Abstract
Community health is disproportionately impacted by social determinants of health, and work constitutes a primary, but often overlooked, social determinant of health. Occupation and work environment influence health through specific mechanistic pathways: work provides opportunities for material consumption (i.e., produces income that can be used to secure housing and determine neighborhood residence); work shapes the conditions that determine the exposure and severity of physical, chemical, ergonomic and biological exposures; and the work-life balance relationship. Precarious work is characterized by job situations with irregular hours or hourly pay, low wages, insufficient health insurance or access to healthcare, the inability to speak freely to an employer, or lack of clarity around who the employer of record is, and/or limited or no work-life balance. People who are low income, women, Black, Indigenous, People of Color (BIPOC), and immigrants disproportionately engage in precarious work. In low income, Black and Latine communities, with high proportions of workers engaged in precarious work, individual and community health are impacted by mechanistic pathways associated with work precarity Community norms around work may also impact health. It is important for communities with high proportions of precariously employed workers to understand how work functions as a social determinant of health.
The Greater Lawndale Healthy Work (GLHW) Project is a community-based participatory research project that explores work as a social determinant of health at the neighborhood level and produces evidence for community-led interventions to promote healthy work. Our community-academic research team created the Greater Lawndale Lotería (GLL), an evidence-informed, historically grounded and worker-justice themed educational game for participatory dissemination of our action research findings and as a popular education method to shift knowledge, attitudes and beliefs of Greater Lawndale (GL) residents on work as a social determinant of health. The GLL functions both as a vehicle for participatory dissemination of our research findings to community members and as a popular education-based intervention to raise critical consciousness on work as a social determinant of health in GL.
In this paper, we describe our participatory process of co-developing the dissemination strategy of the GLL. We also present findings from our mixed-methods evaluation findings of the GLL as a community intervention. Our findings suggest that community-developed, popular education-based games can be an effective way to engage in participatory dissemination. We encourage other community-academic partnerships to replicate and adapt our approach to advance the evidence base on the impact of participatory methods and praxis.