Job Complexity, Race, and Socioeconomic Status: Examining Health Disparities from an Occupational Perspective

Research conducted in the United States on racial/ethnic health disparities and socioeconomic status (SES) has not fully considered occupation. Because racial and ethnic groups are not represented equally in all occupations, differences in job characteristics may help explain racial/ethnic health disparities.  Two recent studies by the National Institute for Occupational Safety and Health (NIOSH) explore job complexity as a factor that contributes to racial health disparities.

Job complexity as an indicator of SES

Job complexity is high if a job requires employees to:

• make decisions while consequences are unknown,
• gather and evaluate information from various sources, and
• solve problems in uncertain situations.

These jobs are engaging and empowering because they provide opportunities to use our skills and to do our best.  For example, doctors and business executives have highly complex jobs, and so do construction managers, barbers, and IT service technicians. Examples of less complex jobs are sorting agricultural products, washing dishes, and cutting meats and vegetables in commercial kitchens.  Jobs are generally more complex at the higher end of SES.

Previous studies have shown that high job complexity is associated with fewer disabilities in retirement and lower mortality. Decision-making power and skill-use opportunities have been consistently associated with better health.  In sum, the literature suggests that job complexity may partly explain health disparities by SES.

Job complexity, race, and SES

Racial composition within an occupation seldom reflects the entire US population. Whites have a higher proportion of high SES jobs, which are generally highly complex. Lower SES jobs, which tend to be less complex, are more common among African Americans and Latinos. Even within the same education level, on average white men hold more complex jobs, a new NIOSH study documented¹.  Reflecting this, the study found that the positive effect of high education and complex jobs was the strongest for white men.  For black men and women of both races, even when they had high levels of education, their jobs were not as complex as their white, male counterparts’, and thus the positive effect of a complex job was limited.

Another recent study from NIOSH² examined job complexity with racial difference in risk of death.  Historically, the annual risk of death is higher for African Americans than whites.  The NIOSH study found that this difference could be reduced by a third if African Americans had the same levels of complexity in their jobs as whites.  This suggests that different experiences of job complexity may be an important factor in creating racial health disparities.

If racial difference in job complexity partly explains racial health disparities, then reducing the difference may help remove such disparities.

We would like to hear from you. What needs to be done to make jobs more engaging and empowering? Please leave your thoughts in the comment section below.

Kaori Fujishiro, PhD, is Senior Epidemiologist in the NIOSH Division of Surveillance, Hazard Evaluations and Field Studies. 

References

1. Fujishiro, K., MacDonald, L. A., Crowe, M., Howard, V. J., McClure, L. A, & Wadley, V. G. (2017). The role of occupation in explaining cognitive functioning in later life: Education and occupational complexity in a US national sample of black and white men and women. Journal of Gerontology, Series B: Social Sciences. Doi: 10.1093.geronb.gbx112 https://academic.oup.com/psychsocgerontology/article/doi/10.1093/geronb/gbx112/4085846/The-Role-of-Occupation-in-Explaining-Cognitive
2. Fujishiro, K., Hajat, A., Landsbergis, P. A., Meyer, J. D., Schreiner, P. J., & Kaufman, J. D. (2017). Explaining racial/ethnic differences in all-cause mortality in the Multi-Ethnic Study of Atherosclerosis (MESA): Substantive complexity and hazardous working conditions as mediating factors. Social Science & Medicine-Population Health, 3, 497-505. http://www.sciencedirect.com/science/article/pii/S2352827317300228