Labor Organizing: An Unexpected Avenue to Health Equity

Leah R. Abrams, MPH ’17

PhD Student in Health Management and Policy

September 13, 2019

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Socioeconomic inequality is a fundamental cause of health disparities in America.¹ Across the country, labor unions are essential for preventing workplace injuries, discrimination, financial insecurity, and inadequate insurance coverage—all of which contribute to socioeconomic differences in health and life expectancy. These efforts make labor organizations inextricably linked to public health.

Longstanding theory and evidence have shown that inequities in socioeconomic status or class— specifically education, income, occupation type, and wealth—are an essential cause of differences in health in the US. For example, only 23 percent of adults who did not graduate from high school report being in excellent or good health compared to 45 percent of those with high school degrees, 56 percent of those with some college education, and 70 percent of those who graduated from college.² Education is such a powerful predictor of health because it shapes downstream factors like health behaviors, risk exposures, and access to disease prevention and treatment.¹ One effective approach to reducing inequity in health in America is to minimize differences in education, income, wealth, and power.¹

Labor unions are one way people can organize to work toward social equity. When employers are required to negotiate contracts with their employees, workers have a strong voice in shaping their workplace conditions and compensations. An example of an effective labor organization here at the University of Michigan is the Graduate Employee Organization (GEO), which represents graduate student instructors and staff assistants. GEO harnesses the collective power of graduate students, who would otherwise be in rather vulnerable and disenfranchised positions in the academic hierarchy. GEO works to ensure that graduate workers’ stipends keep up with Ann Arbor’s cost of living. Given the unique strains of graduate school, GEO has fought for mental health copay caps so that graduate students never pay more than $700 per year on mental health care while studying at the university.

In addition to these benefits for all graduate students, GEO also works to improve the equity and inclusion of specific groups. In the last contract campaign, GEO successfully bargained for contract language that protects international students from being forced to work more than their visas allow. In addition, the last contract campaign won several paid, unionized positions for Diversity, Equity, and Inclusion labor so that minority students are not expected to do such work without pay. Recently, GEO played a critical role in expanding access to gender-affirming services for transgender graduate students, a benefit that was extended to other transgender employees on university insurance plans.³

These examples show how labor organizations like GEO empower workers to assert their needs and bargain for fair benefits and protections. By improving power, income, safety, and insurance coverage, labor unions boost the health of employees so they might achieve the same health status of their employers. While they might not appear to be working on public health research or for public health agencies, all organizations that aim to reduce social inequality actively contribute to reductions in health disparities.

References

1. Phelan JC, Link BG, Tehranifar P. Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications. J Health Soc Behav. 2010;51(1_suppl):S28-S40. doi:10.1177/0022146510383498
2. Braveman PA, Cubbin C, Egerter S, Williams DR, Pamuk E. Socioeconomic disparities in health in the United States: what the patterns tell us. Am J Public Health. 2010;100 Suppl 1(S1):S186-96. doi:10.2105/AJPH.2009.166082
3. BLT Staff. U-M Expands Trans Health Coverage after Graduate Union Campaign. Between the Lines. May 10, 2019. Ann Arbor, Michigan. https://pridesource.com/article/u-m-expands-trans-health-coverage-after-graduate-union-campaign/

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About the Author

 Leah Abrams earned a BA from Emory University and a Master of Public Health degree from the University of Michigan School of Public Health, where she is currently a doctoral candidate in Health Management and Policy. Her research interests are in social epidemiology, aging, mental health, and health equity, and her current research focuses on depressive symptoms in late life.