摘要：Objectives. We investigated the extent to which the political economy of US states, including the relative power of organized labor, predicts rates of fatal occupational injury. Methods. We described states’ political economies with 6 contextual variables measuring social and political conditions: “right-to-work” laws, union membership density, labor grievance rates, state government debt, unemployment rates, and social wage payments. We obtained data on fatal occupational injuries from the National Traumatic Occupational Fatality surveillance system and population data from the US national census. We used Poisson regression methods to analyze relationships for the years 1980 and 1995. Results. States differed notably with respect to political–economic characteristics and occupational fatality rates, although these characteristics were more homogeneous within rather than between regions. Industry and workforce composition contributed significantly to differences in state injury rates, but political–economic characteristics of states were also significantly associated with injury rates, after adjustment accounting for those factors. Conclusions. Higher rates of fatal occupational injury were associated with a state policy climate favoring business over labor, with distinct regional clustering of such state policies in the South and Northeast. Workers in the United States have experienced a sustained decline in the rate of fatal occupational injury over the past decades, yet there are marked differences in fatal injury rates and trends among regions and states. 1 – 5 In the final decades of the 20th century, for example, the average annual rate for all fatal occupational injuries ranged from 1.7 per 100 000 in Connecticut to 24.3 per 100 000 in Alaska; the average rate of decline varied from less than 1% per year in the Northeast to almost 5% per year in the West. 3 , 4 The causes of geographical diversity in occupational injury rates are largely unknown. The spatial variation in natural resources, topography, and climate that condition the kinds of work available in a state or region offer one possible explanation for spatial differences in fatal occupational injury rates. Another explanation for this diversity derives from consideration of government policy on economic development and labor, which can influence where employers locate, how they operate, and the attention they give to worker safety. 6 Some factors common to areas with high rates of fatal occupational injury can be observed. Within the United States, it has been noted that higher fatal injury rates are concentrated in the Western and Southern regions, in rural areas, and in less wealthy states. 7 , 8 The embeddedness of industries and jobs in local conditions implies that the local political–economic structure has an important effect on occupational injury rates. We reasoned that variation in the strength of labor unions, state welfare provisions, and unemployment levels influences the ability of labor to secure better-paying and safer jobs. 9 As jobs in traditional manufacturing decrease, 10 , 11 declining unionization rates, contracting social welfare programs, and increasing capital mobility change the balance of power between capital and labor. 12 In addition, states’ capacity to monitor and regulate health and occupational safety depends on their fiscal health and their strategies for creating an economic climate conducive to capitalist development and growth. 13 The role of states has increased since the 1980s with the rise of the “New Federalism” in US government, which devolved functions once performed by the federal government to state and local jurisdictions. 14 No formal analyses of these patterns have been conducted for a number of years, 15 and states’ economic characteristics and policies have been neglected as potential determinants of geographic variation in occupational injury rates. We examined relationships between fatal occupational injury rates and political–economic characteristics of US states to learn whether fatal occupational injury rates are associated with state political economy after accounting for variation in economic structure and labor force composition. We expected that in states where the capacity of labor is stronger (higher union density), the rate of fatal occupational injury would be lower. We expected states with greater labor market deregulation (e.g., so-called right-to-work laws, which limit labor's ability to organize) to have a higher incidence of fatal injury because of the reduction in the relative power of labor. We also hypothesized that high state debt would be associated with a higher risk of occupational fatality, although one could argue that state debt may also accrue as a result of investment in public infrastructure or social services that reduce the risk of injury or increase the bargaining power of labor.
