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Family Practice Vol. 9, No. 1, 42-48
© Oxford University Press 1992

research-article

Risk Management in the Community: Lessons for Family Medicine

JEFFREY M BORKAN

University of Massachusetts School of Medicine, Department of Family and Community Medicine Worcester, MA, USA and Ben Gurion University of the Negev, Department of Family Medicine Beer Sheva, Israel

Correspondence to: Jeffrey M Borkan, Kibbutz Keturah, D.N. Hevel Eilot 88840, Israel

Three polyurethane factories in Israel were examined using a combination of qualitative and quantitative methodologies. The study contrasts the effects of differing factory social and economic organization on occupational health and safety conditions as well as workers' attitudes and awareness. The central focus of the research addresses how each factory and community manages the risks associated with a particular industrial process. Surprisingly, the results show that the worker-owned and -operated plant, where knowledge and control of hazards was broadly shared and awareness high, had the worst safety, health, and hygiene conditions and outcomes. Worker involvement does not ensure worker protection and safety. These findings can be explained only by a careful examination of the social, economic, cultural and environmental settings in which they are embedded. Such an approach is well suited to family medicine research and training since it emphasizes the role of context on illness and disease.


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