국민의 건강수준 제고를 위한 건강형평성 모니터링 및 사업 개발-노동자 건강불평등

Abstract

건강의 사회적 결정 요인으로서 노동이 갖는 중요성에도 불구하고 건강불평등 연구에서 사회경제적 위치지표로서의 노동에 대한 관심과 활용도는 상대적으로 부족했다. 더욱이 건강형평성이라는 관점에서 노동정책을 설계하고 모니터링하는 데 이르지 못하였다.

이 연구에서는 고용 상태와 근로조건에 따른 노동자 건강불평등 발생 기전을 제시하고, 노동자 건강불평등 현황을 모니터할 수 있는 지표를 제안 및 산출하였다. 나아가 노동자 건강불평등 문제를 해결하기 위한 정책개선 방향을 제시하였다.

Adult workers spend most of their daily lives at work, where the working environment and working conditions have a significant impact on workers' health. However, there is a relative lack of interest in work as a social determinant of health, and monitoring of worker’s health inequality is being conducted scarcely. This study aims to propose an indicator development and monitoring system that could well reveal the health problems of vulnerable workers. In addition, it suggested policy improvement directions to address the problem of worker’s health inequality. In this study, we developed health inequality monitoring indicators which are divided into 'power relationship-employment market-working environment-health’ areas, and 70 final indicators were selected based on previous research review and expert Delphi survey results. As a result of indicator monitoring, significant differences between groups were identified in most indicators, and in particular, workers with unstable employment status, low-wage, small-scale workplace, or low education level, women or elderly workers showed more disadvantageous levels. Through qualitative interviews, we also found that the health problems of vulnerable workers overlap with demographic vulnerabilities amid the dual structure of the labor market and unequal employment relations. In particular, in the case of small businesses sites, several factors remained as “blind spots” in various management and regulations, which inevitably lead to workers’ poor health. In our society, there was a widespread perception that these workers’ health problems were the responsibility of individual workers, and vulnerable workers were in a situation where they had to deal with the resolution of accidents or diseases related to work. To solve the problem of workers' health inequality, strong laws and regulations on occupational safety and health are required, and social safety nets must be strengthened so that workers can fully recover their health and return to work when they are sick.