The digital divide: An ongoing state of emergency in adult literacy programs

COVID-19 and closures of in-person interactions with support programs, education providers, government services, and consumer offerings have raised concerns that vulnerable populations may not be able to mitigate the effects of the digital divide. Our chapter discusses the digital divide with a focus on programs for adult learners who have not completed high school. These include literacy, high school completion, and vocational programs. We look specifically at Ontario as a case sample that shares similarities with programs across Canada. These programs are operated by community-based non-profits, school boards, and community colleges. They are usually marginalized within the broader education system and have not been considered as part of comprehensive supports and initiatives when schools and post-secondary institutions were closed. The digital inequalities learners experience have parallels in the very programs they attend to mitigate their own digital learning divide. © Springer Nature Switzerland AG 2021. All rights reserved.

Dementia and COVID-19

While both dementia and coronavirus disease 2019 (COVID-19) have differing etiology, there is a complex interplay between the two, especially when looking into their effects on certain sub-populations. Hispanic Americans face a higher burden of dementia and COVID-19 due to both modifiable and unmodifiable risk factors, age-related chronic diseases, and environmental factors. The major unmodifiable risk factors include increasing age and predisposing genetics, while the major modifiable risk factors include income/socioeconomic status, educational attainment, exercise, diet, and smoking/tobacco use. Furthermore, specific age-related chronic diseases such as diabetes, kidney disease, hypercholesterolemia, cardiovascular disease, and chronic lung diseases place Hispanic Americans at high risk for dementia and COVID-19. Lastly, Hispanic Americans face the additional disadvantage of environmental factors, such as social inequalities and lack of access to adequate healthcare resources. Given that Hispanic Americans are the largest racial/ethnic minority group within the United States, this chapter will focus upon the research associated with dementia and COVID-19 within the Hispanic American population of the United States. Furthermore, this chapter will explore the four major risk factor categories (unmodifiable risk factors, modifiable risk factors, age-related chronic diseases, and environmental factors), which contribute to the development of dementia and COVID-19 within the Hispanic American population of the United States. © 2023 Elsevier Inc. All rights reserved.

Faith, Hope, and Love in the Time of COVID: A Journal of Bible and Theology

This essay is a reflection on COVID-19 in the United States, specifically in the state of Alabama, and among marginalized populations with whom I work. Past generations have demonstrated living in faith, hope, and love in the midst of and despite great suffering and turmoil. This essay includes my thoughts about how faith manifests itself individually and corporately and raises ongoing questions about how believers may promote radical change and confront societal inequities—especially in light of COVID-19.

Declaration of Cuernavaca

The National Public Health Institutes (NPHI), members of the Latin American Regional Network of the International Association of National Institutes of Public Health, met face to face at the headquarters of the National Institute of Public Health of Mexico, in the City of Cuernavaca, from October 5 to 7, 2022, with the participation of the directors or their representatives of the NPHIs of Bolivia, Brazil, Colombia, Costa Rica, El Salvador, Mexico, Peru and Suriname and representatives of the South American Sub regional Program (SAM), and the Central American Sub regional Program (CAM) of the Pan American Health Organization (PAHO), the Organization of the Amazon Cooperation Treaty (OTCA), the Andean Health Agency/Hipolito Unanue Agreement (ORAS/CONHU) and the Central American Integration System (SICA/COMISCA), analyzing the role of the NPHI in combating health inequities;in confronting the global climate and environmental crisis;combating hunger, food insecurity and malnutrition;successes and challenges in responding to the Covid-19 pandemic;strengthening and continuous improvement of integrated disease surveillance and preparedness for health emergencies;as well as the various existing regional and sub-regional health cooperation programs, noticing that: 1. In the current scenario, the dominating development model is a generator of growing social inequalities, which determine serious inequities in the health conditions of our peoples. 2. Likewise, the current model of production and consumption, adopted at the global level, has increased hunger, food insecurity and malnutrition that possibly constitute nowadays the main health problem in our region. 3. The environmental crisis, which is also a product of the current global development model, has a significant impact on human and animal health and the interaction between both. 4. The NPHIs have played a role of major relevance in confronting the Covid-19 pandemic, not fully applying, however, their full potential for research and for proposing national plans for the disease control. 5. Health surveillance systems, in most of our countries, suffer from significant fragmentation between various sectors and within the health sector itself, implying, in any case, reactive actions that do not allow for anticipating the emergence of new pathologies or health emergencies. 6. The various regional and sub regional cooperation agencies and programs offer an enormous capacity for synergies and mutual cooperation.

Urban public health emergencies and the COVID-19 pandemic. Part 1: Social and spatial inequalities in the COVID-city.

COVID-19 has had unprecedented impacts on urban life on a global scale, representing the worst pandemic in living memory. In this introduction to the first of two parts of a Special Issue on urban public health emergencies, we suggest that the COVID-19 outbreak, and associated attempts to manage the pandemic, reproduced and ultimately exacerbated the social and spatial divides that striate the contemporary city. Here, we draw on evidence from the papers in Part 1 of the Special Issue to summarise the uneven urban geographies of COVID-19 evident at the inter- and intra-urban level, emphasising the particular vulnerabilities and risks borne by racialised workers who found it difficult to practise social distancing in either their home or working life. Considering the interplay of environmental, social and biological factors that conspired to create hotspots of COVID-19 infection, and the way these are connected to the racialised capitalism that underpins contemporary urban development, this introduction suggests that reflection on public health emergencies in the city is not just essential from a policy perspective but helps enrich theoretical debates on the nature of contemporary urbanisation in its 'planetary' guise.

Impact of social and demographic factors on the spread of the SARS-CoV-2 epidemic in the town of Nice.

INTRODUCTION: Socio-demographic factors are known to influence epidemic dynamics. The town of Nice, France, displays major socio-economic inequalities, according to the National Institute of Statistics and Economic Studies (INSEE), 10% of the population is considered to live below the poverty threshold, i.e. 60% of the median standard of living. OBJECTIVE: To identify socio-economic factors related to the incidence of SARS-CoV-2 in Nice, France. METHODS: The study included residents of Nice with a first positive SARS-CoV-2 test (January 4-February 14, 2021). Laboratory data were provided by the National information system for Coronavirus Disease (COVID-19) screening (SIDEP) and socio-economic data were obtained from INSEE. Each case's address was allocated to a census block to which we assigned a social deprivation index (French Deprivation index, FDep) divided into 5 categories. For each category, we computed the incidence rate per age and per week and its mean weekly variation. A standardized incidence ratio (SIR) was calculated to investigate a potential excess of cases in the most deprived population category (FDep5), compared to the other categories. Pearson's correlation coefficient was computed and a Generalized Linear Model (GLM) applied to analyse the number of cases and socio-economic variables per census blocks. RESULTS: We included 10,078 cases. The highest incidence rate was observed in the most socially deprived category (4001/100,000 inhabitants vs 2782/100,000 inhabitants for the other categories of FDep). The number of observed cases in the most social deprivated category (FDep5: N = 2019) was significantly higher than in the others (N = 1384); SIR = 1.46 [95% CI:1.40-1.52; p < 0.001]. Socio-economic variables related to poor housing, harsh working conditions and low income were correlated with the new cases of SARS-CoV-2. CONCLUSION: Social deprivation was correlated with a higher incidence of SARS-CoV-2 during the 2021 epidemic in Nice. Local surveillance of epidemics provides complementary data to national and regional surveillance. Mapping socio-economic vulnerability indicators at the census block level and correlating these with incidence could prove highly useful to guide political decisions in public health.

Socioeconomic disparities and concentration of the spread of the COVID-19 pandemic in the province of Quebec, Canada.

BACKGROUND: Recent studies suggest that the risk of SARS-CoV-2 infection may be greater in more densely populated areas and in cities with a higher proportion of persons who are poor, immigrant, or essential workers. This study examines spatial inequalities in SARS-CoV-2 exposure in a health region of the province of Quebec in Canada. METHODS: The study was conducted on the 1206 Canadian census dissemination areas in the Capitale-Nationale region of the province of Quebec. The observation period was 21 months (March 2020 to November 2021). The number of cases reported daily in each dissemination area was identified from available administrative databases. The magnitude of inequalities was estimated using Gini and Foster-Greer-Thorbecke (FGT) indices. The association between transmission and socioeconomic deprivation was identified based on the concentration of transmission in socially disadvantaged areas and on nonparametric regressions relating the cumulative incidence rate by area to ecological indicators of spatial disadvantage. Quantification of the association between median family income and degree of exposure of dissemination areas was supplemented by an ordered probit multiple regression model. RESULTS: Spatial disparities were elevated (Gini = 0.265; 95% CI [0.251, 0.279]). The spread was more limited in the less densely populated areas of the Quebec City agglomeration and outlying municipalities. The mean cumulative incidence in the subsample made up of the areas most exposed to the pandemic was 0.093. The spread of the epidemic was concentrated in the most disadvantaged areas, especially in the densely populated areas. Socioeconomic inequality appeared early and increased with each successive pandemic wave. The models showed that areas with economically disadvantaged populations were three times more likely to be among the areas at highest risk for COVID-19 (RR = 3.55; 95% CI [2.02, 5.08]). In contrast, areas with a higher income population (fifth quintile) were two times less likely to be among the most exposed areas (RR = 0.52; 95% CI [0.32, 0.72]). CONCLUSION: As with the H1N1 pandemics of 1918 and 2009, the SARS-CoV-2 pandemic revealed social vulnerabilities. Further research is needed to explore the various manifestations of social inequality in relation to the pandemic.

Are we equally at risk of changing smoking behavior during a public health crisis? Impact of educational level on smoking from the TEMPO cohort.

BACKGROUND: The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021. METHODS: Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi2 test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression. RESULTS: Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8-9.4%, p < 0.001). Smokers with high educational level were more likely to decrease their tobacco consumption from 2018 to 2021 compared to low educated smokers (aOR = 2.72 [1.26;5.89]). CONCLUSION: Current findings showed a widening of the social inequality gap in relation to smoking rates, underscoring the increased vulnerability of persons with low educational level to smoking and the likely inadequate focus on social inequalities in relation to tobacco control policies during the pandemic.

Miedos e inquietudes ante la pandemia en España: un análisis exploratorio de las desigualdades sociales Fears and uncertainty about the pandemic in Spain: an exploratory analysis of social inequalities

The Covid-19 crisis impacted Spanish society, modifying its habits and customs. Society shows concerns that evolve into fear and uncertainty of what will happen in the future in different aspects. The main objective of this study is to delve into those fears and evaluate the social inequalities revealed by how those fears are perceived. We analysed the "Efectos y consecuencias del coronavirus” survey from CIS at three different moments: October 2020, September 2021, and December 2021. The results show a higher prevalence of social fears compared to economic ones. However, the perceived economic concerns reveal the main differences in educational level, age, and place of birth. In addition, women express concern the most. It is necessary to wait to see how the crisis unfolds to assess how these fears evolve. © 2023 Federacion Espanola de Sociologia. All rights reserved.

Inequalities in food perceptions during the Covid-19 pandemic. A comparative study in urban and rural contexts of Tucumán (Argentina)

This work describes food experiences during the Covid-19 pandemic, according to the urban or rural ecological configuration and the socioeconomic level (SES) in households in the province of Tucumán (Argentina). A digital field work was carried out in 1342 households classified as urban (942) or rural (400) according to the criteria of the Instituto Nacional de Estadísticas y Censos. Food experiences were assessed through primary data analysis applying the Latin American and Caribbean Scale for the measurement of Food Security and SES through the Family Affluence Scale. Likewise, secondary information sources were used to characterize the structural living conditions of the urban and rural population. The results showed a higher affectation in the experiences of the home in general, compared to the experiences of adults and children and adolescents, in particular. Rural households were the most affected, as were those with low SES. However, the experiences and practices in both environments had in common the care of feeding children and adolescents. © Editado por D. Demarchi

Digital capital and belonging in universities: quantifying social inequalities in the Philippines

This study examines social inequalities in Philippine universities that were exacerbated during the COVID-19 pandemic. A quantitative approach using a national sample of 677 university students was utilized to measure the mediating role of digital capital on social inequalities associated with belonging to academic spaces. For the purpose of determining direct and indirect impacts, structural equation modeling (SEM) was employed. Sociodemographic (i.e., gender, age, type of residence, and family income) and educational (i.e., type of university, year in the university, and excellence criterion) characteristics were the direct predictors that were examined as exogenous variables for both digital capital and belonging. Results indicate that type of residence (beta=0.200, p<0.05), family income (beta=0.220, p <0.001), and excellence criterion (beta=0.271, p <0.01) are major determinants of digital capital. The model also shows that belonging is significantly predicted by age (beta=0.087, p <0.05), family income (beta=-0.207, p <0.001), and digital capital (beta=0.576, p <0.001). Lastly, the findings reveal that the impacts of type of residence (beta=0.116, p <0.05), family income (beta=0.127, p <0.001), and excellence criterion (beta=0.156, p <0.001) on belonging are successfully mediated by digital capital. These results suggest that there are indeed differences in students' abilities to accumulate digital capital and that digital capital enhances the sense of belonging to and together in academic spaces for certain groups.

COVID-19 exposure setting, social and gender determinants in a Mediterranean region

BACKGROUND: Knowledge of social and gender determinants, which influence the places where people are exposed to COVID-19, may be relevant in the development of preventive and control strategies. The aim of this paper was to determine the context in which COVID-19 cases were infected (household, work/labor, health, social-health, and social-leisure settings) according to country of origin, occupational social class and gender, which is essential in order to designing public health strategies. METHODS: A cross-sectional study of an epidemiological registry of 56,628 COVID-19 incident cases was made, whose exposure/ contagion setting was studied according to the previous variables from June 15 to December 23, 2020, in the Region of Murcia (Spain). An exact Fisher test was used to study the distribution of COVID-19 cases based on the above variables. RESULTS: The cumulative incidence was higher in people from Africa (5,133.5 cases/100,000 inhabitants) and Latin America (11,351.1) than in non-immigrants (3,145.7). It was also higher in women (3,885.6) than in men (3,572.6). It is noteworthy, that 53.3% of the cases with employment were workers in industry or construction, artisans, agricultural workers, or elementary occupations. In contrast, during the second semester of 2020, 41.3% of the employed population in the Region of Murcia performed such jobs. The household was the main exposure setting (56.5% of cases with a known setting), followed by social-leisure (20.7%) and work/labor (18.2%). The labor settings were more important in immigrants from Africa (28.4%) and Latin America (35.7%) than in non-immigrants (12%), inversely to social-leisure settings. Labor context was more important in women (19.6%) than in men (16.5%) and in manual workers (44.1%) than in non-manual workers (26.6%). CONCLUSIONS: The context in which COVID-19 cases were infected is different according to social inequalities related to country of origin, gender and occupational social class.

The carelessness and the inhospitable. inhabit times of pandemic

The pandemic has placed us in a situation of estrangement from ourselves. We have been acutely aware of our vulnerability and fragility. Through the stories of lived experiences, we have learned about and witnessed tragic circumstances in which inhospitality and neglect have become evident. We have been shocked by the awareness of the lack of recognition, accompaniment and welcome. Institutional decisions have prioritized public health, the good for all, but have forgotten the biographies of people, full of suffering. And this has produced a moral damage, a loss of trust, a feeling of injustice that we have not been able to fight against. This is why it is necessary to build hospitality, which can be achieved through care. Care with a political dimension that takes charge of reality and transforms society. The key is a responsibility in solidarity. Faced with the possibility of dehumanizing ourselves, we seek hospitality as an alternative way of narrating lives that have to be reconstructed, that have to relearn how to take care of each other amidst the multiple possibilities of estrangement that threaten us. Hospitality is at the heart of a narrative ethics at the height of our times.

Fears and uncertainty about the pandemic in Spain: an exploratory analysis of social inequalities

The Covid-19 crisis impacted Spanish society, modifying its habits and customs. Society shows concerns that evolve into fear and uncertainty of what will happen in the future in different aspects. The main objective of this study is to delve into those fears and evaluate the social inequalities revealed by how those fears are perceived. We analysed the "Efectos y consecuencias del coronavirus" survey from CIS at three different moments: October 2020, September 2021, and December 2021. The results show a higher prevalence of social fears compared to economic ones. However, the perceived economic concerns reveal the main differences in educational level, age, and place of birth. In addition, women express concern the most. It is necessary to wait to see how the crisis unfolds to assess how these fears evolve.

Socio-economic and ethnic health inequalities in COVID-19 outcomes across OECD countries

The COVID 19 pandemic has disproportionately hit some vulnerable population groups. Those living in deprived areas, migrant population, and ethnic minorities are at higher risk of catching and dying from the virus than other groups, and they also face significant indirect health impacts of the COVID-19 pandemic - both mental health impacts and disruption of routine care. The working paper gathers evidence on the direct and indirect health impacts of the COVID-19 on the poor population and the ethnic minorities. It reviews factors underlying these inequalities, and maps policy interventions adopted by OECD countries to help address the disproportionate impacts of the COVID-19 pandemic on vulnerable population groups.

COVID-19 as a catalyst of food security crisis. whether the existing system of agriculture can remain the same

From 2019 to 2022, since the outbreak of the COVID-19 pandemic, the global percentage of hunger rose by 150 million people, which is 10% of the world population. At the same time, one-third of food is thrown away because it cannot reach the final consumer. Climate change, natural catastrophes, wars leading to humanitarian crises are the main and ongoing causes of hunger. COVID- 19 acted as an accelerator of processes that exacerbate the food security crisis, to which import-dependent countries are especially sensitive. Quarantine that was introduced as a tool to combat the spread of the COVID-19 acted as a catalyst of social, economic, political, ecological, and food crisis that is displayed in the global economic system and in agriculture - its subsystem. At first glance, the increase in the percentage of starving populations on the planet is explained by poverty and the inability to purchase basic food products;a rise in prices was caused by breaks in logistics chains, the increase in the price of energy carriers, and economic shifts caused by the lockdown. In practice, despite the constantly growing volumes of global production of agro-industrial products, the balance between demand and supply of products that ensure the world's food security has been disturbed. The research problem lies in the insufficient determination of intangible causes of hunger, other than those caused by poverty and social inequality. The aim of the research is to show the prospects of the aggravation the food security crisis due to excess of food demand over supply, and to propose theoretical ways out of the crisis. The quantitative method of panel data research was used to prepare the article. The visualization method was used to simplify the perception of the proposed array of information. It is possible to overcome such social problems as hunger, poverty, climate and ecology problems caused by the increase in the temperature on the planet's surface, ocean pollution, and soil degradation only through adaptation and achieving synergy between the planet's ecosystems. Agriculture as a main factor of food security should be transformed through implementing principles of climate-optimized agriculture and blue economy (use of ocean resources) as a source of "blue food" to achieve food sustainability.

Editorial: Consequences of the Corona crisis for social inequalities in Germany

The possible consequences of the Corona crisis for social inequalities have received a lot of attention in public as well as scientific debates. On the one hand, concerns have been raised that the pandemic intensified pre-existing patterns of social inequality. On the other hand, the crisis has also been seen as an opportunity for social change and a renegotiation of social relationships. Complementing previous research that focused on the immediate consequences of the pandemic, this Special Issue is devoted to its longer-term effects. It unites six theory-guided empirical studies that use qualitative and quantitative longitudinal data to study changes in social inequality in the course of the pandemic in different life domains. Overall, the results do not show a universal trend of increased inequalities. While changes in different life domains occurred, such as better grading for students, intensified strong ties in families or increased social trust, there is only limited evidence of changes in social inequalities. In general, a complex picture of effects, consequences and concomitants of the pandemic appears. © 2023 Nomos Verlagsgesellschaft mbH und Co. All rights reserved.

COVID-19 and health inequality: the nexus of race, income and mortality in New York City. (Special Issue: It is not just about health: the human rights' implications of COVID-19.)

Purpose: The purpose of this paper is to evaluate socioeconomic factors related to COVID-19 mortality rates in New York City (NYC) to understand the connections between socioeconomic variables, including race and income and the disease. Design/methodology/approach: Using multivariable negative binomial regression, the association between health and mortality disparities related to COVID-19 and socioeconomic conditions is evaluated. The authors obtained ZIP code-level data from the NYC Department of Health and Mental Hygiene and the US Census Bureau. Findings: This study concludes that the mortality rate rises in areas with a higher proportion of Hispanic and Black residents, whereas areas with higher income rates had lower mortality associated with COVID-19, among over 18,000 confirmed deaths in NYC. Originality/value: The paper highlights the impacts of social, racial and wealth disparities in mortality rates. It brings to focus the importance of targeted policies regarding these disparities to alleviate health inequality among marginalized communities and to reduce disease mortality.

The fragile city

The COVID-19 pandemic brought cities around the world to a halt, causing massive disruption and suffering for hundreds of millions of people. This chapter assesses the sources of fragility rooted in our cities and explores approaches that could help cities develop more resilient urban systems, enabling them to function, and even thrive, in times of crisis. The COVID crisis has clearly exposed how unequal cities can be, with migrants, the poor, women, racial minorities, and isolated older people being hardest hit. The pandemic saw hundreds of thousands of people flee urban coronavirus hotspots for rural areas. The digital divide is one of the many inequalities exposed by the pandemic. Focused investments that help address the digital divide will also help address social inequalities, particularly in a world where schools, businesses, and government services have gone digital. © 2022 John Wiley & Sons Ltd. All rights reserved.

Réforme du régime de prévention en SST au Québec : analyse critique, sensible au genre et aux autres sources d'inégalités

Nous examinons le potentiel et les conditions de l'efficacité de dispositions clés de la réforme du régime québécois de prévention introduite par la Loi modernisant le régime de santé et de sécurité du travail (LMRSST) en septembre 2021. Pour ce faire, nous mobilisons la typologie en deux axes proposée par Tucker (2007) afin de caractériser la citoyenneté au travail en SST, et ce, dans une version renouvelée par une perspective sensible au genre et autres sources d'inégalités. D'une part, nous traitons des changements à la participation représentative, à l'influence des travailleur.euse.s et au contrôle interne, ajoutant l'examen de la protection de toutes les personnes au travail (sans égard à leur statut d'emploi) et de la responsabilisation le long des chaînes de valeur. D'autre part, nous traitons du contrôle externe et proposons de tenir compte de la couverture des risques souvent invisibilisés du travail des femmes. Le projet de loi initial reproduisait cette sous-estimation de certains types de risques. Devant l'opposition, l'adoption de dispositions clé a été reportée et un régime intérimaire établi. La LMRSST permettra, à terme, la couverture de l'ensemble des secteurs d'activité par des mécanismes de prévention (contrôle interne) et de participation représentative des travailleur.euse.s;au prix cependant d'un risque de conformité formelle plutôt que réelle quant au contrôle interne, un niveau variable d'influence des travailleur.euse.s et de l'affaiblissement de plusieurs conditions d'efficacité des mécanismes de participation. On peut anticiper des obstacles à l'exercice de leurs droits par les travailleur.euse.s non syndiqués et des petits établissement. Le Réseau de santé publique n'a plus un accès systématique aux établissements et on ne sait rien sur les ressources dont celui-ci comme l'inspectorat disposeront. Il reste à voir dans quelle mesure les travaux réglementaires paritaires à venir apporteront des avancées en prévention et en même temps, renforceront plutôt que d'affaiblir la citoyenneté au travail. Précis Nous examinons le potentiel et les conditions de l'efficacité de dispositions clés de la réforme du régime québécois de prévention introduite par la Loi modernisant le régime de santé et de sécurité du travail (LMRSST) en septembre 2021. Pour ce faire, nous mobilisons la typologie proposée par Tucker (2007), et ce, dans une version renouvelée par une perspective sensible au genre et autres sources d'inégalités sociales. L'analyse du contenu du régime de prévention défini par la LMRSST s'appuie sur un état des connaissances quant à la portée et aux limites des stratégies étatiques en prévention, une revue de littérature sélective examinant l'application, la portée et les limites du régime pré-LMRSST et sur l'examen des mémoires déposés à l'occasion des consultations publiques sur le projet de loi.Alternate :We examine the potential effectiveness of key provisions of the Québec prevention regime as reformed by the Act to modernize the occupational health and safety regime (AMOHS) in September 2021. We expand Tucker's (2007) two-axis typology characterizing citizenship at work to include a perspective sensitive to gender and to other sources of inequalities such as class and race. In this expanded model, the right to representative participation, worker influence and internal control extends to all workers (regardless of employment status), and includes accountability along value chains. In the expanded model,risks addressed by the prevention regime, and subject to external control, include often invisibilized risks associated with women's work. In the face of opposition to the initial reform bill, which underestimated the risks associated with women's work, adoption of key elements of the reform – the provisions on preventive and participatory mechanisms – was postponed and an interim regime established. The AMOHS will eventually allow for worker participation mechanisms aimed at increasing internal control in all sectors. This, however, comes with a risk that internal control will result in cosmetic rather than substantive compliance, lead to inconsistent levels of worker influence and undermine some of the conditions that underpin effective participation mechanisms, especially for non-unionized workers and those in small establishments. Further, the Public Health network has lost systematic access to workplaces, and it is not known what resources will be available to it or to the inspectorate. It remains to be seen whether the ongoing joint regulatory process to determine future preventive and participatory mechanisms will strengthen prevention and at the same time bolster, rather than weaken, citizenship at work.