Missed Connections: Hypertension and Occupational Health at the San Francisco Municipal Railway

This chapter analyses efforts of the union and the management of a large urban transit company to address the high prevalence of hypertension among transit operators. Ethnographic evidence recounts the efforts to change the structure of work in order to decrease the problem. The chapter's key finding is that the features of the work environment that produce hypertension in transit operators in the first place also make it difficult for them to work together with their union leadership to push for lasting work changes necessary to improve their health over the long run.