The Critical Alliance of Worker, Immigrant, and Public Health Advocates

In 1911 in New York City, 146 young immigrant women garment workers died attempting to escape a fire at the Triangle Shirtwaist Factory. Trapped by locked exit doors, many were forced to jump to their deaths. The horrific scene spurred social reformers to support union organizing efforts and to advocate basic workplace safety protections—fire safety regulations and workers’ compensation for injured workers. The tragedy also led them to support workers’ efforts to organize a union to protest production pressures, long hours, and low wages in the industry.¹

THE CONTINUED THREAT

Immigrant workers continue to face dangerous conditions today. They are disproportionately concentrated in high-hazard jobs and often unable to access protections required by labor law. A 2008 survey found that undocumented immigrant workers in the low-wage labor markets in three major US cities experienced a higher rate of serious work-related injuries than did other workers. The survey also revealed that employers reacted more negatively to injured foreign-born workers than to their native counterparts; as a result, these workers were less likely to seek medical attention or file for workers’ compensation.²

The risk to immigrant workers’ health is compounded by changes in employment structures that create increasingly precarious jobs.³ Hector Saldivar Arriaga came to the United States from Mexico in the 1980s and eventually secured work driving a bobtail truck. He was required to pay for and maintain his own vehicle, and the trucking company classified him and other drivers as independent operators rather than employees to circumvent wage, hour, and health and safety protections required of employers. When Saldivar Arriaga was 57 years old, he sustained a serious back injury while loading cargo onto his truck. Despite deducting workers’ compensation fees from his paycheck for years, neither the company nor its insurers would refer him for treatment through workers’ compensation. Desperate for treatment and unable to work or pay his bills, he was forced to seek care on his own. Meanwhile his co-workers continue to work in pain, fearful of speaking up while they suffer from injuries generated from the fast pace of production.

A century apart, these examples illustrate how the sociopolitical and economic context that trapped immigrant workers in garment factories has evolved into workers being trapped by exploitative employers and by the threat of deportation. In one case, US Immigration and Customs Enforcement arrested immigrant workers involved in a union-organizing campaign at a slaughterhouse with rampant safety and other labor violations.⁴ This practice sends a message that condones exploitation and has a chilling effect on workers.

THE ROLE OF PUBLIC HEALTH ADVOCATES

To combat this context of fear and exploitation, worker, immigrant, and health advocates are creating alliances that address the constellation of risk factors facing immigrant workers. In 2018, hundreds of workers and labor and community allies protested both the trucking industry’s fraudulent misclassification of immigrant port truck drivers as independent operators and the government’s threat to withdraw the temporary protected status of Central American immigrants. At the culmination of three days of strikes by workers organizing with the Teamsters and warehouse workers, more than 60 union and community leaders participated in civil disobedience, shutting down traffic to call for respect for immigrants’ and workers’ rights.

Public health advocates can play a critical role in these struggles. The American Public Health Association has adopted policy statements that provide a foundation to advocate government policies that confront systemic discrimination facing immigrant workers.^5,6 Researchers can document the impact of work hazards on immigrant workers’ health and evaluate changes in health and legal policies; instructors can integrate immigrant worker case studies into courses on health equity, available in a work and health equity curriculum⁷; and master’s in public health programs can support students in pursuing internship opportunities that expose them to the intersections of health, labor, and immigrant rights.