Healthy workplaces for a healthy living

This year marks a landmark decision for workers' rights, as safety and health have been added to the International Labour Organization (ILO)'s framework of Fundamental Principles and Rights at Work and are now recognised as a universal labour right. Safe and healthy workplaces can save lives. Almost 2 million people die prematurely due to work-related diseases and injuries every year, impacting also the families of the workers, their employers, and our societies at large. This issue of The Lancet Public Health provides a collection of Articles and Reviews examining how the many neglected facets of work affect people's health and wellbeing.The COVID-19 pandemic changed nearly everyone's working life and exposed existing labour market fragilities and inequalities—but it also highlighted the importance of the workplace as an overlooked focus for public health. Worker experiences varied, with a disproportionate burden being placed on already-disadvantaged groups, overrepresented in jobs that required close physical proximity, carrying a higher risk of infection and job insecurity. In their Article, Yea-Hung Chen and colleagues report higher COVID-19 mortality among essential workers in California (USA), especially those working in the agriculture, transportation, logistics, facilities, emergency, and manufacturing sectors, compared with those working in non-essential sectors. WHO estimated that more than 100 000 health-care workers around the world could have died due to COVID-19 between January, 2020, and May, 2021. Nursing home workers had disproportionately higher death rates associated with COVID-19. Preventive measures (including access to COVID-19 vaccination) have been taken to mitigate worker risk of occupational exposure to SARS-COV-2 and minimise the spread of the virus—as described, for example, by Ezra Cohn and colleagues who report on the joint impact of vaccine policies in New York City, NY, USA, including a proof-of-vaccination requirement, $100 incentive to get the first dose, and employer-based mandates.Work can take different forms, including unpaid work, which is unrecorded and undervalued. Care for a family member or friend due to illness, disability, or old age, is often provided by unpaid caregivers. 80% of long-term care is provided by informal carers in Europe, according to Eurocarers. Youth caregiving, in particular, has been understudied, as most studies have been focusing on the health of adult caregivers, with youth caregivers left behind in social policies. In their systematic review, Rebecca Lacey and colleagues find that young caregivers (<18 years of age) have poorer mental and physical health than their non-caregiving peers. They call for more quantitative research, and highlight research gaps in low-income and middle-income countries.Importantly, women continue to shoulder a disproportionate share of unpaid work, including housework and childcare. This unequal distribution of unpaid work affects women's labour market participation. In this issue, the Review by Jennifer Ervin and colleagues highlights that gender inequalities in unpaid labour expose women to greater risk of poor mental health than men, among employed adults. Prioritising care in national laws, policies, and budgets will help reduce the amount of unpaid care work.The gender pay gap is another dimension of inequality between women and men in the labour market. According to a report by ILO and WHO, gender pay gaps in the health and care sector (a highly feminised sector) are wider than in other sectors and women earn on average 24% less than men. Moreover, workplace harassment and violence against women undermine equality at work, and negatively affect the health, pay, and career progression of women. Svava Jonsdottir and colleagues found that about a third of women in Iceland report exposure to workplace sexual harassment or violence during their lifetime and 8% in their current workplace.Work-related stresses and deaths can be prevented. Governments, employers, workers, and policy makers should participate in a meaningful dialogue to scale up efforts to prevent those unacceptable losses. For a healthier, gender-equal, and sustainable world of work, it is crucial to rethink the way we view workplaces. Productivity cannot be achieved without support for worker's health and wellbeing. Major gaps persist in care policies and services, as revealed by ILO's Care at Work report, with only 98 countries providing maternity leave with adequate benefits. All workers must enjoy the highest level of health protection and support— this is a right that should not be negotiable. This year marks a landmark decision for workers' rights, as safety and health have been added to the International Labour Organization (ILO)'s framework of Fundamental Principles and Rights at Work and are now recognised as a universal labour right. Safe and healthy workplaces can save lives. Almost 2 million people die prematurely due to work-related diseases and injuries every year, impacting also the families of the workers, their employers, and our societies at large. This issue of The Lancet Public Health provides a collection of Articles and Reviews examining how the many neglected facets of work affect people's health and wellbeing. The COVID-19 pandemic changed nearly everyone's working life and exposed existing labour market fragilities and inequalities—but it also highlighted the importance of the workplace as an overlooked focus for public health. Worker experiences varied, with a disproportionate burden being placed on already-disadvantaged groups, overrepresented in jobs that required close physical proximity, carrying a higher risk of infection and job insecurity. In their Article, Yea-Hung Chen and colleagues report higher COVID-19 mortality among essential workers in California (USA), especially those working in the agriculture, transportation, logistics, facilities, emergency, and manufacturing sectors, compared with those working in non-essential sectors. WHO estimated that more than 100 000 health-care workers around the world could have died due to COVID-19 between January, 2020, and May, 2021. Nursing home workers had disproportionately higher death rates associated with COVID-19. Preventive measures (including access to COVID-19 vaccination) have been taken to mitigate worker risk of occupational exposure to SARS-COV-2 and minimise the spread of the virus—as described, for example, by Ezra Cohn and colleagues who report on the joint impact of vaccine policies in New York City, NY, USA, including a proof-of-vaccination requirement, $100 incentive to get the first dose, and employer-based mandates. Work can take different forms, including unpaid work, which is unrecorded and undervalued. Care for a family member or friend due to illness, disability, or old age, is often provided by unpaid caregivers. 80% of long-term care is provided by informal carers in Europe, according to Eurocarers. Youth caregiving, in particular, has been understudied, as most studies have been focusing on the health of adult caregivers, with youth caregivers left behind in social policies. In their systematic review, Rebecca Lacey and colleagues find that young caregivers (<18 years of age) have poorer mental and physical health than their non-caregiving peers. They call for more quantitative research, and highlight research gaps in low-income and middle-income countries. Importantly, women continue to shoulder a disproportionate share of unpaid work, including housework and childcare. This unequal distribution of unpaid work affects women's labour market participation. In this issue, the Review by Jennifer Ervin and colleagues highlights that gender inequalities in unpaid labour expose women to greater risk of poor mental health than men, among employed adults. Prioritising care in national laws, policies, and budgets will help reduce the amount of unpaid care work. The gender pay gap is another dimension of inequality between women and men in the labour market. According to a report by ILO and WHO, gender pay gaps in the health and care sector (a highly feminised sector) are wider than in other sectors and women earn on average 24% less than men. Moreover, workplace harassment and violence against women undermine equality at work, and negatively affect the health, pay, and career progression of women. Svava Jonsdottir and colleagues found that about a third of women in Iceland report exposure to workplace sexual harassment or violence during their lifetime and 8% in their current workplace. Work-related stresses and deaths can be prevented. Governments, employers, workers, and policy makers should participate in a meaningful dialogue to scale up efforts to prevent those unacceptable losses. For a healthier, gender-equal, and sustainable world of work, it is crucial to rethink the way we view workplaces. Productivity cannot be achieved without support for worker's health and wellbeing. Major gaps persist in care policies and services, as revealed by ILO's Care at Work report, with only 98 countries providing maternity leave with adequate benefits. All workers must enjoy the highest level of health protection and support— this is a right that should not be negotiable. COVID-19 mortality and excess mortality among working-age residents in California, USA, by occupational sector: a longitudinal cohort analysis of mortality surveillance dataWorkers in essential sectors have continued to bear the brunt of high COVID-19 and excess mortality throughout the pandemic, particularly in the agriculture, emergency, manufacturing, facilities, and transportation or logistics sectors. This high death toll has continued during periods of vaccine availability and the delta surge. In an ongoing pandemic without widespread vaccine coverage and with anticipated threats of new variants, the USA must actively adopt policies to more adequately protect workers in essential sectors. Full-Text PDF Open AccessThe effect of a proof-of-vaccination requirement, incentive payments, and employer-based mandates on COVID-19 vaccination rates in New York City: a synthetic-control analysisThe combination of a proof-of-vaccination requirement, incentive payments, and vaccine mandates increased vaccination rates among adults in NYC compared with jurisdictions that did not use the same measures. Whether the impact of these measures occurred by inducing more people to get vaccinated, or by accelerating vaccinations that would have occurred later, the increase in vaccination rates likely averted illness and death. Full-Text PDF Open AccessRisk factors for workplace sexual harassment and violence among a national cohort of women in Iceland: a cross-sectional studyLifetime exposure to workplace sexual harassment or violence seems common among women in a Nordic welfare state. These findings provide nuanced targets for prevention and for public policies aimed at promoting women's safety in the work environment. Full-Text PDF Open AccessGender differences in the association between unpaid labour and mental health in employed adults: a systematic reviewGlobally, billions of hours are spent on unpaid labour every year, a burden that is disproportionately carried by women. However, the potential health effects of unpaid labour have largely been unexplored. This Review examines the gendered association between unpaid labour and mental health among employed adults. We did a search of six databases and examined the association between different forms of unpaid labour and mental health. 19 studies (totalling 70 310 participants) were included. We found substantial heterogeneity, and low-to-moderate methodological quality, in the existing research. Full-Text PDF Open AccessThe mental and physical health of young carers: a systematic reviewThe health of those who care for someone with a health condition or advanced age is poorer, on average, than non-carers. However, the health of young carers (<18 years of age) has been under-researched, especially in quantitative studies. This systematic review aimed to summarise studies assessing the mental and physical health of young carers. 1162 unique studies were screened and 14 associations between being a young carer and health were identified (two studies were treated as a single unit of analysis as they had information from the same sample). Full-Text PDF Open Access