Unionization, collective agreements offer positive influence on health outcomes

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A new paper out of York University argues health promoters should consider the role of unionization and collective agreements when examining the social determinants of health.

Dennis Raphael
Dennis Raphael

Authored by graduate student Jessica Muller and Faculty of Health Professor Dennis Raphael, the study argues unions and collective agreements should be a focus of health promotion by considering how they influence health outcomes in wealthy, developed nations.

Published Dec. 13 in the journal Health Promotion International, the study “Does unionization and working under collective agreements promote health?” offers four ways in which these factors influence health, including:

  • higher union density and collective agreement coverage are associated across nations with a lower percentage of low-waged workers, less income inequality, and lower low birthweight and infant mortality rate;
  • greater union density and collective agreement coverage within national sub-jurisdictions are associated over time with more equitable distribution of social determinants of health and better health outcomes;
  • within nations, unionization and working under a collective agreement improves the quality and equitable distribution of 0the social determinants of health; and
  • a Canadian case study showing how power relations, working through economic and political systems, determine the extent of unionization and collective agreement coverage and the inclination of health promoters to consider these issues.

The findings in this study show the ability to collectively bargain offers workers “strength in solidarity and workplace protections otherwise not easily provided to the individual.” What this suggests is that unionization and collective agreement coverage can reduce precarious work, improve wages and benefits, and makes other working conditions more favourable.

The authors suggest, like many others who work in the public sector, the reluctance of health promoters in Canada to address the issue of unionization and how it promotes is a result of unions and unionization being seen as “political” and therefore a potentially problem realm to enter.

“Health promoters in Canada and elsewhere have an ethical obligation to engage with the labour movement and communicate about, and advocate for, unionization and collective agreement bargaining for workers,” the paper concludes. “It may not be a comfortable path, but one that needs to be undertaken if we truly wish to promote health in these trying times.”

The read the full paper, go here.