State of Physician Unionization.

OBJECTIVES: To provide an overview of the current state of physician unionization, potential factors surrounding increased unionization, and the ethical and financial issues that may arise. DESIGN: Review article. SETTING: Not applicable. PARTICIPANTS: Not applicable. RESULTS: Over the last few years, there has been a recent surge in physician unionization. Union membership among residents and fellows is also at an all-time high and continues to increase, as seven residency programs voted to unionize in 2023. The resulting threat of strikes has grown considerably over the last year as residents across 6 hospitals have threatened to strike, resulting in New York's first physician strike in over three decades. As physician practice continues to shift from private to corporate health system-based employment, more opportunities for unionization will arise. Globally, these trends have been comparable, with thousands of physicians striking across the United Kingdom, Germany, Italy, Nigeria, and New Zealand in the last year. CONCLUSION: The current state of physician unionization is of increasing significance as more physicians are presented with opportunities for unionization. Physicians perceive a lack of autonomy, and the demand to deliver high level outcomes with diminishing resources is becoming an insurmountable challenge. Additionally, physician satisfaction with their workplace has decreased with increased burnout rates. Thus, it is important to understand the current state of unionization, potential reasons for unionization among physicians and residents, and its future impact on the field of medicine.

Cumulative Unionization and Physical Health Disparities among Older Adults.

Whereas previous research shows that union membership is associated with improved health, static measurements have been used to test dynamic theories linking the two. We construct a novel measure of cumulative unionization, tracking individuals across their entire careers, to examine health consequences in older adulthood. We use data from the Panel Study of Income Dynamics (1970-2019) and predict self-rated health, functional limitations, and chronic health conditions in ages 60 to 79 using cumulative unionization measured during respondents' careers. Results from growth models show that unionized careers are associated with .25 SD to .30 SD improvements in health among older adults across all measures. Analyses of life course mechanisms reveal heterogeneous effects across unionization timing, age in older adulthood, and birth cohort. Moreover, subgroup analyses reveal unionization to partially, but not fully, ameliorate disparities based on privileged social positions. Our findings reveal a substantial and novel mechanism driving older adulthood health disparities.

Does unionization reduce CO2 emissions in Canada?

The existing literature is ambivalent on the relationship between unionization and climate change. There is some anecdotal evidence that in some cases, labor unions play a role in implementing climate protection measures. In other cases, unions were more concerned with saving jobs than with reducing emissions. Nonetheless, empirical studies on the relationship between unions and environmental outcomes are limited. The objective of this study is to fill the gap in the literature by examining if unionization has any impact on CO2 emissions in Canada, after controlling for energy consumption, unemployment rate, and real GDP per capita. Cointegration techniques including Johansen methods and autoregressive distributed lag (ARDL) techniques are applied to a dataset that covers the period from 1969 to 2016. The results suggest that, on average, a 1% increase in unionization reduces CO2 emissions by approximately 0.25%. This is the first study that examines the union-climate dynamics for Canada. One policy implication of the finding is that the governments should develop incentives for industries to implement climate measures through collective bargaining.

Trends in Precarious Employment in Sweden 1992-2017: A Social Determinant of Health.

The aim of this study was to identify trends in precarious employment in the Swedish workforce from 1992 to 2017. This is a repeated cross-sectional study, analyzing the total working population aged 16-75 in Sweden at five-year intervals. We used version 2.0 of the Swedish Register-based Operationalization of Precarious Employment, covering the following dimensions: employment insecurity, income inadequacy, lack of rights and protection. The proportion in precarious employment increased from 9.7 to 12% between 1992 and 2017, a relative increase of 24%. The prevalence was higher among those of lower age, of low education, and immigrants. Differences between sexes converged, and there were slightly more precarious men than women in 2017. The relative increase was most pronounced among men, especially those with low educational attainment and of European origin. The increasing proportion of precarious employees is a clear challenge to the tripartite Nordic model, which requires sufficient trade-union bargaining power.

A bibliometric analysis of Health Promotion International content regarding unions, unionization and collective agreements.

A recent article brought together the health benefits of unionization and working under collective agreements. It was noted how Canadian health promotion texts, reports and statements made no mention of unionization and working under collective agreements as promoting health. This was seen as a significant omission and reasons for this were considered. In this article this analysis is extended to consider how contributors to the flagship health promotion journal Health Promotion International (HPI) conceptualize unions, unionization and working under collective agreements as promoting health. Of 2443 articles published in HPI since its inception, 87 or 3.6% make mention of unions, unionization, collective agreements or collective bargaining, with most saying little about their promoting health. Instead, 20 make cursory references to unions or merely see them as providing support and engagement opportunities for individuals. Forty-five depict unions or union members as involved in a health promotion programme or activity carried out by the authors or by government agencies. Only 33 articles explicitly mention unions, unionization or collective agreements as potentially health promoting, representing 1.3% of total HPI content since 1986. We conclude that the health promoting possibilities of unionization and working under collective agreements is a neglected area amongst HPI contributors. Reasons for this are explored and an Organisation for Economic Cooperation and Development report on the importance of collective bargaining is drawn upon to identify areas for health promotion research and action.

Box-Cox power transformation unconditional quantile regressions with an application on wage inequality.

This study proposes a semi-parametric estimation method, Box-Cox power transformation unconditional quantile regression, to estimate the impact of changes in the distribution of the explanatory variables on the unconditional quantile of the outcome variable. The proposed method consists of running a nonlinear regression of the recentered influence function (RIF) of the outcome variable on the explanatory variables. We also show the asymptotic properties of the proposed estimator and apply the estimation method to address an existing puzzle in labor economics-why the 50th/10th percentile wage gap has been falling in the USA since the late 1980s. Our results show that declining unionization can explain approximately 10% of the decline in the 50/10 wage gap in 1990-2000 and 23% in 2000-2010.

Globalization, Work, and Health: A Nordic Perspective.

The Nordic countries are among the world's leading countries in international rankings on prosperity, productivity, social equity, trust, and health. Such positive results may be linked to how these countries have organized their working life. The aim of this article is to describe core elements of the Nordic working life model (emphasizing Norway) and discuss how globalization may challenge the model, and thereby influence public health. Based on an extensive review of relevant research, we show that the Nordic working life model with a coordinated wage bargaining system between well-organized employers and employees results in productive enterprises, small wage differences, good working environments, and a high level of well-being. Global trends of liberalization of working life, increased labor migration, the platform economy, reduced unionization, and more precarious work challenge the Nordic working life model and its reliance on standard working contracts. Such a trend may result in increased inequity, reduced generalized trust, and poorer public health. Politicians and other stakeholders in the Nordic countries should cope appropriately with globalization and technological changes so that the Nordic countries will uphold their well-organized working life and good societal achievements.

The role of labour unions in explaining workers' mental and physical health in Great Britain. A longitudinal approach.

OBJECTIVES: To assess whether there are mental and physical health benefits of being employed in a workplace where there is a union or staff association recognized by the management or being a member of such a union. METHODS: Using four waves [W2 (2010-11), W4 (2012-13), W6 (2014-15), W8 (2016-18)] from Understanding Society (UKHLS), we use a propensity score matching method and apply a latent growth modeling on the original dataset and on the matched dataset to estimate the impact of change in union presence and union membership between wave 2 and wave 4 for the employed population on the change in mental health (Mental Component Summary - MCS) and physical health (Physical Component Summary - PCS), after controlling for socioeconomic characteristics, age and sector of activity. RESULTS: Collective negotiation within the workplace plays a statistically significant role in supporting workers' mental and, to a greater degree, physical health. Being unionized does not add up significant physical health benefits but a slight positive effect on mental health is observed. CONCLUSION: About 50 per cent of the employed population is not represented by a labour union at company level and this has negative effects on health. A major health policy issue is also about promoting collective negotiation at the workplace and more research is needed about the impact of implementing such type of negotiation. The study shows the benefits of using a longitudinal approach when analysing the impact of union presence and union membership on workers' health.

Are there health benefits of being unionized in late career? A longitudinal approach using HRS.

OBJECTIVE: To assess whether unionization prevents deterioration in self-reported health and depressive symptoms in late career transitions. METHODS: Data come from the Health and Retirement Study (N = 6475). The change in self-perceived health (SPH) and depressive symptoms (CESD) between wave 11 and wave 12 is explained using an interaction effect between change in professional status from wave 10 to wave 11 and unionization in wave 10. RESULTS: The odds of being affected by a negative change in CESD when unionized are lower for unionized workers remaining in full-time job (OR:0.73, CI95%:0.58;0.89), unionized full-time workers moving to part-time work (OR:0.66, CI95%:0.46;0.93) and unionized full-time workers moving to part-retirement (OR:0.40, CI95%:0.34;0.47) compared to non-unionized workers. The same conclusion is made for the change in SPH but with odds ratios closer to 1. CONCLUSION: The reasons for the associations found in this paper need to be explored in further research.

Does 'right to work' imperil the right to health? The effect of labour unions on workplace fatalities.

OBJECTIVE: Economic policies can have unintended consequences on population health. In recent years, many states in the USA have passed 'right to work' (RTW) laws which weaken labour unions. The effect of these laws on occupational health remains unexplored. This study fills this gap by analysing the effect of RTW on occupational fatalities through its effect on unionisation. METHODS: Two-way fixed effects regression models are used to estimate the effect of unionisation on occupational mortality per 100 000 workers, controlling for state policy liberalism and workforce composition over the period 1992-2016. In the final specification, RTW laws are used as an instrument for unionisation to recover causal effects. RESULTS: The Local Average Treatment Effect of a 1% decline in unionisation attributable to RTW is about a 5% increase in the rate of occupational fatalities. In total, RTW laws have led to a 14.2% increase in occupational mortality through decreased unionisation. CONCLUSION: These findings illustrate and quantify the protective effect of unions on workers' safety. Policymakers should consider the potentially deleterious effects of anti-union legislation on occupational health.

Condiciones laborales de trabajadores sociales en el Poder Judicial de Neuquén / Work conditions of the social workers from the Judiciary of Neuquén

El presente artículo se propone recuperar la experiencia organizacional, sindical y política, de las Trabajadoras Sociales del Poder Judicial de Neuquén. Este proceso de sindicalización del sector se extiende hasta el año 2007. El análisis pone énfasis en las tensiones que se producen entre la "cuestión social" y las formas de enfrentamiento que asume una institución del Estado como el Poder Judicial, constituyendo a la profesión como un permanente campo de lucha.

This article aims at recovering the organizational, political and union experience of the social workers from the Judiciary of Neuquén. Such a unionization process of the sector went on until 2007. The analysis emphasizes the tensions between the "social issue" and the ways the Judiciary confronted it, which made the profession become a permanent field of struggles.