Occupational Injuries and Illnesses In Indigenous Populations

The research conducted for this dissertation aims to expand evidence of the deep inequities in Indigenous occupational health evidence and provide recommendations for targeted future research that will appropriately inform policy, practice, and community level outcomes that might reduce the gap in life expectancy between Indigenous and non-Indigenous peoples. This was done through a series of three analyses that used existing data sets to assess their utility for elucidating unique experiences of Indigenous peoples’ occupational health in the United States (U.S.). Our first project examined the utility of incorporating outpatient and emergency department hospital data into current occupational health surveillance systems and specifically assessed how ED and outpatient data improves our understanding of Indigenous occupational health issues. The second and third study of this dissertation used a national cross-sectional survey, the National Health Interview Survey (NHIS), to gain a better understanding of the role of structural and intermediary determinants on occupational and mental health outcomes for Indigenous people. Outcomes examined in the second study included labor force participation (based on employment status in past week), employment status, paid sick leave benefits at job last week, health insurance offered at workplace for those who reported working last week and income below 200% federal poverty level (FPL) during past year. Our third aim, using the NHIS, provided a detailed description of the characteristics of AIAN adults with depressed symptoms and examined their sociodemographic, health, functional and disability characteristics by working status. Despite focusing on occupational health and wellbeing this research has several key findings that are relevant across other areas of AIAN research. Specifically, (1) there is lack of consistency and rigor in reporting of race/ethnicity for Indigenous Americans in health data and national/regional surveys which impedes workforce development and planning and targeted occupational health and safety research, (2) occupational health indicators from national surveys reflect western concepts and development of Indigenous-centered indicators of occupational health and wellbeing is required, (3) ED data usage can be used to contribute to the understanding of patterns of work-related injuries and illnesses presenting to hospital.