The biosocial health of U.S. long haul truckers: Syndemics of the road

Introduction

Due to daily and enduring economic and other pressures, poor working conditions, and a common pattern of behaviors and practices, long-haul truck driving is a physiologically stressful and both biologically and psychologically challenging job that is not conducive to healthy living or routine healthcare seeking. The work context of this occupation fits the definition of a “risk environment,” namely a space in which a variety of factors interact to increase the chances of harm occurring. While prior research on this population has tended to focus on one or two primary health conditions or separately review multiple health conditions as a consequence of specific trucker lifestyle and working conditions, newer models of health, like syndemic theory, consider synergistic interactions among comorbid diseases that are interconnected within a set of linked social determinants of health. This approach is concerned with assessing how intersecting living/working conditions promote the clustering and adverse interaction of diseases and other health factors.

Methods

This paper reviews identified bodies of literature that address: the nature of the work conditions of long haul truckdrivers and the factors responsible for these conditions, the health risks associated with the conditions, and the potential syndemic interactions of diseases that are frequent in this population and pathways of disease interaction. Because of the multiple literatures involved the paper does not employ a systematic review approach.

Setting

and Population: The paper focuses on long haul truck drivers--who may travel coast to coast remaining on the road for weeks and sometimes months at a time--in the U.S.

Results

A number of likely syndemics common among long haul truck drivers are identified and assessed. This review affirms that a syndemics approach is well suited to the challenge of better understanding and improving worker health. A syndemics lens pushes researchers to develop a comprehensive biosocial picture of health in a population and to consider biosocial and multi-disease interventions.

Conclusion

This paper employs a syndemics lens to review the key health risks of long haul truck drivers in the U.S., identify the factors increasing their behavioral and other health risks, and suggest likely synergistic health consequences in need of public health intervention. In light of the serious consequences of the health, social, and economic cost of syndemics of the road, there is a need for expanded attention to this issue in research, funding, and policy.