March 2, 2018 Celeste Monforton, DrPH, MPH 0Comment


I first read the phrase “occupational health literacy” in a study by Kim Rauscher and Doug Myers. The West Virginia University epidemiologists modifed HHS’s definition of “health literacy” to coin the term occupational health literacy (OHL). In their 2014 paper “Occupational health literacy and work-related injury among U.S. adolescents,” they define OHL as:

“the degree to which individuals have the capacity to obtain, process, and understand basic occupational safety and health (OSH) information and services needed to make appropriate decisions with regard to health and safety at work.”

I liked the concept then, and I like it now.

Rauscher and Myers used survey data from 2,260 teen workers to evaluate the relationship between OHL and work-related injuries. An OHL score was calculated for each worker based on responses to questions on training, information, knowledge and awareness. “Training” referred to employer-provided safety training; “Information” was the extent to which the worker obtained OHS information from outside the workplace (e.g., a teacher, a friend); and the other two referred to the worker’s awareness and knowledge of specific OHS laws, regulations, and principles.

Rauscher and Myers’ findings were unexpected (I won’t get into them here) but it makes further development of an OHL measure even more worthwhile. It’s a topic I thought deserved attention by the OHS community then, but I didn’t do anything to focus attention on it.

But this week, I read a newly published paper by researchers at the University of Illinois at Chicago (UIC) School of Public Health. They interviewed 51 low wage workers to investigate the individuals’ experiences with work-related injuries and their interactions with the workers’ compensation system. Among other things, the researchers found 41 percent of the workers had personally experienced a work-related injury. Sixty-five percent of those who had been injured said their employer paid for the medical care they received. The care was provided at outpatient clinics, emergency rooms, and hospitals.

The UIC researchers noted, however, that the vast majority of workers had little understanding of the workers’ compensation system. In fact, only 16 of the 51 workers were even familiar with the term “workers’ compensation.” Many workers were not aware of the wage-replacement protections for lost-time injuries, rehabilitation services offered for high impairment injuries, or provisions for light-duty accommodations. The authors write:

[These findings] “demonstrate limited ‘occupational health literacy’ among low wage workers and failure of employers to adequately inform them about their rights and protections which are mandated by federal and state law.

Their lack of knowledge may interfere with their health outcomes and with their employment rights.”

Seeing the phrase “occupational health literacy” caught my attention and brought me back to Rauscher and Myers’ 2014 paper. It wasn’t simply that the UIC authors mentioned OHL. They wrote this:

“Interviewees had many ideas for overcoming the barriers to reporting work-related injuries and accessing WC insurance. These included: increasing their own knowledge about workplace health and safety; increasing their knowledge about legal rights related to health and safety and employment; seeking advocacy from co-workers, family members, and attorneys; and addressing health and safety with their supervisors when it is appropriate.

They suggested getting better information and training on these issues and pointed out that their employers should be required to provide this. They also described networking with co-workers and seeking out reliable, external sources of information.”

Training, information, knowledge and awareness—the factors identified by the Chicago-area workers as contributors to safe jobs. They are the very same OHS elements integrated in the OHL scoring tool developed by Rauscher and Myers.

So here I am, back to where I was in 2014.  The OHL concept has merit. I think it deserves attention—at least some conversations—in the OHS community.

  • Do you use the phrase “occupational health literacy” in your work?
  • How would your OHS research and advocacy be improved with a consistently used tool to measure of OHL?
  • How would using the phrase OHL change the dialogue about workers’ rights and safety protections?
  • Are you interested in discussing OHL?







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