Mechanisms of inequalities in health and safety : conceptual model and research agenda

A growing number of studies from industrialized countries have documented elevated rates of occupational injuries and illnesses for foreign-born workers relative to their native counterparts. However, the mechanisms at play remain poorly understood. We propose a conceptual model of the mechanisms that underlie the observed inequalities. We describe how language barriers, cultural differences, vulnerable legal status, precarious economic status, newness in the host country and job, lower education and skill levels, and discrimination all generate vulnerabilities that are embodied as poor working conditions, limited knowledge of health and safety, impeded communication with employers and service providers, detrimental behaviours towards risks or health, and constrained agency. These processes, in turn, engender inequalities in exposures as well as in prevention, care, compensation and rehabilitation, which impact health. We note that in-depth information is lacking on pathways to inequalities, on how they differ by gender and ethnicity, and on how they are shaped by broader social, economic, political and legal structures. We also note the lack of information on strategies to reduce inequalities. We propose avenues for research that have the potential to lead to meaningful and actionable results. ; Un nombre croissant d’études provenant de pays industrialisés ont documenté des taux élevés d’accidents et de maladies professionnelles pour les travailleurs nés à l’étranger. Par contre, les mécanismes en jeu sont mal compris. Nous proposons un modèle conceptuel des mécanismes qui sous-tendent les inégalités. Nous décrivons comment les barrières linguistiques, les différences culturelles, la vulnérabilité liée au statut légal, la précarité économique, la nouveauté dans le pays hôte et/ou dans l’emploi, le niveau inférieur d’éducation ou d’expérience et la discrimination génèrent des vulnérabilités qui se reflètent dans des conditions de travail difficiles, des connaissances inférieures sur la santé et la sécurité, des ...