Operationalizing Justice: Translating “Days Without Incident” to Health Equity

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The concept of the “safer space” is one of the more profound new movements in diversity and equity work. It is powerful because it draws away the fluff of rose-colored viewpoints and initiatives for addressing organizational disparities, and instead it lends itself to grounded and pragmatic attitudes. It forces us to operate in the following truth: Safety cannot be promised, physically or emotionally.

The concept of the 'safer space' is one of the more profound new movements in diversity and equity work. It is powerful because it draws away the fluff of rose-colored viewpoints and initiatives, and instead it lends itself to… Share on X Safety cannot be promised, physically or emotionally. Share on X

A safety practice for workspaces with indisputably hazardous conditions has its roots dating back to at least the early 1900s: In a prominent location, you will see a bold safety sign highlighting “XX days without incident.” The logic goes: these are days to collectively celebrate! Each day without bodily harm is one more win against the long-term suffering and premature death of employees and stakeholders; and all parties involved are considered equal. However, it is understood that this blaring, unmissable sign is a goal. This sign is a covenant between the organization and employees to share accountability for the livelihood of all related parties and to take explicit steps in the pursuit of longer life. Yet, safety is not a promise. This sign cannot guarantee protection — regardless of how many days have passed since the last injury.

We know that striving to be safer makes a difference. It becomes part of our culture. It is a collective embodiment of our inalienable right to a full life. Institutional racism and discrimination are disproportionately shortening the lives of BIPOC employees. Imagine how much safer our institutions would be if leadership developed policies and practices that approached discrimination as a chronic safety hazard.

Institutional racism is shortening the lives of BIPOC employees. Imagine how much safer our institutions would be if leadership developed policies and practices that approached discrimination as a chronic safety hazard. Share on X

As an Afro-Latinx in the U.S. choosing to identify as a Black man from Baltimore, MD, I must wonder: did the visionary Labor Law makers of the early 1900s see my inalienable rights on par with theirs? I wonder because today, all things are not equal, equitable or just. Studies of socially determined health disparities reveal that, regardless of the current institutional best practice policies, the location in which employees are born, grow, live, age and work impacts their quality and length of life.

The average U.S. citizen will spend ⅓ of their life working for their employers. It is only logical to assert that our workplaces impact individual well-being over the course of our lives…and it is not unfounded to seriously consider policy development that supports institutional equity practices as a lifesaving imperative.[1] Let me be clear: I am not insinuating that it is the responsibility of employers to hold themselves accountable for all their employees’ social health factors. Rather, we must normalize the awareness of social disparities and prioritize daily vigilance for creating psychological safety and reducing hostile work environments.

It is not unfounded to seriously consider policy development that supports institutional equity practices as a lifesaving imperative. Share on X

In this era of social media, a single relatable experience of trauma and injustice can shatter decades of social capital and goodwill with customers. Employers must go beyond training and public statements because an informed, justice–centered workforce is here — and they will demand to know what preventive measures organizations are implementing against inequitable Social Determinants of Health.

For example: consider inequities in maternal and infant mortality rates for Black women. Typical markers of health and status — such as higher education degrees and level of income — are not protective factors for Black mothers and infants as they are for white, Asian and Hispanic women. Research is beginning to identify this deadly disparity as a result of disproportionately hostile work and life environments faced by Black women.[2] Diversity scholars such as Arline Geronimus explain contributing factors such as “Chronic Stress “and “the Weathering Effect.”[3]

In work environments in which people are not aware of this disparity, policies and culture are significantly more likely to include norms and behaviors that harm Black women. In organizations where leadership and employees are aware of this disparity and its causes, behavior can be adjusted and everyone involved benefits. Once organizational leaders understand such an inequity, addressing contributing factors in the workplace requires a pedagogical shift championed by leadership and implemented by all. Thus, for institutions striving to go further than conventional approaches to employee wellness in the workplace, equity visioning should involve all ready and willing staff. Justice for all also implies “injustice anywhere is a threat to justice everywhere.”

Mortality rates of Black women and children are just one example of lived consequences within a population, stemming from systematically based social health disparities. With health indicators ranging from age, birthplace and childhood neighborhood, to current place of residence, literally anyone within a company can find ways to contribute to support the dismantling of health disparities for workplace safety. Still, organizations should start from the top to align their work with best practices set by community organizers and institutions like the World Health Organization. This will support organizations in creating environments that truly feel like “safer spaces” for authentic and vulnerable dialogue.

Strategies aligned with The Social Determinants of Health–approach to wellness present an exploratory roadmap to nurture safer social and physical environments in a workplace. When developing an employer framework, consider these two points of implementation:

1) Take the Time to Build Internal Consensus and Capacity, and

2) Develop Clear Goals and Objectives for action.[4]

First: Take the Time to Build Internal Consensus

Culture shift requires a movement. Movements are often sparked by a deep dissatisfaction with the status quo. If the goal is building consensus around healthy equity efforts, leaders cannot just mandate change;[5] staff must see leadership champion holistic health equity practices as prominently as the blaring safety signs in hazardous workspaces. Just as we would aim to go as long as possible without an employee injury, we should take similar precautions based on the experiences of employees. Consider surveying employees and asking health equity questions such as:

If the goal is building consensus around healthy equity efforts, leaders cannot just mandate change; staff must see leadership champion holistic health equity practices as prominently as the blaring safety signs in hazardous… Share on X

What causes the unequal distribution of health-promoting and health-harming conditions?
How can we address dangerous conditions?
How can individuals protect themselves against health threats?
How can community organizing and alliance building help bring about policies that protect [XY and Z]?” [4]

When leaders pose these questions to staff, this will indicate desire for equitable health on a broad organizational level. Follow–up and building of frameworks indicate readiness for step 2.

Second: Develop Clear Goals and Objectives for Action

Employees and leaders co-creating a health equity framework within a workplace grants everyone insight into the root causes of problems and enhances the effectiveness of structural reform. It is an action to be celebrated. This milestone indicates investment in the possibility of success because of the shared contributions of staff and leadership.

The next step is to collectively identify the policies and procedures known to directly impact life expectancy. Reducing Wealth Inequalities, Improving Social Inclusion, Decreasing Social Inequality, Promoting Racial Justice and Promoting Better Working Conditions are just a few policy areas identified as having immense impact on increasing “the equitable distribution of advantages across society.” [4]

Reduce Wealth Inequalities: Raise the minimum wage to a livable level; pay employees as much as possible; improve protections against layoffs; strengthen on-the-job learning opportunities; offer intern training for the next generation; and have explicit and quantifiable policies and criteria for career advancement.
Improve Social Inclusion: Decrease social inequality: stand against all forms of discrimination; encourage democratic decision-making; strengthen participation across all departments and leadership; resist the urge to create a color-blind workplace culture.
Promote Racial Justice: Strengthen existing anti-discrimination practices and their enforcement; share transparently your compensation data and practices; build diverse teams; provide resources for professional development access and retention.
Promote Better Working Conditions: Decrease job strain; increase job autonomy and worker participation; provide flexible work hours and job security; give incentives to leadership that hire locally; strengthen and enforce occupational safety laws and demand paid sick leave and vacations. [4]

In the broadest sense, advancing health equity means envisioning a society that works for everyone. For outcomes to improve, we must broaden our thinking by prioritizing daily efforts to reduce incidents of psychological workplace trauma. While this may feel overwhelming, remember that even small steps matter.

The root causes creating life–shortening disparities predate our nation’s first consideration of labor laws and safety protocols. Culture change can take just as long as the injustice thrived unquestioned. Yet, even if none of these co-created policies can guarantee safety each day thereafter, this work is an opportunity to collectively celebrate one more win against the long-term suffering and premature death of employees and stakeholders — so that one day, all parties involved can actually be considered equal.