Low Wage, Contingent and Temporary Workers How can TWH serve them? Laura Welch, MD CPWR: Center for Construction Research and Training AFL-CIO

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1 Low Wage, Contingent and Temporary Workers How can TWH serve them? Laura Welch, MD CPWR: Center for Construction Research and Training AFL-CIO

2 39 million workers in the US are low wage workers (<150% minimum wage, or $435/week) Disproportionately women, African-American, Hispanic, foreign-born, lacking a high school diploma, and under 24 years of age. Most common occupations: cashiers, food service workers, personal and home care aides, housekeepers, hand packagers, farm workers, and child care workers

3 Occupations employing >250,000 workers paying <150% of Minimum Wage ($11.00) Occupation Hourly wage($) No. of worker Cashiers ,354,170 Food Prep/Serve Workers, Incl Fast Food ,692,170 Waiters and Waitresses ,244,480 Home Health Aides ,840 Maids and Housekeeping Cleaners ,960 Food Preparation Workers ,650 Personal Care Aides ,030 Packers and Packagers, Hand ,870 Childcare Workers ,280 Cooks, Fast Food ,350 Dishwashers ,950 Bartenders ,350 Counter Attendants, Cafeteria, Concession ,660 Dining Room, Cafeteria Attds, Bartend Help ,920 Host/ Hostess, Restaurant, Lounge ,020 Cleaners of Vehicles and Equipment ,110 Amusement and Recreation Attendants ,630

4 Low-wage workers often have temporary or contingent employment Lead Company Labor only staffing firm, temporary firm, labor contractor, franchise Workers

5 Outsourcing has a negative impact on wages and working conditions Janitors pay dropped 7% Food service workers pay dropped $6/hour 25% of workers report minimum wage violations Up to 70% are not paid overtime Conscientious employers experience competition from lower-bidding companies National Employment Law Project. Who s the Boss May 2014

6 Janitorial Industry example 2.1 million workers in industry 37% in contracted work 30% Hispanic, 18% African American 26% report minimum wage violations, 71% overtime violations, 72.5% off the clock violations Survey of 4,387 workers in low-wage industries in Chicago, Los Angeles, and New York City. See Broken Laws, Unprotected Workers: Violations of Employment and Labor Laws in America s Cities (September 02, 2009) at nelp.org

7 Social Ecological Framework for TWH Personal Institutional Worksite Health Department Community Clinics Community Based Community Policy

8 Levels of Influence Worksite Examples of Program Activities at Multiple Levels of the SEF Clinics Health Depts Community Intrapersonal Individual Disseminate information on smoking risks and cessation programs; and on how smoking may interact with workplace exposures to increase disease risk. Asking each patient about what they do for work and about hazardous activities and exposures Discuss the importance of smoking cessation and physical activity during clinic visits Disseminate information on asthma prevention and control (including workrelated asthma) to patients through health care providers. Disseminate information about workplace exposures and proper use of protective equipment through door to door visits by community outreach workers Baron et al. AJIM 2013 Promoting Integrated Approaches to Reducing Health Inequities among Low-Income Worker: Applying a Social Ecological Framework

9 Levels of Influence Examples of Program Activities at Multiple Levels of the SEF Worksite Clinics Health Deprtnt Community Community + Society: Local, State, Regional, National Government State health dept. surveillance of work-related injuries and illnesses as well as relevant chronic health conditions (e.g., diabetes, metabolic syndrome, ischemic heart disease) by sector and occupational category. Developing standard protocols for assessment and management of occupational and environmental hazards across CMHC network Incorporating health and safety interventions into the purview and agenda of health departments. Apply for community based job training grants and include incentives for employers who comply with safety standards. Use community development funds for infrastructure projects that promote physical activity (pools, parks etc)

10 Smoking cessation most effective campaigns act in concert at multiple levels INDIVIDUAL: Clinicians advise smokers to quit and recommend they use effective cessation treatments EMPLOYER: Health insurers, health insurance purchasers, and health systems include counseling and medications for smoking cessation as covered benefits COMMUNITY/POLICY: Increased excise taxes, mass media campaigns, and smoke-free laws.