The health of restaurant work: A historical and social context to the occupational health of food service.

The United States currently has over one million restaurants, making food service one of the largest workforces and industry sectors in the nation's economy. Historically, concern for the health of early restaurant workers was tied largely to the hygiene of the food and thus the wellbeing of the customer rather than the individuals preparing the food. The landscape of occupational illness and injury that resulted is fraught with some of the starkest health disparities in wages, discrimination, benefits, injuries, and illness seen among US laborers. These disparities have consistently been associated with social class and economic position. Conditions identified during the early years of restaurant work, before the introduction of occupational safety and health protections, persist today largely due to tipped wages, dependence on customer discretion, and the management structure. Research and intervention efforts to control occupational health hazards should be directed toward the socioeconomic and structural roots of health problems among food service workers in the United States. Such efforts have important implications for enhancing worker protections, improving wages, and restructuring working conditions for restaurant and food service workers. They also suggest opportunities for occupational health practitioners and researchers to contribute to system-level change analysis to address centuries-old occupational health challenges still facing one of the largest sectors of workers in the country.