Proposing a social ecological approach to address disparities in occupational exposures and health for low-wage and minority workers employed in small businesses

Occupational disease and injuries are the 8th leading cause of death in the United States. Low-wage and minority workers are more likely to work in hazardous industries and are thus at greater risk. Within the small business sector, in particular, the health of low-wage and minority workers is threatened by a multitude of complex and interrelated factors that increase their risk for injuries, death, and even chronic disease. The COVID-19 pandemic has amplified these concerns, as many low-wage and minority workers are essential workers, and many small businesses are reopening with little to no guidance. The article describes work-related health risks and reviews current research on occupational and social ecological approaches to improving the health of minority and low-wage workers primarily employed by small businesses. We propose a conceptual framework that integrates the social ecological model with the hierarchy of controls to address work-related health among low-wage and minority workers specifically in the small business sector. Community-based strategies are recommended to engage small business owners and workers in efforts to address their immediate needs, while building towards sustainable policy change over time. These strategies are of particular importance as small businesses reopen in the ongoing pandemic.