According to the World Health Organization’s framework for action on the social determinants of health, occupation is one key determinant of wellbeing and health disparities. Our profession not only determines our place in the societal hierarchy and exposure to specific occupational risks, but it also identifies working relations of domination and subordination.

Inequality in occupational health: the importance of the working sector

The industry of travel and tourism keeps growing year after year on a global scale, an industry that promotes and takes advantage of the desire of modern citizens to exchange cultural, economic, and academic experiences. As with every business sector, growth leads to competition, so hospitality services often find the highest competitive margins in low labor costs. However, insufficiently compensated employees impose challenges both for the industry and for the whole society.

All around the world it is seen that low-wage jobs relate to a high burden of illness, injury, and disability. This burden seems to be multifaceted as it falls disproportionately on workers who are further disadvantaged in society, such as migrants or women. Hotel workers have higher rates of occupational-related health problems as compared with workers in other service industries; being exposed to many high work-induced risks and more likely to experience physical, ergonomic, chemical, biological and psychosocial disorders and conditions.

Indeed, regardless of geographic variation, hotel cleaners are predominantly women, immigrants, and minorities working under adverse conditions such as long hours, chemical exposure, poor pay, job insecurity and a wide array of other physical and mental health risks. Many hotel employees have few viable employment alternatives because they have limited education attainment and few marketable skills, with many of them migrating from rural areas, and it is known there is a particular vulnerability to migrant workers in the labor market. Economy hotels, under the pressure of severe price competition and cutting-edge profit margins, are highly dependent on domestic migrant workers.

An example to follow: Las Kellys fight for their occupational health

Las Kellys is a group of hotel room cleaners that have organized themselves to fight for better working conditions and their occupational health in Spain, a country that economically relies very much on the tourism sector- 5.4% of the GDP, which is US$ 78,464 million in 2018-. Las Kellys represent room cleaners working in big cities that were born in rural areas, as well as other countries in Latin America and Eastern Europe. Their migration processes and their unstable legal status are correlated to other social determinants such as gender, age and education: Las Kellys are not younger than 40 years, and all of them are women. Now they speak loudly after a long time working in a precarious sector that is conditioning their health.

Las Kellys started a social movement that answers to the need of being heard and denounces the violation of labor rights in a sector that today means 958,100 job positions in Spain. Their collaborative and heterogenous ways are contrary to the classical approach in which trade unions tend to consider migrants primarily as workers, rather than as migrant workers with particular and overlapping forms of oppression. The potential solutions to address the conflict start with the public recognition of the human rights infringement in the tourism industry and continue with enforcement of occupational safety standards by employers.

The Ministry of Industry, Energy and Tourism has significant responsibility in regard to business and human rights within the Spanish government, meaning the government plays an important role to ensure them. However, the last labor reform approved in 2012 pushed against the guarantee of workers’ rights by manipulating the basic aspects of contracting mechanisms, intern flexibility, layoffs and collective negotiation. In addition, migration laws and welcoming policies to newcomers need to be revised to ensure access to health care. The political will is, then, a remarkable potential factor to improve the situation. But there is also a need to address the unique risks that lead to high injury rates among hotel cleaners and employers must conduct risk assessments to identify and control them. All in all, multilevel, multisectoral and multistakeholder preventive interventions are needed in order to prevent and mitigate work-related risks.

Las Kellys: the impact of their fight

At the political level, their biggest success is the denominated Law Kelly, a change on the 42nd article of the Workers Agreement. This amendment aims to fight against the major regulation gap on their employability, which is the externalization of the core services by the hotel companies. This law also demands better conditions such as extension of work-related injuries catalogue and would be an important step to ensure that affected groups in the tourism sector see their rights protected.

As it is, Las Kellys illustrate the problem of accessing health in Spain, showing clearly that different exposure to risk factors linked to social vulnerability makes the hotel room cleaners a target group for health inequity. Furthermore, they are a good example on how approaching an issue with an intersectional approach that combines health and social spheres can work under a self-organized movement. This could hopefully set a new path to stop classifying vulnerable populations’ profiles under different labels and fighting them independently, as well as to remark the absolutely necessary resolution to include the affected group when developing health policies.

Neus Rosell
Neus Rosell

Neus Rosell is a pharmacist from Barcelona, Spain. She holds a MSc in Global Health from ISGlobal in Barcelona. She has a background in training delivery in the field of Peace Education and Conflict, as well as political and social activism. She is passionate about Development Cooperation and Food Security. Her main interests are focused on Health Education, Gender Inequity, Policy-making, Anthropology and Advocacy.


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