Occupational class, power, and hypertension inequity: The implication of the inverse hazard law
among healthcare workers
Tongtan (Bert) Chantarat
HSRP&A Doctoral Candidate
Division of Health Policy & Management
When we think about interventions to eliminate health inequities among healthcare workers, we tend to focus on redesigning jobs and workplace environments to minimize occupational health risks. But what happens at the workplace is only one component of a very long and complex pathway of the social production of workers’ health.
This seminar examines the extent to which occupational segregation by race and gender patterns the hypertension risk exposure and contributes to the persistent racial inequity in hypertension between Black and White healthcare workforces. Chantarat uses microsimulation to connect the mechanism that gives rise to occupational segregation in the healthcare workforce and the hypertension pathogenesis together. His model used occupational class attributes and workers’ health behaviors to predict workers’ hypertension status over a 40-year career. He tracked hypertension prevalence among the simulated “control” cohort of racially segregated US healthcare workforce and the “experimental” cohort in which occupational segregation was absent. His findings show that the prevalence of hypertension is consistently lower in the “experimental” cohort with no occupational segregation than in the “control” cohort. The margin of health loss for the Black workers and the health gain for White workers due to occupational segregation represents W.E.B. Dubois’ “wage of Whiteness”. Overall, the study suggests that policies designed to de-segregate the healthcare workforce can help reduce racial health inequities in this population.