Decent work in the United States: A public health perspective

BackgroundThe United Nations (U.N.) recognizes "Decent Work" as a basic human right. The components of Decent Work include four pillars defined by the U.N.'s International Labor Organization (ILO): basic rights at work, employment creation, social protection and social dialogue. The United States fares poorly in comparison to peer countries on multiple measures related to Decent Work.ObjectiveThe goal of this study was to describe 1) perceptions of decent work, 2) perceived barriers and opportunities to decent work, and 3) the role of public health in promoting and supporting decent work in the United States.MethodsKey informants identified from a pool of local, regional, state, national, and international organizations addressing concepts relating to worker rights and worker health and safety in the United States were interviewed from May 2021 to March 2022. Responses were analyzed using qualitative content analysis.ResultsParticipants defined decent work in terms very similar to the ILO definition: providing a livable wage with benefits, job security, just, safe, sustainable, meaningful work. Several addressed opportunities for growth, work providing a sense of agency/autonomy/power, and contributing to overall health, social, and emotional well-being. Significant barriers identified included the absence of legal protection, low levels of collective bargaining, poverty wages, and a lack of affordable healthcare.ConclusionsThere is widespread recognition that the U.S. lags significantly behind other high-income countries in the regulation of working conditions. Public health can amplify a decent work strategy by emphasizing the relationship between work and health.