The specific aim of this study is to determine whether there are disparities in the occurrence of occupational injuries and illness and in associated medical care for work-related disorders, based on workers' race ethnicity, and socioeconomic status. This exploratory study will advance the NORA health services research mission by illuminating socially-based patterns of disease occurrence and medical care delivery, and test a novel research methodology that employs large national health care databases to collect and analyze information about the health and health care experiences of injured workers. The proposed investigation also directly applies to the NORA focus on social and economic consequences, social disparities in the incidence of work-related injuries and illness and inequalities in health care services are potentially a significant social impact of workplace accidents that must be considered when evaluating the overall human burden imposed on workers suffering job injuries. The proposed study methodology is based on the use of three national population-based surveys of patients and health care providers containing information about patient sociodemographic attributes, employment experiences and medical care services. Data sources include the National Ambulatory Medical Care Survey, the National Longitudinal Study on Youth, and the Health and Retirement Survey. Pilot studies conducted by this research team have demonstrated the usefulness of these databases in providing an innovative source of new information on this topic, and have provided initial evidence suggesting that blacks and Hispanics, and those of low socioeconomic status are more vulnerable to sustaining workplace injuries and receiving inferior medical care. This study will result in a descriptive analysis of work-related cases databases, and selected multivariate analyses to assess the interactive effect of patient sociodemographic characteristics with employment experiences, occupational health events, medical services, and vocational outcomes. This study has significant policy implications related to the NORA health services research objective of collecting new information about the determinants of health services for injured workers, and thereby helping to eliminate barriers to securing appropriate care. Eliminating social disparities in health is one of the two overarching national goals articulated in Health People 2010 and the focus of President Clinton's and the Department of Health and Human Service's recently announced national initiative: Eliminating Racial and Ethnic Disparities in Health.

Agency
National Institute of Health (NIH)
Institute
National Institute for Occupational Safety and Health (NIOSH)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21OH007322-01
Application #
6314953
Study Section
Special Emphasis Panel (ZOH1-MJG (06))
Project Start
2000-09-30
Project End
2002-09-29
Budget Start
2000-09-30
Budget End
2001-09-29
Support Year
1
Fiscal Year
2000
Total Cost
$117,000
Indirect Cost
Name
University of Massachusetts Medical School Worcester
Department
Family Medicine
Type
Schools of Medicine
DUNS #
660735098
City
Worcester
State
MA
Country
United States
Zip Code
01655
Dembe, Allard E; Savageau, Judith A; Amick 3rd, Benjamin C et al. (2005) Racial and ethnic variations in office-based medical care for work-related injuries and illnesses. J Natl Med Assoc 97:498-507