The Role of Work in Health Disparities in the U.S. (R01 Clinical Trials Optional)

NIMHD supports this Funding Opportunity Announcement (FOA) focused on population-based research that can contribute to identifying and understanding pathways and mechanisms through which work or occupation influences health outcomes and health status among populations with health and/or health care disparities. Previously, occupational health disparities research has mainly focused on work as a source of hazardous exposures linked with a specific health outcome. The main objective of this initiative is to determine the extent and the mechanisms by which work as a social determinant of health (SDOH) both contributes to, and helps improve, health and health care disparities.

This FOA is a call for applications to examine work beyond only being a source of “exposures and risk factors”, by examining it also as a source of beneficial social and economic resources and attainment of social position and status. Few studies have explored how work explains health disparities, especially in the contexts of racial and ethnic populations and socioeconomic status. Projects should be designed to use conceptual model(s) grounded in minority health and health disparities theories that recognize that health disparities arise by multiple and overlapping contributing factors acting at multiple levels of influence (see the NIMHD Research Framework). Studies must examine one or more NIH-designated U.S. populations experiencing health disparities and those involving primary data collection with human participants are strongly encouraged to incorporate SDOH measures available in the PhenX Toolkit.

NIMHD is interested in projects that:

• Evaluate the role of work as a SDOH for individuals as well as household members and extended families, teasing apart work as a social class marker, as a source of “exposures and risk factors”, and/or source of beneficial social and economic resources.
• Examine whether work can explain the health or health care disparities seen within diseases or conditions (e.g., COVID-19, mental/behavioral health, diabetes) or clusters of diseases (e.g., syndemics) as well as disparities in co-morbidities and general indicators of health (e.g. quality of life, daily functioning), and the mechanisms and causal pathways through which work can explain those disparities.
• Examine ways in which the contribution of work to health and health care disparities is influenced by structural racism, such as occupational segregation and workplace segregation, as well as other inequity-generating mechanisms (e.g. climates of racism or perceived societal discrimination by other factors such as sex, age, marital or immigration status).
• Examine the extent to which work as a SDOH is influenced by structural racism within macro-level conditions (e.g., decline in unions, globalization and workplace restructuring, entrepreneurism, rise of self-employment occupations) and can explain, exacerbate, or mitigate national, regional, or location-specific health disparities.
• Evaluate the implementation of laws and regulations at the municipal, state or national levels (e.g., paid family and medical leave, paid sick leave, workers’ compensation, medical benefits, minimum wage, and diversity, equity and inclusion policies) and their differential effects for populations with health disparities.
• Examine the reciprocal relationship between work and health, and how health for populations, such as increased burden of disease and co-morbidities impacts work as a SDOH, including access to different work opportunities, working conditions, and work benefits, and how that varies by different social identities.

For the complete list of studies that NIMHD is interested in supporting and full details for the application, please see the FOA.

NIH Guide No.: PAR-21-275

Page updated Jan. 12, 2024