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Occupational Injuries Among Low-Wage Workers Pack a Big Economic Punch

Feb. 8, 2013
Working Americans who earn low wages are at a greater risk of facing additional financial struggles if they become injured or sick on the job, according to a policy brief from the George Washington University School of Public Health and Health Services.

For the 31 million American workers who earn a median wage below $11.19 an hour, occupational injuries and illnesses – and their economic impact – are of special concern, suggests a new policy brief from the George Washington University School of Public Health and Health Services (SPHHS). The brief was released in conjunction with a white paper that reveals injuries and illness among low-wage workers cost the nation more than $39 billion in 2010.

“Workers earning the lowest wages are the least likely to have paid sick leave, so missing work to recuperate from a work-related injury or illness often means smaller paychecks,” said the lead policy brief author Celeste Monforton, a professorial lecturer in environmental and occupational health at SPHHS. “For the millions of Americans living paycheck to paycheck, a few missed shifts can leave families struggling to pay rent and buy groceries.”

Low-wage workers make up a large and growing share of the U.S. work force, and are particularly vulnerable to financial struggle following occupational injuries or illnesses. The policy brief, “Mom’s off Work ’Cause She Got Hurt: The Economic Impact of Workplace Injuries and Illnesses in the U.S.’s Growing Low-Wage Workforce,” analyzes and contextualizes research by health economist J. Paul Leigh of University of California, Davis.

Leigh zeroed in on approximately 31 million people – 22 percent of the U.S. work force – in 65 occupations for which the median wage is below $11.19 per hour. Janitors, housecleaners, restaurant workers, and others earning that wage full-time will bring home just $22,350 per year – an amount that means a family of four must subsist at the poverty line.

By the Numbers

Leigh calculated that in 2010, 596 low-wage workers suffered fatal on-the-job injuries and 12,415 died from occupational ailments such as black lung disease or certain kinds of cancer. Another 1.6 million suffered from non-fatal injuries, and 87,857 developed non-fatal occupational health problems such as asthma. The costs of the 1.73 million injuries and illness amounted to $15 billion for medical care and another $24 billion for lost productivity – the cost when injured or sick workers cannot perform their jobs or daily household duties.

The policy brief explains that workers’ compensation insurance either does not apply or fails to cover many of these costs, which can bankrupt families living on the margin. Some employers are not required to offer this kind of insurance, and some workers who do have coverage may learn, after becoming injured or sick on the job, that insurers generally do not have to provide wage replacement until the worker has lost between three and seven consecutive shifts. Furthermore, workers at the low end of the wage scale often are discouraged from reporting on-the-job injuries as work-related, which leaves them with no insurance benefits at all, the brief said.

Leigh calculated that insurers cover less than one-fourth of the costs of occupational injuries and illnesses. The rest falls on workers’ families, non-workers-compensation health insurers and taxpayer-funded programs like Medicaid.

“When low-wage workers miss even a few days of pay while recovering from an occupational injury or illness, the effects spread quickly,” said Liz Borkowski, an SPHHS researcher and co-author of the brief. “They will usually have to cut back on their spending right away, which affects the local economy.” And families with children might skip meals or cut back on the heat, money-saving tactics that can put vulnerable family members such as children at risk of developmental delays and poor performance in school.

The brief suggests that policymakers should address this public health problem more forcefully by improving workplace safety and strengthening the safety net to reduce the negative impacts caused by the injuries and illnesses that still occur.

“We hope that having a $39 billion price figure for illnesses and injuries in low-wage workers will motivate public officials to address this problem more forcefully than they currently do,” the brief states. “We recommend efforts to address both prevention and mitigation. Improvements in workplace health and safety can prevent injuries and illnesses from occurring in the first place. A stronger safety net can reduce the likelihood that missing a few days of work will spell missed rent payments or children going hungry.”

Both the policy brief and white paper, which were funded by the Public Welfare Foundation, are available online at

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