The State as Public Employer: The Organization and Conditions of Work and Health Outcomes

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The last century featured enormous strides in establishing the link between work and well-being in contributing to persistent racial health inequalities in the U.S. Despite the impressive body of sociological literature that has been amassed on the role of work in contributing to disparities in racial well-being, however, as yet we know little about the structural origins of these inequalities or how the distribution of health across racial groups is linked to larger socioeconomic processes. Because the relationship between work and well-being has chiefly been studied by linking proximate job conditions to individual health outcomes, prevailing inquiries tend to neglect larger social forces setting those very mechanisms into play. The state - as public employer - has largely been overlooked despite the central role it plays in structuring those very proximate job conditions, which in turn bear on individual experience. This is particularly the case for African Americans, for whom state intervention has been a potent force in propelling their occupational advancement in the post war period.

The central aim of this dissertation is to examine the relationship between the conditions of work and health disparities and to incorporate public employment and its organizational correlates into our vision of the process. Guided by promising leads offered by theory and research on the welfare state and labor markets, organizations and workplace inequality, and work and well-being, several pathways were identified linking sector of employment and jobs conditions to individual health. Drawing on survey data from the Aging, Stress, and Health (ASH) Study, preliminary evidence suggests that public employment plays an indirect role in enhancing individual health through fashioning the organizational context of the workplace. The structure of opportunities serves as a critical intervening link between sector and other job conditions, which in turn, bear on well-being. In sum, sector plays a role in affecting individual well-being by creating the concrete realities under which people work and the extent of their exposure and vulnerability to stressful conditions. While an indirect relationship between sector and health exists for all workers, however, the association was not found to be especially consequently for women and blacks.