Power-building Partnerships for Health: Lessons From Santa Barbara About Building Power to Protect Farmworker Health and Advance Health Equity.

The distribution of power in society is "upstream of the upstream" social determinants of health, and community organizers redistribute power to change social and political systems that shape health. Power-building Partnerships for Health (PPH) was launched in 2018 and pairs local public health departments and community organizing groups to support transformational health equity work, prioritizing trust and relationship building as precursors for action. Through PPH, the Santa Barbara County Public Health Department partnered with 2 grassroots organizations, CAUSE and MICOP. This partnership led to their launching a Latinx Indigenous Migrant Health COVID-19 Task Force and to the passing of a first-of-its-kind Health Officer Order on safety in farmworker housing. This practice brief discusses the importance of relationship building and key activities within PPH, and the roles of both the health department and community organizers in taking action to advance health equity in Santa Barbara County during the pandemic.

Wage theft as a neglected public health problem: an overview and case study from San Francisco's Chinatown District.

Wage theft, or nonpayment of wages to which workers are legally entitled, is a major contributor to low income, which in turn has adverse health effects. We describe a participatory research study of wage theft among immigrant Chinatown restaurant workers. We conducted surveys of 433 workers, and developed and used a health department observational tool in 106 restaurants. Close to 60% of workers reported 1 or more forms of wage theft (e.g., receiving less than minimum wage [50%], no overtime pay [> 65%], and pay deductions when sick [42%]). Almost two thirds of restaurants lacked required minimum wage law signage. We discuss the dissemination and use of findings to help secure and enforce a wage theft ordinance, along with implications for practice.

Effects of social, economic, and labor policies on occupational health disparities.

BACKGROUND: This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States. METHODS: We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities. RESULTS: Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker's compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities. CONCLUSIONS: There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all.

Protecting labor rights: roles for public health.

Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some public health agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine public health functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards.

Studying and addressing urban immigrant restaurant worker health and safety in San Francisco's Chinatown district: a CBPR case study.

With its emphasis on empowerment, individual and community capacity building, and translating research findings into action, community-based participatory research (CBPR) may be particularly advantageous in work with urban immigrant populations. This paper highlights eight ways in which CBPR has been shown to add value to work with urban underserved communities. It then describes the background, context, and methods of an ecological CBPR project, the Chinatown Restaurant Worker Health and Safety Study, conducted in San Francisco, California, and draws on study processes and outcomes to illustrate each of the eight areas identified. Challenges of using CBPR, particularly with urban immigrant populations, briefly are described, drawing again on the Chinatown study to provide illustrative examples. We discuss lessons learned, through this and other studies, for the effective use of CBPR with urban immigrant populations. We conclude that despite its challenges, this transdisciplinary, community-partnered and action-oriented approach to inquiry can make substantial contributions to both the processes and the outcomes of the research.

Promoting health and safety in San Francisco's Chinatown restaurants: findings and lessons learned from a pilot observational checklist.

Noncompliance with labor and occupational health and safety laws contributes to economic and health inequities. Environmental health agencies are well positioned to monitor workplace conditions in many industries and support enhanced enforcement by responsible regulatory agencies. In collaboration with university and community partners, the San Francisco Department of Public Health used an observational checklist to assess preventable occupational injury hazards and compliance with employee notification requirements in 106 restaurants in San Francisco's Chinatown. Sixty-five percent of restaurants had not posted required minimum wage, paid sick leave, or workers' compensation notifications; 82% of restaurants lacked fully stocked first-aid kits; 52% lacked antislip mats; 37% lacked adequate ventilation; and 28% lacked adequate lighting. Supported by a larger community-based participatory research process, this pilot project helped to spur additional innovative health department collaborations to promote healthier workplaces.

Creating tools for healthy development: case study of San Francisco's Eastern Neighborhoods Community Health Impact Assessment.

The San Francisco Department of Public Health recently completed a 2-year collaborative process, the Eastern Neighborhoods Community Health Impact Assessment (ENCHIA), to evaluate the potential positive and negative health impacts of land use development. ENCHIA resulted in a number of outcomes, including (1) a vision of a healthy San Francisco; (2) community health objectives to reflect the vision; (3) indicators and data to assess and measure the objectives and vision; (4) a menu of urban development strategies to advance the objectives; and (5) the Healthy Development Measurement Tool, an evidence-based tool to support accountable, comprehensive, evidence-based, and health-oriented planning. This case study describes the 18-month ENCHIA process, key outcomes, and lessons learned. The case study also provides an overview of the Healthy Development Measurement Tool and examples of its first applications to urban planning. Given the growing understanding of built environmental influences on health, ENCHIA illustrates the ability of a local public health agency to effectively engage in land use policy as a health promotion strategy.