The Decline of American Unions Is a Threat to Public Health

Source: Michael J. Wright, American Journal of Public Health, Vol. 106, No. 6, June 2016
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From the abstract:
Empowerment is critical for public health. The empowerment of women translates to health for all members of society. Community empowerment enables access to affordable health care, decent housing, and public safety. Unions are the organizations through which workers collectively become empowered. But today unions are under attack and in decline. Two articles in this issue of AJPH demonstrate why this is a threat to public health.

Hagedorn et al. examined 16 binding union contracts with employers in the Pacific Northwest, showing how the contracts improved the lives and promoted the health of union members. They found that the contracts raised earnings, provided retirement benefits, included employer-paid health insurance, promoted occupational safety and health, and protected workers from discrimination and unfair treatment. All are important determinants of health.

The article by Tsao et al. indirectly shows why union efforts to increase earnings are especially important. The authors modeled an increase in New York City’s minimum wage to $15, and found that it could have prevented 2800 to 5500 premature deaths between 2008 and 2012. Of course, wage increases for members are usually at the top of union collective bargaining agendas, especially for newly organized low-wage workers. Unions also are at the forefront of efforts to increase the minimum wage for all workers.
The Role of Labor Unions in Creating Working Conditions That Promote Public Health
Jenn Hagedorn, Claudia Alexandra Paras, Howard Greenwich, Amy Hagopian, American Journal of Public Health, Vol. 106, No. 6, June 2016
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From the abstract:
We sought to portray how collective bargaining contracts promote public health, beyond their known effect on individual, family, and community well-being. In November 2014, we created an abstraction tool to identify health-related elements in 16 union contracts from industries in the Pacific Northwest. After enumerating the contract-protected benefits and working conditions, we interviewed union organizers and members to learn how these promoted health. Labor union contracts create higher wage and benefit standards, working hours limits, workplace hazards protections, and other factors. Unions also promote well-being by encouraging democratic participation and a sense of community among workers. Labor union contracts are largely underutilized, but a potentially fertile ground for public health innovation. Public health practitioners and labor unions would benefit by partnering to create sophisticated contracts to address social determinants of health.

Estimating Potential Reductions in Premature Mortality in New York City From Raising the Minimum Wage to $15
Tsu-Yu Tsao, Kevin J. Konty, Gretchen Van Wye, Oxiris Barbot, James L. Hadler, Natalia Linos, Mary T. Bassett, American Journal of Public Health, Vol. 106, No. 6, June 2016
(subscription required)

From the abstract:
Objectives. To assess potential reductions in premature mortality that could have been achieved in 2008 to 2012 if the minimum wage had been $15 per hour in New York City.

Methods. Using the 2008 to 2012 American Community Survey, we performed simulations to assess how the proportion of low-income residents in each neighborhood might change with a hypothetical $15 minimum wage under alternative assumptions of labor market dynamics. We developed an ecological model of premature death to determine the differences between the levels of premature mortality as predicted by the actual proportions of low-income residents in 2008 to 2012 and the levels predicted by the proportions of low-income residents under a hypothetical $15 minimum wage.

Results. A $15 minimum wage could have averted 2800 to 5500 premature deaths between 2008 and 2012 in New York City, representing 4% to 8% of total premature deaths in that period. Most of these avertable deaths would be realized in lower-income communities, in which residents are predominantly people of color.

Conclusions. A higher minimum wage may have substantial positive effects on health and should be considered as an instrument to address health disparities.