When data are not there, what do we do? A multi-step approach to occupational health inequity research

When we have a research question but cannot find a dataset to answer it, what should we do? This situation happens quite often in new areas of research, such as occupational health inequities. One approach is to get funding to do primary research so that you can collect the data you need to answer the research question. This is easier said than done because without some assurance that the question is worth asking (i.e., there is existing data to show that the new research has the potential to benefit the public’s health), funders would be hesitant to grant the money needed. Without existing data to answer the research question and without data to justify new data collection, researchers can get stuck in a cycle of needing the data to get the data.

We recently published a paper¹ giving step-by-step instructions to show researchers who are interested in work-related health inequities how they can make the most of existing data, even though these data might not be optimal for answering the health equity question. The conceptual model focuses on two interconnected mechanisms by which inequities arise: occupational segregation (i.e., different groups of people are sorted into different jobs) and occupational health inequity (i.e., avoidable differences in work-related health). The two mechanisms explain how work may create observed differences in health across demographically defined groups (e.g., how does work contribute to gender or racial/ethnic health inequities?).

We used inequities in access to adequate bathrooms in the workplace as an example of a research question for which no suitable large-scale data exist. In small-scale studies, many workers report using the bathroom at work less frequently than they want to, which can lead to urinary tract infection, urinary incontinence, and other issues. However, there was no large-scale representative dataset to investigate the problem. We first set up a simple conceptual model that shows how inequities in bathroom access could occur, and then used various data sources to gain information on each path described in the model. In the end, we were able to identify not only which groups of workers were likely to experience inadequate bathrooms in the workplace, but also what kind of data are needed for future research on this topic.

For example, if men were more likely to work as a roofer than women, roofing was more likely than other jobs to involve outdoor work far from bathrooms, and working far from bathrooms caused bladder problems, then men would have a higher-than-expected prevalence of bladder problems than women would: a gendered health inequity attributable to occupation. A key component of our conceptual model is that the second mechanism, occupational health inequity, involves avoidable differences in working conditions. In our example, we could avoid the gendered health inequity in bladder problems by providing roofers portable bathrooms on the job site and frequent breaks to use them. The model therefore suggests solutions to work-mediated health inequities: improving working conditions across occupations. This solution is fully compatible with existing occupational safety and health practices.

Data availability does not need to decide what research question we ask, particularly in emerging areas of research where we usually do not have suitable data. If we only investigate topics that have available data, we may miss new and important areas of research that could improve worker health.

Have you experienced the problem of not finding data for the question you want to investigate? Have you ever felt that your research questions are limited by data availability? Tell us in the comments below.

Kaori Fujishiro, PhD, is a Senior Research Epidemiologist in the Division of Field Studies and Engineering at NIOSH. 

Candice Johnson, PhD, is an Assistant Professor in Family Medicine and Community Health at Duke University and Guest Researcher in the Division of Field Studies and Engineering at NIOSH.  

Reference

1. Johnson CY, Fujishiro K. Identifying occupational health inequities in the absence of suitable data: are there inequities in access to adequate bathrooms in US workplaces? Occupational and Environmental Medicine Published Online First: 05 September 2023. doi: 10.1136/oemed-2023-108900 https://oem.bmj.com/content/early/2023/09/05/oemed-2023-108900