The Empathy Gap

Drawing attention to low-paid work’s invisible ills

I doubt if more than a handful of the readers of this publication are familiar with the name Karen Messing or with her field of expertise, ergonomics. I am sure, however, that many will enjoy learning about the author and her research field by reading this informative and provocative little book.

Karen Messing is a retired professor of occupational health and safety who taught for three decades at the Université du Québec à Montréal. She is an American who came to Montreal in the 1970s, after doing undergraduate studies at Harvard. After graduate studies in genetics at McGill University and postdoctoral research in the United States, she landed a tenure-track job in the biology department at UQAM but rapidly gravitated toward research on occupational health and safety with a focus on the work situations of low-income women. In part, this short volume is her intellectual autobiography, including a certain amount of rather personal detail that is probably of interest to a limited audience only.

Two features of her career are likely to be of considerable general interest. Messing is, as noted, an English-speaking American whose academic career has flourished in Quebec’s French-language university system. She has taught and published in French while also carrying out a distinguished scholarly career in English-language journals and academic circles. The number of anglophones working in Quebec’s French universities has, I think, increased somewhat in recent years, but back in the 1970s and ’80s, Quebec’s identity-based nationalism was at high tide and anglophones teaching in Quebec’s French-language universities were few and far between. While Messing does not really address the language or culture issue directly, she does pay more attention to a second feature of her career that also has some general relevance—her ability to move with relative ease from an undergraduate career in the social sciences to graduate studies in biology to an academic career first in genetics and then in ergonomics. Particularly at a place such as UQAM, disciplinary boundaries were, as Messing notes, much easier to cross or ignore than they have become. For all our verbiage about inter- and multi- and trans–disciplinarity, very little in the way of institutional change has been implemented to embody and support this discourse.

The field in which Messing has made her mark, nationally and internationally, is ergonomics, a branch of the field of occupational health and safety that she defines succinctly as “the analysis of paid work activity in order to improve it.” Her book can provide an effective “for dummies” introduction to this important subfield. It can also serve as an accessible and persuasive guide to the distinctive way in which she and her colleagues at UQAM have defined and practised ergonomics and to the important contributions they have made to the field. Messing and her colleagues have brought to Canada an approach to ergonomics that they learned from colleagues in France and that is different from standard Canadian approaches.

As indicated by her book’s subtitle, “What Science Can Learn about Work from the People Who Do It,” this approach involves collaborating with trade unions and community groups at all stages of the research and, above all, paying careful attention to the actual work that people do and to what they say about it, rather than focusing on statistical indicators and the assessments of employers and physicians. In addition, Messing and her colleagues focus on a range of occupations that are rarely studied—supermarket cashiers, department store clerks, hospital cleaners, call-centre operators, food service workers, bank tellers, teachers, nursing home attendants. These are low-paid workers whose typical occupational health problems are not the kinds of injuries caused by sudden accidents or by acute exposures to toxins on which most occupational health and safety researchers focus, but rather the physical and psychological harms caused by long-term exposure to poorly designed and badly organized work. As the title of one of Messing’s multi-year research programs indicates, these are “l’invisible qui fait mal” (invisible sources of harm).

The key point that Messing makes repeatedly in this book is that the complaints and compensation claims of these sorts of low-paid, low-skilled and low-status employees tend to be ignored or dismissed by their employers, compensation boards and even researchers. According to Messing, these types of occupational harms do not get the attention and compensation they deserve largely because of what she calls “the empathy gap.” What she means is a widespread phenomenon that makes people with power and expertise indifferent, unresponsive and unsympathetic to these types of workers. It is this empathy gap to which the book’s title, Pain and Prejudice, refers. She sees it as a pervasive, class-based mindset that blinds employers, policy makers and researchers to the suffering of many workers and to the inappropriate design and organization of many types of work.

A prime example is the chapter on the women who clean the toilets on commuter trains in a Paris station. Messing describes how she followed cleaners on their shifts, what she learned about the complexities and challenges of the work (up to 200 toilets to clean in a shift, 60 to 120 seconds per toilet, 23 kilometres walked per shift), the tricks developed by the cleaners to make this possible, a series of recommendations that she made to reduce these workers’ risk of injury (including providing a lighter pail for carrying their supplies and more effective cleaning products) and the failure of the employers to adopt any of these recommended changes.

One common feature of the workers Messing studies, and that she describes in this book in touching detail, is gender. Messing has played a major role in placing women and women’s work issues at the foreground of occupational health and safety research in Quebec and in Canada. She makes a persuasive argument that women’s work is different from men’s and that women’s ergonomic problems need to be studied as such. Many of the chapters of Pain and Prejudice present case studies of groups of women workers whose ergonomic problems have been ignored and misunderstood. She is particularly exercised about the back, leg and foot pain caused by the prolonged standing required, at least in North America, by many occupations dominated by women—bank tellers and supermarket cashiers, for example. And she argues that this problem has been ignored by employers and researchers not because it is unimportant or because there is no evidence to demonstrate its prevalence, but rather because of the empathy gap that separates managers, compensation officials and researchers from those low-paid, low-prestige women workers.

Above all, this book is a lament by someone who spent her career trying to call attention to, and make amends for, the impact of that empathy gap on the health of workers and who feels that she did not really succeed. Her repeated refrain is “nobody cared,” “nobody was interested.” Reading the stories she presents about these workers will provide important, and often surprising, insights about low-paid, mainly female workers, the damage inflicted on their bodies and their minds by their jobs, the “secrets” they know about their work that employers and researchers generally ignore at their peril, and the potential contribution that occupational health and safety science could, in Messing’s words, make to “bridging the empathy gap.” This is an eloquent and sobering book that, although its case studies and analysis may focus a bit too exclusively on Quebec, will be of interest to readers across the country.