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Why we must address immigrant work safety now

America is just now belatedly waking up to the reality that immigrant workers deserve far greater safety protections at work. RIsk & Insurance ran my column on this problem in its Sept.1, 2013 issue:

The rise of immigrant labor has been so incremental that it’s hard to pinpoint when the workers’ compensation community should have collectively realized that immigrant workers often pose a heightened work injury risk. But it’s clear that we are past that date.

Foreign-born workers (including legal and undocumented) comprised about one tenth of the country’s workforce in 1990. Today they amount to about 17 percent, and are much more widely distributed geographically.

Since 2000, foreign-born workers have added more bodies to the workforce than have native-born Americans. Demographers expect this trend to continue through 2020.

Many immigrants are very highly skilled. But a large share, those that are less well educated, provide manual labor that on balance is relatively injury-prone. These workers also have limited access to safer work.

Our manual workforce is thus segregated by injury risk. Pair an immigrant and a native-born worker, both doing jobs that require limited education, and statistics reveal that the foreign-born worker encounters twice the risk of work injury than the native.

I estimate from federal data that in the top 30 jobs that don’t require a high school education, immigrants sustain at least one out of every four injuries.

That’s based on an assumption that they report injuries at the same rate of native-born workers.

The immigrant worker is less inclined to have health insurance. Having health insurance is widely thought to lower work injury claims and to fund the treatment of co-morbidities which left untreated can complicate injury recovery.

In fact, the Affordable Care Act and the current version of the Senate’s Immigration Reform bill prohibit access for large numbers of non-naturalized immigrants to federally supported health insurance. That’s despite the fact they are here legally and paying taxes.

A lack of literacy in English further precludes immigrant workers from access to adequate healthcare and exposes them to a lack of understanding of safety procedures, making them even more vulnerable.
Many naturalized citizens speak their native language at home. Among non-citizens, only one tenth speak English at home. In fact, one third of non-citizen households, even after five years in the United States, fit the formal definition of being linguistically “isolated.”

We in the work safety and workers’ compensation fields have deflected the literacy problem for decades. We typically assign safety and injury response tasks to someone who speaks the worker’s native language. This induces co-workers towards learned ignorance.

Further isolating immigrant workers is fear on the part of employers of legal prosecution should they be found to harboring an illegal immigrant.

Employers fear if they are too proactive they will stumble over an undocumented worker and incur legal liability. Millions of supervisors therefore lack the education to effectively manage immigrant workers.

One positive step for employers would be to adhere to a timidly publicized OSHA requirement that “instruction must be provided in a language the employee can understand.”

Another step is for medical provider networks to expect that their providers adhere to a requirement arising out of the 1964 Civil Rights Act that health professionals conduct patient encounters in the preferred language of the patient.

We have a yet more difficult step ahead. Some say we are a multi-ethnic society.

But, as with much of the world, we are moving towards a trans-national society. Millions of American residents including even naturalized citizens see themselves as members of two societies. Many of our workers are trans-nationals, not permanent immigrants per the iconic Ellis Island narrative.

To ensure work safety and injury recovery, we may need to devote a lot more attention to buying into the culture of the foreign-born workers rather than waiting for the worker to learn how to speak and act live a native

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