Occupational Health Disparities among Immigrant Workers in Low-Wage Jobs: The Case of Home Care Workers

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Principal Investigator: Linda Delp

Demographic changes have fueled the growth of the home care workforce, now one of the most rapidly expanding segments of health care. The work is characterized by low wages, limited benefits and stressors, but also by job satisfaction. The personal attendants who assist the frail elderly and disabled in their homes straddle the informal arena of the home and formal employment, prompting policy debates about the structure of the industry and the relations between the workers, those they care for, government and private agencies. California’s In-Home Supportive Services Program (IHSS) is uniquely positioned as a consumer-directed model that allows payment for family providers and a collective voice for workers through union representation. Research demonstrates an association between job satisfaction and workers’ belief in the importance of belonging to a union as well as workers’ concerns about job security, both measure of control. Decision latitude, however, is not significant and important differences remain between racial/ethnic subgroups of the workforce. The dominant model of job stress in the field of occupational health, with constructs of demands, control and support, must be adapted to the context of particular employment relations and to racial/ethnic differences in the workforce.