While the health of all depends on the food chain, few studies have focused systematically on the health of food chain workers themselves (production, manufacturing, wholesale, retail, and commercial and institutional services). In this study we used 2018 and 2019 data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine health-related metrics of food chain workers, combined and by industry sector, compared to non-food chain workers, among 32 U.S. states. Logistic regression indicated U.S. food chain workers had higher prevalences of barriers to health care access, smoking, no physical exercise, and poor self-reported health than all other workers. Patterns were similar among food chain workers in all industry sectors except wholesale. Additionally, commercial food services workers had higher prevalence of poor mental health, while institutional food services workers had higher prevalences of obesity, diabetes, and hypertension than all other workers. We discuss implications of these results for interventions, with specific attention to improving employment conditions. Food chain worker health is critical for food system sustainability and population health equity.
RosembergMASAdamsMPolickCLiWVDangJTsaiJHC. COVID-19 and mental health of food retail, food service, and hospitality workers. J Occup Environ Hyg. 2021;18(4-5):169–179. doi:https://doi.org/10.1080/15459624.2021.1901905.
4.
BufquinDParkJYBackRMde Souza MeiraJVHightSK. Employee work status, mental health, substance use, and career turnover intentions: An examination of restaurant employees during COVID-19. Int J Hosp Manag. 2021;93:102764. doi:https://doi.org/10.1016/j.ijhm.2020.102764.
5.
BillockRMSteegeALMiniñoA. COVID-19 Mortality by usual occupation and industry: 46 states and New York city, United States, 2020. Natl Vital Stat Rep. 2022;71(6):1–33.
6.
FreeHLuckhauptSEBillockRM, et al.Reported exposures among in-person workers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in 6 states, September 2020–June 2021. Clin Infect Dis. 2022;75(Supplement_2):S216–S224. doi:https://doi.org/10.1093/cid/ciac486
7.
WaltenburgMARoseCEVictoroffT, et al.Coronavirus Disease among Workers in Food Processing, Food Manufacturing, and Agriculture Workplaces. Emerg Infect Dis J – CDC. 2021;27(1). doi:https://doi.org/10.3201/eid2701.203821.
Committee on a Framework for Assessing the Health, Environmental, and Social Effects of the Food System, Food and Nutrition Board, Board on Agriculture and Natural Resources, Institute of Medicine, National Research Council. A Framework for Assessing Effects of the Food System. (Nesheim MC, Oria M, Yih PT, eds.). National Academies Press (US); 2015. Accessed April 7, 2022. http://www.ncbi.nlm.nih.gov/books/NBK305181/
10.
FrankJMustardCSmithP, et al.Work as a social determinant of health in high-income countries: Past, present, and future. Lancet. 2023;402(10410):1357–1367. doi:https://doi.org/10.1016/S0140-6736(23)00871-1.
11.
LoJJacobsonA. Human rights from field to fork: Improving labor conditions for food-sector workers by organizing across boundaries. Race/Ethn: Multidiscip Glob Contexts. 2011;5(1):61–82. doi:https://doi.org/10.2979/racethmulglocon.5.1.61.
12.
DuffyM. Reproducing labor inequalities: Challenges for feminists conceptualizing care at the intersections of gender, race, and class. Gender Soc. 2005;19(1):66–82. https://www.jstor.org/stable/30044569. Accessed August 17, 2020.
13.
ClaytonMLSmithKCPollackKMNeffRARutkowLUS. Food system working conditions as an issue of food safety. New Solut. 2017;26(4):599–621. doi:https://doi.org/10.1177/1048291116661845.
14.
BenachJVivesAAmableMVanroelenCTarafaGMuntanerC. Precarious employment: Understanding an emerging social determinant of health. Annu Rev Public Health. 2014;35:229–253. doi:https://doi.org/10.1146/annurev-publhealth-032013-182500.
15.
PeckhamTFujishiroKHajatAFlahertyBPSeixasN. Evaluating employment quality as a determinant of health in a changing labor market. RSF: Rus Sage Foundat J Soc Sci. 2019;5(4):258–281. doi:https://doi.org/10.7758/RSF.2019.5.4.09.
SnipesSACooperSPShippEM. “The only thing I wish I could change is that they treat us like people and not like animals”: Injury and discrimination among latino farmworkers. J Agromedicine. 2017;22(1):36–46. doi:https://doi.org/10.1080/1059924X.2016.1248307.
19.
HolmesSM. Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States, With a Foreword by Philippe Bourgois. University of California Press; 2013.
20.
FraserCESmithKBJuddFHumphreysJSFragarLJHendersonA. Farming and mental health problems and mental illness. Int J Soc Psychiatry. 2005;51(4):340–349. doi:https://doi.org/10.1177/0020764005060844.
21.
FreireCKoifmanS. Pesticides, depression and suicide: A systematic review of the epidemiological evidence. Int J Hyg Environ Health. 2013;216(4):445–460. doi:https://doi.org/10.1016/j.ijheh.2012.12.003.
22.
SchneiderDHarknettK. Consequences of routine work-schedule instability for worker health and well-being. Am Sociol Rev. 2019;84(1):82–114. doi:https://doi.org/10.1177/0003122418823184.
23.
JayaramanSDropkinJSibySAlstonLRMarkowitzS. Dangerous dining: Health and safety in the New York city restaurant industry. J Occup Environ Med. 2011;53(12):1418–1424. doi:https://doi.org/10.1097/JOM.0b013e3182363b9f.
24.
SuzmanMSSobocinskiKHimelHYurtRW. Major burn injuries among restaurant workers in New York city: An underappreciated public health hazard. J Burn Care Rehabil. 2001;22(6):429–434. doi:https://doi.org/10.1097/00004630-200111000-00014.
25.
AndreaSBMesserLCMarinoMBoone-HeinonenJ. Associations of tipped and untipped service work with poor mental health in a nationally representative cohort of adolescents followed into adulthood. Am J Epidemiol. 2018;187(10):2177–2185. doi:https://doi.org/10.1093/aje/kwy123.
26.
NewmanKLLeonJSNewmanLS. Estimating occupational illness, injury, and mortality in food production in the United States: A farm-to-table analysis. J Occup Environ Med. 2015;57(7):718–725. doi:https://doi.org/10.1097/JOM.0000000000000476.
27.
BoyceJMSchaffnerDW. Scientific evidence supports the use of alcohol-based hand sanitizers as an effective alternative to hand washing in retail food and food service settings when heavy soiling is not present on hands. J Food Prot. 2021;84(5):781–801. doi:https://doi.org/10.4315/JFP-20-326.
28.
FengYBruhnCM. Motivators and barriers to cooking and refrigerator thermometer use among consumers and food workers: A review. J Food Prot. 2019;82(1):128–150. doi:https://doi.org/10.4315/0362-028X.JFP-18-245.
YangWSteeleMLopmanBLeonJSHallAJ. The population-level impacts of excluding norovirus-infected food workers from the workplace: A mathematical modeling study. Am J Epidemiol. 2019;188(1):177–187. doi:https://doi.org/10.1093/aje/kwy198.
31.
AlkonAGuthmanJ, eds. The New Food Activism: Opposition, Cooperation, and Collective Action, First ed.University of California Press; 2017.
32.
Standard Occupational Classification (SOC) System. Bureau of Labor Statistics. Published 2010. Accessed April 7, 2022. https://www.bls.gov/soc/
33.
ShierholzHPoydockMMcNicholasC.Unionization Increased by 200,000 in 2022: Tens of Millions More Wanted to Join a Union, but Couldn’t. Economic Policy Institute; 2023. Accessed November 28, 2023. https://www.epi.org/publication/unionization-2022/
AhonenEQFujishiroKCunninghamTFlynnM. Work as an inclusive part of population health inequities research and prevention. Am J Public Health. 2018;108(3):306–311. doi:https://doi.org/10.2105/AJPH.2017.304214.
Uninsurance I of M (US) C on the C of. Effects of Health Insurance on Health. National Academies Press (US); 2002. Accessed December 3, 2019. https://www.ncbi.nlm.nih.gov/books/NBK220636/
39.
AsariaMAliSDoranT, et al.How a universal health system reduces inequalities: Lessons from England. J Epidemiol Community Health. 2016;70(7):637–643. doi:https://doi.org/10.1136/jech-2015-206742.
LeighJPChakalovB. Labor unions and health: A literature review of pathways and outcomes in the workplace. Prev Med Rep. 2021;24:101502. doi:https://doi.org/10.1016/j.pmedr.2021.101502.
43.
LuckhauptSETakSCalvertGM. The prevalence of short sleep duration by industry and occupation in the national health interview survey. Sleep. 2010;33(2):149–159. doi:https://doi.org/10.1093/sleep/33.2.149.
Food Preparation and Serving Related Occupations. Bureau of Labor Statistics. Occupational Employment and Wages, May 2021. Accessed August 25, 2022. https://www.bls.gov/oes/current/oes350000.htm
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
