Women’s History Month Reflections on Occupational Exposures and Health Equity

March was Women’s History Month and this year’s theme was “Women Who Advocate for Equity, Diversity and Inclusion.” This theme urged us to think about the diversity of U.S. women workers and how NIOSH is addressing health equity. Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health.[1] Occupational health inequities [2] can be influenced by exclusion and discrimination based on factors such as gender, socioeconomic position, and racism. Researchers at NIOSH are studying how to improve health equity for many groups, such as diverse women at work, including women workers across social identities such as racial or ethnic groups, socioeconomic position, and others.

What NIOSH is doing

Surveillance has shown that certain occupational exposures are more prevalent among female than male workers. For example, women are more likely to work permanent night schedules than men. Female workers who are Black, Hispanic, and American Indian are more likely to work rotating shifts versus people who are Non-Hispanic White, which could negatively impact health by disrupting normal sleep cycles. [3] [See NIOSH Worker Health Charts)]

A few examples of NIOSH work that addresses the health of diverse women in the workplace include:

• Understanding gender, racial, and ethnic disparities for a variety of occupational exposures and outcomes, including workplace discrimination and mistreatment, motor vehicle crashes, and cognitive aging after retirement.
• Improving personal protective equipment fit for diverse populations.
• Advancing methods to improve data collection.
• Exploring needs and issues for diverse workers in specific occupations (e.g., patient care aides) and industries (e.g., mining).
• Communicating to diverse audiences through new channels (e.g., Wikipedia).
• Researching workplace exposures, like high physical job demands and overnight shift work, that are associated with increased menstrual dysfunction.[4] [5]
• Researching workplace factors, like adequate bathroom access, that disproportionately affect certain workers and can have different impacts on menstruating workers.

What’s next?

NIOSH continues to study how workplace exposures impact the health of different groups of workers; how workplaces can support the needs of all workers; and understand to what extent occupational segregation―that is, how certain demographic groups are disproportionately represented in certain jobs—might underlie disparities we see in some health outcomes by race, gender, and socioeconomic class.

The framework of intersectionality might help future researchers understand how social structures impact the disproportionate exposures and burden of occupational ill-health. Intersectionality calls attention to the interlocking social structures that influence patterns of wellness and illness across multiple demographic axes.[6] The CDC Office of Health Equity has created a video to help explain intersectionality.

NIOSH recognizes that we can increase our ability to address the needs of all workers by attracting, retaining, and supporting a diverse workforce. One of NIOSH’s seven core values is for its employees and contractors to “reflect the full spectrum of diversity found in the American workforce and our research and interventions reflect the diversity of solutions needed for the American workplace”.[7] In 2019, NIOSH launched a strategic planning initiative designed to support and promote diversity and inclusion through its workforce, workplace, and its research.

The following blog posts provide examples of NIOSH’s talented diverse women in the workplace.

• International Women in Engineering Day
• Women’s History Month: NIOSH Recognizes Female Leaders
• Women in STEM
• Black History Month: Recognizing Two Young NIOSH Researchers
• Christine M. Branche, PhD, Protecting America’s Construction Workers

We want to hear from you

How do you see intersecting social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) affecting occupational health?

How have you addressed gender in your work on occupational health?

Amel Omari, PhD, is a Research Epidemiologist in the NIOSH Division of Field Studies and Engineering.

Sue Afanuh, MA, is a Technical Information Specialist in the NIOSH Division of Science Integration. 

Ursula “Asha” Brogan, MS, is a Health Communication Specialist in the Engineering and Physical Hazards Branch in the NIOSH Division of Field Studies and Engineering.

Deborah V. Hirst, PhD, is the Deputy Branch Chief for the Engineering and Physical Hazards Branch in the NIOSH Division of Field Studies and Engineering.

Sara Luckhaupt, MD, MPH, is the Associate Director for Science in the NIOSH Division of Field Studies and Engineering.

Carissa M Rocheleau, PhD, is a Reproductive Occupational Epidemiologist in the NIOSH Division of Field Studies and Engineering.

Jennifer Tyrawski, PhD, is a Health Communications Specialist in the NIOSH Division of Field Studies and Engineering.

Grace Vixama, MPH, CHES, is a Health Communications Specialist in the Science Application Branch in the NIOSH Division of Science Integration. 

References

[1] CDC [2022b]. What is health equity? Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/whatis/index.html

[2] NIOSH [2019b]. Occupational health equity. NIOSH Program Portfolio. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. www.cdc.gov/niosh/programs/ohe/default.html

[3] Ferguson JM, Bradshaw PT, Eisen EA, Rehkopf D, Cullen MR, Costello S [2023]. Distribution of working hour characteristics by race, age, gender, and shift schedule among U.S. manufacturing workers. Chronobiol Int 40(3):310–323. https://doi.org/10.1080/07420528.2023.2168200

[4] Lawson CC, Johnson CY, Chavarro JE, Lividoti Hibert EN, Whelan EA, Rocheleau CM, Grajewski B, Schernhammer ES, Rich-Edwards JW [2015]. Work schedule and physically demanding work in relation to menstrual function: the Nurses’ Health Study 3. Scand J Work Environ Health. 41(2):194–203. https://doi.org/10.5271/sjweh.3482

[5] Johnson CY, Grajewski B, Lawson CC, MacDonald LA, Rocheleau CM, Whelan EA [2024]. Occupational physical demands and menstrual cycle irregularities in flight attendants and teachers. Occup Environ Med 81:3–8. https://doi.org/10.1136/oemed-2023-109099

[6] Bowleg L [2012]. The problem with the phrase women and minorities: intersectionality—an important theoretical framework for public health. Am J Public Health 102(7):1267–1273. https://doi.org/10.2105/AJPH.2012.300750

[7] NIOSH [2014]. NIOSH strategic plan outline 2010–2015. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. www.cdc.gov/niosh/docs/strategic/default.html