
In France, blue-collar workers and men are more often victims of work-related accidents leading to permanent disability. "This is a fact that receives little media coverage, given the extent of the suffering it causes in the population," according to the Observatoire des inégalités.
In 2019, 19,280 accidents at work resulting in permanent disability were recorded in France among blue-collar workers, compared with 1,805 among executives. If the number of accidents is related to the number of hours worked in each category, it appears that the risk of being the victim of a serious accident is seven times higher for manual workers than for managers. The victims are more often men, as they are over-represented in the sectors most at risk. This is the case in the construction sector, with structural work and carpentry, for example, or in agriculture, with forestry and horse breeding in particular. Mining, transport and storage are also among the most dangerous sectors. It should be noted that female workers, although less numerous, are almost as often victims of serious occupational accidents as their male counterparts. Occupational accidents resulting in death are also more frequent among manual workers, who alone account for two-thirds of the fatal accidents at work recorded in France in 2019. In relation to the number of hours worked, there are 4.6 times more fatal accidents among manual workers than among senior managers. Once again, a gender gradient linked to the sector's accidentology is observed: 91% of deaths are male.
In Belgium, a recent note from the Belgian Inequality Observatory (OBI) makes a similar observation: 'health inequalities can be understood through the prism of professional activity'. There is an excess mortality rate, from all causes, in professions where working conditions are difficult. Dustmen, switchboard operators, construction workers, public transport drivers, waiters, postmen, railway workers, industrial cleaners and care assistants have much higher mortality than lawyers, scientists, dentists, company directors, doctors, senior managers, building contractors, engineers and teachers in higher education. The ranking of occupations by mortality reflects a social hierarchy. Prestigious and power-related occupations are under-mortalized, while subordinate occupations that consist of executive tasks are clearly over-mortalized. Subjective health, as reported by the workers themselves, follows the same logic: the higher the excess mortality of the category, the higher the proportion of people feeling in average or poor health.
These different results underline the cumulative dimension of social inequalities: in addition to being confronted with more strenuous and poorly paid jobs, the lower classes live less long and feel in poorer health. Furthermore, inequalities are largely reproduced from generation to generation: a child of a low-skilled worker is 53 times less likely to be a senior manager than a low-skilled worker. Thus, depending on the social position of his or her parents, an individual will have a greater or lesser chance of having a valued profession, good health and a long life. While the study does not establish a causality between excess mortality and professional activity, it suggests that work activity could indeed have a significant impact on health and life expectancy. Work cannot be dissociated from living conditions: having an arduous job also means having a lower salary, which determines the size and comfort of one's home, which conditions one's food choices, the free time available, etc. "It is all of these interactions between inequalities that must be understood from a public health perspective," points out the IBO. "A public policy concerned with reducing social inequalities in health would thus imply profound structural changes with a view to reducing social inequalities in areas other than health strictly speaking, particularly in terms of employment, housing and income.