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Quinn MM, Markkanen PK, Galligan CJ, Sama SR, Lindberg JE, Edwards MF. Healthy Aging Requires a Healthy Home Care Workforce: the Occupational Safety and Health of Home Care Aides. Curr Environ Health Rep 2021; 8:235-244. [PMID: 33982149 PMCID: PMC8114970 DOI: 10.1007/s40572-021-00315-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE OF REVIEW To identify important home care (HC) aide occupational safety and health (OSH) hazards and examine how addressing these can improve aide health and the delivery of HC services overall. Specifically, this review seeks to answer: Why is HC aide OSH important? What are the most significant OSH challenges? How can improving HC aide OSH also improve the safety and health of their clients? What implications do the findings have for future research? RECENT FINDINGS HC is one of the fastest growing US industries. Aides comprise its largest workforce and are increasingly needed to care for the rapidly aging population. There is an aide shortage due in part to instabilities in HC work organization and to serious job-specific hazards, resulting in aides losing work time. Recent social, economic, and technological factors are rapidly changing the nature of HC work, creating OSH hazards similar to those found in nursing homes. At the same time, aides are experiencing social and economic inequities that increase their vulnerability to OSH hazards. These hazards are also a burden on employers who are challenged to recruit, retain, and train aides. OSH injuries and illness interrupt the continuity of care delivery to clients. Many OSH hazards also put HC clients and families at risk. A new framework and methodologies are needed to assess aide and client safety together in order to guide future HC research, policies, and practices. Government, industry, and labor commitment is needed to fund and coordinate a comprehensive, multidisciplinary research program.
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Affiliation(s)
- M. M. Quinn
- Safe Home Care Project, Lowell Center for Sustainable Production and Department of Public Health, University of Massachusetts Lowell, 600 Suffolk Street, Suite 520, Lowell, MA 01854 USA
| | - P. K. Markkanen
- Safe Home Care Project, Lowell Center for Sustainable Production and Department of Public Health, University of Massachusetts Lowell, 600 Suffolk Street, Suite 520, Lowell, MA 01854 USA
| | - C. J. Galligan
- Safe Home Care Project, Lowell Center for Sustainable Production and Department of Public Health, University of Massachusetts Lowell, 600 Suffolk Street, Suite 520, Lowell, MA 01854 USA
| | - S. R. Sama
- Safe Home Care Project, Lowell Center for Sustainable Production and Department of Public Health, University of Massachusetts Lowell, 600 Suffolk Street, Suite 520, Lowell, MA 01854 USA
| | - J. E. Lindberg
- Safe Home Care Project, Lowell Center for Sustainable Production and Department of Public Health, University of Massachusetts Lowell, 600 Suffolk Street, Suite 520, Lowell, MA 01854 USA
| | - M. F. Edwards
- Safe Home Care Project, Lowell Center for Sustainable Production and Department of Public Health, University of Massachusetts Lowell, 600 Suffolk Street, Suite 520, Lowell, MA 01854 USA
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Ojha RP, Stallings-Smith S, Flynn PM, Adderson EE, Offutt-Powell TN, Gaur AH. The Impact of Vaccine Concerns on Racial/Ethnic Disparities in Influenza Vaccine Uptake Among Health Care Workers. Am J Public Health 2015; 105:e35-41. [PMID: 26180953 DOI: 10.2105/ajph.2015.302736] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We explored whether collective concerns about the safety, effectiveness, and necessity of influenza vaccines mediate racial/ethnic disparities in vaccine uptake among health care workers (HCWs). METHODS We used a self-administered Web-based survey to assess race/ethnicity (exposure), concerns about influenza vaccination (mediator; categorized through latent class analysis), and influenza vaccine uptake (outcome) for the 2012 to 2013 influenza season among HCWs at St. Jude Children's Research Hospital in Memphis, Tennessee. We used mediation analysis to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the total, direct, and indirect effects of race/ethnicity on influenza vaccine uptake. RESULTS Non-Hispanic Blacks had lower influenza vaccine uptake than non-Hispanic Whites (total effect: PR = 0.87; 95% CI = 0.75, 0.99), largely mediated by high concern about influenza vaccines (natural indirect effect: PR = 0.89; 95% CI = 0.84, 0.94; controlled direct effect: PR = 0.98; 95% CI = 0.85, 1.1). Hispanic and Asian HCWs had modestly lower uptake than non-Hispanic Whites, also mediated by high concern about influenza vaccines. CONCLUSIONS Racial/ethnic disparities among HCWs could be attenuated if concerns about the safety, effectiveness, and necessity of influenza vaccines were reduced.
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Affiliation(s)
- Rohit P Ojha
- Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover
| | - Sericea Stallings-Smith
- Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover
| | - Patricia M Flynn
- Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover
| | - Elisabeth E Adderson
- Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover
| | - Tabatha N Offutt-Powell
- Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover
| | - Aditya H Gaur
- Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover
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