How Does Worker Health and Safety Matter for Full Employment?

December 30, 2022

Community Development & District Engagement, SF Fed Blog

To support the San Francisco Fed’s congressionally-mandated mission of promoting full employment and stable prices, the SF Fed’s Community Development team has been engaging with low-wage workers to better understand the tradeoffs that workers and their families consider as they navigate decisions related to work. These considerations include the costs of child care, transportation, housing near job opportunities, the challenges of unstable schedules and canceled shifts, on-the-job safety, and other issues related to working conditions.

Dr. Lola Loustaunau is a visiting scholar at the SF Fed whose work with food processing workers in Oregon and Washington touches on all these challenges that workers navigate. In this interview by Senior Researcher Lina Stepick, Dr. Loustaunau shares her research, how worker health and safety relates to full employment, ways to address barriers workers face, and how COVID-19 impacted workers in essential industries.

Lina Stepick (LS): Your findings on worker health and safety are especially relevant to labor force participation of frontline workers in this industry. Can you tell us a bit about your research?

Lola Loustaunau (LL): My research primarily focuses on job quality, labor mobility, and the extensive impacts of precarious work on the lives of frontline workers. In the past six years I have focused on the working conditions in the food processing industry.

Food processing workers play a central role in sustaining the food supply chain, but the sector remains one of the most dangerous for workers. Because of the higher levels of acute and chronic health issues these workers face as a normal consequence of working in this industry compared to others, I refer to these workers’ experiences as “endemic precarity.” I find that these conditions impact workers’ ability to remain employed within the industry or to find alternative employment.

I have focused my research on Oregon and Washington, two states with a high concentration of food processing companies, and on the experiences of migrant workers, particularly women, who are employed in some of the lower paid and most dangerous roles within these companies. All my projects have been developed in close collaboration with different community and worker organizations, as I believe workers’ voices are critical to any discussion of job quality and workforce development. My findings are based on in-depth interviews with over 70 food processing workers, managers, and other stakeholders in the two states, as well as participant observation of worker collective actions and public agency meetings, content analysis of public agency records, and analysis of publicly available workforce and industry data.

LS: The SF Fed seeks to understand barriers to employment as part of our congressionally-mandated mission for full employment and stable prices. How does your research deepen our understanding of worker health and safety and how it relates to full employment?

LL: Let me start by stating what is the most straightforward connection, which is that the working conditions and related physical injury experienced by workers in this industry translates into workers losing their employment due to an inability to continue performing their job duties. Many workers are forced to leave their employment as a result of the physical strain and pain they must endure as part of their working conditions, or they discover that their subsequent employment options are severely limited as a result of previous workplace injury or illness.

In my research, I found a continuum from serious, “recordable” injuries that employers and public agencies register to other more subtle forms of cumulative damage. Fifty-five percent of the workers I interviewed had suffered a severe injury in the workplace, and 30% had sustained injuries more than once. These figures are consistent with the fact that the food processing industry overall has one of the highest injury rates in manufacturing—1.7 times the incident rate for all of manufacturing, and 1.8 times the overall rate for workers in the U.S. in 2021.

Workers also reported “non-recordable” injuries that stem from chronic ergonomic issues related to the conditions in which they work. For instance, workers must stand on the line for long periods, may often bump into hard edges when extending over a conveyor belt, or face frequent falls on slippery floors. The cumulative effect of these injuries over time lead to conditions such as sciatica, joint compression, varicose veins, and muscle fatigue, among others that are highly prevalent in the industry. Unlike with serious accidents that need immediate care, employers and regulatory agencies do not record these forms of slow, chronic harm that take place over more extended periods. The limited data we have indicate that these types of musculoskeletal disorders are one of the primary health issues for workers in the food processing industry.

What also emerges from hearing from workers directly that is not fully captured by statistics is the cumulative debilitation that results from their work environment. The overwhelming majority of workers I interviewed suffered chronic pain in their legs, back, and arms, due to the way and the amount of hours they are required to work. For some workers, the chronic pain has made it hard for them to do everyday tasks in their homes, such as opening a jar, picking up their kids, or even sitting down or walking.

This cumulative debilitation and damage has serious impacts on workers’ physical and mental wellbeing. To put it simply, workers in this essential industry reported feeling like they were treated as disposable—and this was particularly the case for BIPOC workers. Moreover, there are very limited regulations to prevent this cumulative damage or redress it after the fact. As just one example, workers reported encountering significant barriers in navigating the workers’ compensation system, which is reflected in data on low rates of successful claims. I found that to really understand the impacts of dangerous and unhealthy workplaces on workforce development and on full employment, we need to bring to light both what workers experience daily on the shop floor and what happens to them after they are injured, hurt, or get sick as a result of their working conditions.

Finally, I found that this cumulative bodily damage and the lack of recognition of this harm by employers or public agencies had significant emotional impacts on workers. While the emotional labor that workers in public-facing jobs are expected to perform is often more visible and better understood, people are less likely to comprehend the emotional toll that factory workers can experience. This occurs at multiple points, both on and off the shop floor, as workers I interviewed often expressed anxiety about the speed of the lines and depression about the need to continue working under hazardous conditions. They expressed that their pain is regularly dismissed by management and public agencies where they tried to get recourse.

LS: Can you expand on what you’ve learned about the barriers workers identified and how they could be addressed?

LL: Workers shared with me the multi-layered barriers they encounter when they try to access proper care, try to get paid time off to recover from a workplace injury, or try to get back to work after an injury but need to be assigned to light duty to accommodate the consequences of their injuries. Workers expressed first encountering these barriers in the workplace when managers tell them that their employer is not responsible for injuries inflicted at the worksite. However, workers also shared that they continue to encounter barriers later when dealing with insurance companies and medical providers. This situation leads many workers to continue working while in pain, which can often further damage their health and potentially shorten their work lives, with implications for labor force participation and full employment.

One concrete example is the difficulty workers experience navigating the complexity of the workers’ compensation system, which requires coordinating across multiple entities—including employers, insurance companies, and medical care providers—with no guarantee of proper or adequate care. Workers I interviewed detailed how employers and insurance companies limit the duration of sick and injured workers’ treatment, or require time-consuming second opinions, audits, or reviews that can override recommendations made by workers’ primary care doctors. Navigating multiple systems that do not necessarily interact seamlessly with each other, workers reported being left with few options, high costs, and delayed treatments.

At the same time, there is a growing body of evidence, including findings from my own work, that most workers who are dealing with work-related illness and injury ultimately are only partially compensated for lost wages, if they are compensated at all. Workers described this process as time-consuming, costly, and emotionally exhausting, explaining how it creates desperate financial situations that force many workers to prematurely close their claims to be able to keep paying their bills.

When we think about addressing the complexity of these barriers to improve workers’ health and safety, we also need to think in a multi-level fashion. As a first step, ensuring existing health and safety regulations are enforced, and dedicating more resources to that end, would help level the playing field around worker health and safety standards in industries where these challenges are endemic. Provisions like universal paid sick leave would also help support workers as they navigate the systems we have in place. We also need to understand how workplace regulations interact with systems meant to help workers and with the healthcare system to ensure those interactions are not producing unintended consequences or complications.

LS: Your research spans many years, including during the height of the COVID-19 pandemic. How have the dynamics of the endemic precarity that you identified in food processing work shifted due to the pandemic and workers’ responses during this time?

LL: In many ways, the pandemic made visible workplace and workforce dynamics that were previously generally invisible, even in large, essential industries like food processing. Through the discourse of “essential work,” gendered and racialized work that had remained on the margins of our field of vision reappeared in the scene with a profoundly uneven distribution of risk, vulnerability, and harm.

It has now been well documented how food processing workplaces were particularly hazardous sites for the spread of COVID-19. Workers were confronted with a serious health crisis, with large numbers severely ill and many dying, but workers reported that employers and public agencies did not respond quickly to significantly protect workers. Workers experienced this as a sudden heightening of workplace hazards–what I discuss as the shift from chronic, endemic hazards and precarity to a heightened, crisis event in the pandemic.

This meant that workers themselves had to step outside of the factories to demand safety for themselves and their families. For example, a public records request showed that workers’ filed hundreds of complaints to their state labor standards agency, but the response time lagged. By the time their workplaces were inspected, workers had been striking for weeks due to the unsafe working conditions, the number of sick workers, and the preventable deaths of many coworkers. As the global health crisis unfolded, workers were asked to continue using a system that was not prepared to react with the urgency that was needed. An advocate and organizer who works closely with the refugee community in eastern Washington said that agencies kept “passing the buck,” leaving workers going from agency to agency without any solution to the problems they were facing.

At the same time, even though it was slow, during the pandemic we witnessed the temporary roll-out of policies that have been under discussion for years, such as paid sick leave. And we were able to see how these policies successfully ensured workers were able to properly recover from illness and injuries, reduce contagion, and be able to continue performing their duties for longer. This means we now have empirical proof of the expansive benefits of these policies. The critical question is now: What would it take to make some of these practices permanent, and how could that shape full employment as well as stability in these industries through future crises?

In contrast, during the pandemic we also saw an increase in overwork in essential industries, including suspensions of fair work week regulations. Overwork—including long shifts, long workweeks, long work periods without days off, and inadequate rest time between and during shifts—compounds workplace health and safety hazards. This was an issue that the food processing workers I interviewed raised clearly and repeatedly—and one we examine in more depth in a forthcoming research brief.