Employment Conditions and Health Inequalities. Benach J, Muntaner C, & Santana V, eds., Barcelona, Spain: Health Inequalities Research Group, 2007 Sep; :43-44
The United States belongs to the cluster of core liberal countries with a more unequal social structure. Traditionally, the market has dominated over state regulation as the main mechanism for resource allocation in the country. Although historically there has been some variation concerning income distribution, in recent decades income inequality has been increasing in the United States, with a rising Gini index (measure of income inequality) from the 1960s to the 1990s, followed by a leveling of the index in the 1990s (Moss 2000). The Gini index increased 4 per cent from 1995 to 2005 (DeNavas-Walt et al. 2006). In the United States the top 1 per cent of the population accounts for 40 per cent of the wealth in the nation (Moss 2000). In a continuing downward trend over the past three decades, only 13 per cent of workers were unionized in 2005 (U.S. Department of Labor 2006a). Blacks, men, and public sector workers were more likely to be union members (U.S. Department of Labor 2006a). In 2005, union workers' median weekly income was $801 compared with $622 for non-union workers (U.S. Department of Labor 2006a). The federal minimum wage has not been increased since 1996. Unions and anti-poverty organizations support the increase in the minimum wage, while small businesses and retailers oppose such an increase (Anonymous 2002). Many organizations support the introduction of a living wage, which more adequately and realistically meets the needs of cost of living of families (Pew Partnership for Civic Change 2006). Fifteen per cent of the population has no health insurance coverage (some 45 million Americans) including a growing number of workers and their families (Arheart et al. 2006) particularly in blue collar occupations, so there is a debate in the United States about the merits of creating a health care system with universal access (Rosenblatt 2005). In 2005, about 25 per cent of female workers were part-time compared with 11 per cent of male workers (U.S. Department of Labor 2006b). These female part-time workers are found among all different age groups, compared with male part-time workers who are more commonly younger workers. In the third quarter of 2006, full-time Black male workers made 80 per cent of what White men made, while Black female workers made 84 per cent of what White women made (U.S. Department of Labor 2006c). Hispanic salaries lagged behind those of Blacks, Whites, and Asians, respectively. From 2003 to 2005, there were 3.8 million workers age 20 and older displaced from their jobs. Of these, 49 per cent lost their jobs due to company or work site closings, 29 per cent because their job was abolished, and 22 per cent because of insufficient work (U.S. Department of Labor 2006d). About 40 per cent of these displaced workers received advance written notice of the displacement (U.S. Department of Labor 2006e). The largest group of displaced workers in the United States has been in the manufacturing field (28 per cent). Another diverse group of nontraditional workers is the contingent and alternate arrangement workers. This group includes workers who do not expect their job to last, or who report that their work is temporary. However, this group is diverse in that it includes independent contractors (7.4 per cent of those employed in 2005; largely white males, over age 35, with only 10 per cent preferring a more traditional work status), as well as on-call workers and temporary help agency workers (0.9 per cent of those employed in 2005; largely female, young, Black, and Hispanic, with 56 per cent preferring a more traditional work status) (U.S. Department of Labor 2005). All of these contingent and alternate arrangement workers were less likely to have health insurance or employment-based pension plans (U.S. Department of Labor 2005).