Amid this reality, Tyson Foods recently announced a plan to open medical clinics at several of its U.S. plants. Coupled with the addition of 200 nurses and administrative positions in the company’s health services team, the plan, executives claim, will help “promote a culture of health” among workers. With the new initiative, Tyson joins a growing list of companies with on-the-job medical providers.
But our nation’s history suggests that worksite clinics may do more damage than good, further harming worker health. The U.S. meat and poultry industry has a long history of obstructing workers’ access to medical care and compensation benefits, and it has failed to provide adequate worksite medical treatment.
At the dawn of the 20th century, as the U.S. economy industrialized, workplace injuries in manufacturing were commonplace. Injured workers did not have the right to free medical treatment, wage replacement for lost work time or permanent disability benefits that would later be protected by the workers’ compensation system. Instead, courts decided whether employers bore any responsibility for work-related injuries and deaths. Employers easily and swiftly contested their liability, leaving tremendous burdens on workers’ families and communities.
During this period, to avoid costly liability lawsuits, several companies hired doctors to treat injuries in-house. These “industrial physicians,” as they became known, also redesigned plant layouts and operations. Their efforts prevented workplace injuries, but they also enabled more stringent personnel management and surveillance, and prioritized production efficiency. By allowing direct control over diagnoses and duration of treatment, corporations’ provision of medical care became a mechanism for surveilling and controlling workers and reducing labor costs.
In 1906, Upton Sinclair’s famed “The Jungle” shocked readers with its description of dangerous working conditions and industrial accidents in Chicago’s meatpacking industry. Incidents such as the 1911 Triangle Shirtwaist Factory fire, in which 150 workers perished after being locked inside, further raised consciousness about the plights faced by workers and the need to address occupational health and safety hazards. Captivated and alarmed, a moral discourse on workplace injury and illness began to take shape among the American public. “As the work is done for the employer, and therefore ultimately for the public,” remarked President Theodore Roosevelt in 1907, “it is a bitter injustice that it should be the wageworker himself and his wife and children who bear the whole penalty. ”
A compromise among business and labor interests led to the passage of state-based workers’ compensation legislation beginning in 1911. The “grand bargain,” as it became known, protected employers from liability lawsuits and, in exchange, promised workers access to independent medical care and limited compensation for their temporary and permanent disabilities. Within a decade, nearly every state had a system of workers’ compensation, though they were vastly uneven and inadequate, and would remain so for decades to come.
A commission convened by President Richard M. Nixon discovered as much a half-century later, finding that in 1970, 34 states did not meet even half of the workers’ compensation standards prescribed by the newly created Occupational Safety and Health Administration (OSHA). While the Labor Department tracked states’ compliance with these guidelines in the decades that followed, by 2004, budget cuts ended all accounting of state compliance with OSHA’s minimum standards.
With federal oversight waning, workers’ compensation provisions have suffered legislative rollbacks in many states, weakening protections for ill and injured workers. A century after the establishment of workers’ comp protections, work-related illness, injury and disability remain underreported, undertreated and undercompensated by employers, medical providers and insurance companies alike.
It is in this context that poultry and meatpacking workers labor in some of the most dangerous and lowest paid jobs in the country. Carpal tunnel, for example, occurs at seven times the national average, and pre-pandemic statistics suggest that these workers suffer occupational illness and injury at a rate more than five times higher than other workers across the country. The coronavirus has only exacerbated these inequities in the workplace.
In addition to being one of the worst perpetrators of workplace injuries in the country, slaughter and processing plants often go to great lengths to ensure that workers receive as little medical treatment and compensation for their injuries as possible.
At the Mississippi Poultry Workers’ Center, which coordinated a project to educate and support injured chicken-plant workers from 2004 to 2008, workers regularly shared stories of obstructionist plant nurses who impeded access to treatment by recommending Tylenol and Bengay in lieu of rotation, rest or medical care. Others reported being sent to compromised local doctors who often misdiagnosed or underestimated the extent of workers’ injuries.
One debone worker landed on his tailbone after stepping into a drainage channel that was missing its protective grate. The “plant doctor” took X-rays, said the worker was fine and sent him back to work. After a month of excruciating pain, the worker went to a specialist on his own accord. Using the original X-rays, he was diagnosed with multiple vertebrae fractures. Years after receiving spinal surgery, he still lived in constant pain and was unable to work.
When another worker’s hand was mangled in the polyester-cord strapping machine he operated to bundle boxes of processed chicken, the plant’s preferred doctor improperly set his bones. A month later his bones were re-broken by a hand surgeon, and he endured multiple surgeries to repair the damage. Stories of medical mismanagement like these are all too frequent among poultry workers in the United States
The meat and poultry industry has also been known to intimidate and terminate injured workers as a strategy to suppress workers’ compensation claims. The lengths to which some corporations will go to decrease their liability for these broken bodies have been well-documented.
During the pandemic, industry executives have repeatedly attempted to deflect responsibility for coronavirus infection rates in poultry and meatpacking onto the workers themselves, suggesting that workers’ living conditions are to blame. They also implicitly deny the connection between below-poverty pay and people’s cramped, suboptimal housing. Meanwhile, occupational health experts have pinned the industry’s high infection rates on a combination of cramped, cold working conditions and the lack of paid sick leave for workers suffering from extreme economic precarity.
The remedy for high rates of injury, illness and coronavirus infection among our nation’s food chain workers is hardly the establishment of in-plant medical clinics. To the contrary, this plan risks deepening employer control over workers and further imperiling their quest for impartial and qualified medical care.