOSH) established the National Occupational Research Agenda (NORA) to stimulate innovative research and improve workplace practices. The NORA agenda included an explicit emphasis on worker populations that have been overlooked and underserved by past efforts including immigrant workers, low-wage, contingent and temporary workers, racial and ethnic minority workers, workers with disabilities, and younger and older workers. Later, through a joint effort with the National Institute of Environmental Health Sciences (NIEHS) to develop and release a request for proposals involving environmental and occupational justice, NIOSH provided unprecedented support to community-based coalitions of community and academic groups addressing the needs of underserved worker groups. This funding further spurred the development of research and intervention activities aimed at understanding and eliminating occupational health disparities [Birnbaum et al., 2009]. In 2007, the Occupational Health and Safety Section of the American Public Health Association initiated the Occupational Health Disparities Institute (OHDI), to focus attention on research findings demonstrating disproportionate impacts of occupational injuries and illnesses, with a focus on immigrant and racial and ethnic minority worker groups. Last year, OHDI and NIOSH worked with AJIM to plan a call for papers on occupational health disparities, soliciting submissions from OHDI presenters, attendees at a recent NIOSH-sponsored workshop on improving surveillance for occupational health disparities (for a summary of this workshop, see [Souza et al., 2010] in this issue), and others who may be working in this area. This current issue of the American Journal of Industrial Medicine expands the body of scientific literature addressing disparities in occupational health. In this special issue, we showcase research that raises urgent and compelling concerns about the unequal distribution of work-related outcomes. Articles examine both the disproportionate employment of certain groups of workers in higher hazards occupations as well as other potential risks factors including language barriers, job insecurity, and discrimination. Contributors to this issue have also linked occupation to disparities in access to health care, and have pointed to the convergence of poorer overall health status and higher hazard occupations, suggesting an equally urgent need to integrate occupational health into the practice and delivery of ‘‘mainstream’’ public health. Two invited commentaries discuss many of the issue’s articles in the context of a broader examination of health disparities research [Krieger, 2010] and of evolving occupational health surveillance methods which might better detect and track health disparities [Souza et al., 2010]. A third commentary [Landsbergis, 2010] explains some of the methodological challenges in designing research that examines occupational exposures in the context of socioeconomic inequalities. One of the goals of Healthy People 2010 was reduction in health disparities in theUSpopulation. This special issue is dedicated to increasing the knowledge about occupational health disparities to facilitate that goal. Although many workplaces in the US are safer, cleaner, and healthier than they were 20, 50, or 100 years ago, disparities remain and many workers today become sick or die due to well known and preventable workplace exposures. We hope that this special issue of the journal will inspire occupational and other public health practitioners to focus renewed attention, research, and intervention efforts aimed at eliminating health disparities for underserved workers.
Sherry Baron, CDC, NIOSH, DSHEFS, 4676 Columbia Parkway, Cincinnati, OH 45226