Forty years of struggle in North Carolina: Workplace segregation and fatal occupational injury rates

Am J Ind Med. 2024 Jun;67(6):539-550. doi: 10.1002/ajim.23586. Epub 2024 Apr 12.

Abstract

Objective: To assess workplace segregation in fatal occupational injury from 1992 to 2017 in North Carolina.

Methods: We calculated occupational fatal injury rates within categories of occupation, industry, race, age, and sex; and estimated expected numbers of fatalities among Black and Hispanic male workers had they experienced the rates of White male workers. We also estimated the contribution of workforce segregation to disparities by estimating the expected number of fatalities among Black and Hispanic male workers had they experienced the industry and occupation patterns of White male workers. We assessed person-years of life-lost, using North Carolina life expectancy estimates.

Results: Hispanic workers contributed 32% of their worker-years and experienced 58% of their fatalities in construction. Black workers were most overrepresented in the food manufacturing industry. Hispanic males experienced 2.11 (95% CI: 1.86-2.40) times the mortality rate of White males. The Black-White and Hispanic-White disparities were widest among workers aged 45 and older, and segregation into more dangerous industries and occupations played a substantial role in driving disparities. Hispanic workers who suffered occupational fatalities lost a median 47 life-years, compared to 37 among Black workers and 36 among White workers.

Conclusions: If Hispanic and Black workers experienced the workplace safety of their White counterparts, fatal injury rates would be substantially reduced. Workforce segregation reflects structural racism, which also contributes to mortality disparities. Root causes must be addressed to eliminate disparities.

Keywords: health equity; injury; mortality; workplace.

MeSH terms

  • Accidents, Occupational / mortality
  • Accidents, Occupational / statistics & numerical data
  • Adult
  • Aged
  • Black or African American* / statistics & numerical data
  • Female
  • Hispanic or Latino* / statistics & numerical data
  • Humans
  • Industry / statistics & numerical data
  • Male
  • Middle Aged
  • North Carolina / epidemiology
  • Occupational Injuries* / mortality
  • Occupations / statistics & numerical data
  • Social Segregation
  • White People* / statistics & numerical data
  • Workplace / statistics & numerical data
  • Young Adult