Rerum Novarum: The Link Between Work and Health
By Georgetown University School of Nursing and Health Studies Population Health Initiative
This year marks the one hundred twenty-fifth anniversary of Rerum Novarum, the papal encyclical that laid the foundation for Catholic social teaching on labor and the dignity of work. We will feature a series of blogs highlighting efforts underway to lift up workers and in anticipation of a special event on November 15, 2016 at 4:00 p.m. in Dahlgren Chapel.
Population health offers a framework to understand what determines health among groups of people by exploring differences—or disparities—among populations. As the leading expert in the field, Sir Michael Marmot, says, “health inequalities arise from the conditions in which people are born, grow, live, work, and age—the social determinants of health.”
These social determinants of health include social class, income, education, housing, work, access to green spaces, and experiences of individual or community poverty, discrimination, or racism. The ultimate aim of population health is to improve the health of individuals within specific populations by investing in specific policies and interventions to reduce health inequalities by taking action to reduce socioeconomic and other inequalities. There are other factors that influence health, but these exert their influence within the overwhelming impact of social and economic factors—the material, social, political, and cultural conditions that shape our lives and our behaviors. In fact, so close is the link between social conditions and health that zip code in the United States strongly predicts life expectancy.
Work is the origin of many important determinants of health, indeed work can provide financial security, social status, personal development, social relations, self-esteem, and protection from physical and psychosocial hazards. Employment conditions and the nature of work are both important to health: mortality is higher among temporary workers than permanent workers, precarious employment causes stress and poor mental health outcomes, and adverse working conditions can expose individuals to a range of physical health hazards and cluster in low-status occupations. Stress at work, defined as a combination of high psychological demands and low control or as an imbalance between effort and reward, is associated with a 50 percent excess risk of coronary heart disease and other indicators of mental and physical ill health. This link between work and health was recognized long ago by Rerum Novarum, the nineteen century encyclical that highlights the need to protect workers' rights, particularly through the formation of unions and collective bargaining.
Strikingly, areas with higher union density also see better health outcomes. In economic terms, these areas have lower levels of income inequality and increased job security and benefits, but the existence of unions also improves agency of workers. Marmot’s work has demonstrated that organizational justice, defined as having fair supervisors, leads to better cardiovascular health outcomes and cognitive functioning. In short, job security, job productivity, and fair treatment at the workplace all matter significantly for health. Worker rights, including the right to unionize, are important social justice foundations that have an enormous impact on health outcomes.
The Population Health Initiative (PHI), based out of the School of Nursing and Health Studies at Georgetown University, is focused on the social determinants of health or the non-clinical factors that play an important role in producing health outcomes. PHI is a year-long program to identify, coordinate, and plan population health education, research, and service activities that will strengthen current efforts, transform institutional capabilities, and catalyze future collaboration between the university and external stakeholders.