Students Participate in Interdisciplinary Training: Policy Roundtables Op-Ed 2

Student Op-Ed #2 

Roundtable Session: “Effects of Minimum Wage Policies on the Health of Workers” featuring Dr. Paul Leigh, an economist from the University of California, Davis, on November 9, 2016.

A few years ago, I had a discussion with an old high school friend who worked as a barista during the day, a restaurant chef in the evening, and a full-time babysitter on the weekends. He did not attend college and was working jobs that paid him a low hourly wage without any health benefits or paid time off. He told me about the economic burdens he faced after his parent’s mutual agreement to separate near the end of high school, the lingering physical disabilities after his mother’s car accident a year after, as well as the responsibility to provide for his three younger siblings. Although his dream after high school was to further his education in college, he felt responsible to place the needs of his family first by providing them with food and shelter. When I asked him how he was doing, he quietly said, “I am doing okay. I wish I didn’t have to work multiple part-time jobs, that I could find one that would hire me full time, provide me with health benefits, and have reasonable hours. I needed to make the money, so I took jobs that would be flexible with my other jobs.”

I wasn’t convinced he was doing okay. His facial expressions were more pensive and reserved compared to the classmate I knew who was outgoing and bright in high school. After our talk many years ago, I often think back about whether work stress and low-wage contributed to any health or health behaviors he experienced.

An interdisciplinary group of researchers, practitioners, and policymakers gathered on November 9th in Seattle, WA for informal discussions on how employment characteristics and working conditions influence health. The group speaker, Dr. Paul Leigh, presented his research on mechanisms explaining how low wages result in poor health or health behaviors. These mechanisms include decreased self-esteem, job satisfaction, insufficient funds, time loss from work, reduced life expectancy, and poor health, all resulting from low wages. Dr. Leigh went on to bring attention to the overwhelming amount of scientific studies providing support to both sides of an argument. Which should we believe? How do studies get traction? What is the power of data? These questions highlight the fact that data isn’t enough to make positive changes anymore. We must appeal to people’s emotions through personal stories and specific examples to make change. We need to appeal to what is morally right, not just what is logistically correct.

Low wages resulting in poor health or health behaviors can affect all occupations.

Researchers in occupational health services research (OHSR) focus on bridging concepts of income inequality and worker health and health behaviors by implementing, evaluating, and disseminating policies that address both individual and population level health needs for all workers. An important part of OHSR is the ability to study the relationships between various social determinants of health and the effect on overall health and health behaviors. The ability to address differences in risk factors such as health insurance coverage, the distance to the nearest medical facility or provider, and the availability of certain medical services act as major economic and social barriers that disproportionately affect individuals who already lack much financial control in their workplace. Conducting research in workers’ compensation systems and reimbursements for work-related injuries and illnesses is an example of work in this field.

UW Center for One Health Research

The One Health at the Human Animal Interface (OHHAI)discipline at the University of Washington is interested in the interaction of animal and human health. Animal workers are employed in various settings such as farms, aquariums, and clinics (veterinarians), among others, and face biological, chemical, physical and mental hazards (including high physical and emotional stress levels) that can be exacerbated by low wages. Low wage positions in this line of work tend to be filled by workers with less education and experience, thus increasing injury potential while working with animals. Animal workers may experience depression and compassion fatigue when animals die, and when coupled with low wages may lead to poor health behaviors as coping mechanisms.

Occupational health nurses (OHN) play a role in ensuring the safety and health of workers in their jobs. These measures extend from monitoring worker health by conducting blood tests to assess exposure to toxic chemicals, to conducting research on the effects of workplace exposure through the collection of health and hazard data. The focus on low wages as determinants of health helps enrich the field of OHN by extending research beyond the immediate workplace and into the economic conditions that shape it. This enriches the OHN field by furthering the perspective that workplace conditions are social determinants of health.

Conversations about health and low wages have not been sufficiently addressed in Seattle. Dr. Leigh’s presentation and the discussion it sparked with members of the broader community, including union organizers, city officials, business representatives, and academia, marks the emergence of a new approach towards discussing and addressing occupational health issues.

DEOHS Adjunct Faculty Member Quoted - Phthalates in Your Mac and Cheese

Dr. Sathyanarayana 

Dr. Sheela Sathyanarayana, DEOHS Adjunct Associate Professor and Co-director of the Pediatric Environmental Health Specialty Unit in Region X, was quoted in the recent New York Times article, Chemicals in Your Mac and Cheese on July 12, 2017.

Potentially harmful chemicals called phthalates have been banned from children's teething rings and rubber duck toys for over a decade, but have been found in high concentrations in macaroni and cheese mixes using powdered cheese.

According to recent research conducted by Dr. Sathyanarayana, early childhood exposure to phthalates could be linked to neurodevelopment and behavioral problems in young children such as aggression, hyperactivity, and possible cognitive delays. For those who are concerned over exposure to phthalates she suggests avoiding processed foods if you are pregnant, have a young child, or want to reduce your exposures to phthalates for other reasons.

In a follow up article posted by Slate.com, Dr. Sathyanarayana states that she has not run the numbers herself, but you would most likely need to eat multiple boxes of Mac and Cheese every day to see clear negative health effects. The Slate.com article notes that the study cited in the New York Times article did not indicate the levels of phthalates found in the powdered cheese samples, so it is difficult to say if the dose is high enough to be harmful.

Recommendations for Updating the Current Lead Standard in Washington State – an Interdisciplinary Activity

University of Washington Occupational and Environmental Medicine Fellow, Esi Nkyekyer, MD, became interested in Washington State's Lead Standards and the process of updating them after attending one of the lead stakeholder meetings held by the Department of L&I in the fall of 2015.

"I was intrigued by the process of applying updated scientific evidence on the of adverse health effects associated with lead exposure to the process of rule-making about the lead standards," says Nkyekyer, "I felt that if we could come up with a product that highlighted how both labor and industry could benefit from a new lead standard that perhaps we could move the policy needle forward."

Dr. Nkyekyer and other Northwest Center ERC Trainees embarked on a mission to inform the new lead standards for Washington State. Nkyekyer and her fellow researchers reviewed literature on the health effects of lead, and worked to find evidence that a recommendation for a lower lead standard could positively impact worker health.

"This project was part of the ERC Multidisciplinary Trainee Workshops and Activities program. The theme was the ‘Role of Occupational Health professionals in Policy-making’. As part of this project, we were tasked with working on an occupational health policy statement that is relevant to an issues in Washington state. Our group, which was comprised of trainees in industrial hygiene, occupational health nursing, occupational medicine, occupational health at the human-animal interface, and occupational health services research, decided to focus on the current issue of the lead standard."

Nkyekyer and her team created an infographic to sum up the findings of their research, and presented at the 2016 UW Department of Environmental and Occupational Health Sciences Worker Memorial Day Event. The research team gathered evidence for the health effects of lead exposure, and uncovered the costs associated with lead-related diseases and disabilities. The infographic highlighted key findings from the literature review, and recommends improvements to the Washington State standards.

"The most enjoyable part of this project was working as an interdisciplinary team. The insights we all brought to the table given our expertise in the different arenas of occupational and environmental health sciences was very rewarding. Also, coming up with a product (the infographic) that could be used to help educate stakeholders during the rule-making review process was very rewarding," said Nkyekyer.