Health and Labor

Yesterday in the U.S. we celebrated Labor Day, in commemoration of the contribution made by ordinary workers to the prosperity and well-being of our nation.  It is an interesting amalgamation of two themes: it recognizes an American idea that people can achieve success and prosperity by hard work within the free enterprise system, while at the same time recognizing the role that labor organizing and collectivism have played in raising the standard of living of Americans.  Somehow these incongruous values come together in a uniquely American way.  Aiding and intersecting with fruitful labor are health status and health resources.

There are many ways in which health intersects with work.  Employment is one of the basic determinants of health.  It is hard to sustain long-term health without the resources provided by work, such as good food, housing, and access to medical care.  Long-term unemployment usually predicts declining health status for the unemployed worker as well as dependent children.  By extension, communities with high unemployment will typically be places with poor, community-wide health indicators.  These places don't have the economic vitality to attract the resources on which a health society are based.  Because of the traditional practice in our country for local property taxes to be a large part of school funding, communities with high unemployment (and therefore low property values) will often have poorly performing schools which provide a very tenuous foundation for long term prosperity and healthful living.  We have not had a lot of success breaking this cycle.

From the opposite perspective, labor is facilitated by good health.  A portion of unemployment and underemployment is due to disability and worker health problems, both physical and mental.Though not a perfect correlation, those individuals and segments of society with the best health status are likely to have the  best employment success, with other factors also important.  This is also true for school-aged children.  Those kids with the best health are likely to be the most successful in school, with other factors again very important.  This provides the rationale for school meal programs, and other health promotion efforts mounted in schools.  If we really believe no child should be left behind in school, the health barriers to success must be minimized and if possible removed.

Our society seems to be heading toward a growing group of disadvantaged individuals and families and a small segment of those very affluent.  The lower income group suffers from many severe health disparities: their health status is substantially worse than other people more affluent.  The solution to this problem is partially to provide more focused and vigorous health promotion programs for the disadvantaged groups.  However, at least equally important will be to find social policies to create and expand more and better employment opportunities.  Work opportunity is a more basic necessity for health than are public health programs.  Full employment is an important partner of health promotion.