Cornell University: Home health care workers face their own health challenges

Home health care workers often suffer from poorer physical and mental health, when compared with similar low-wage frontline workers, according to new research by Weill Cornell Medicine.

The paper, published Dec. 8 in the American Journal of Public Health, indicates more than a quarter of home health care workers rated their general health as fair or poor, while one in five reported poor mental health and 14% have poor physical health. Factors linked to all three aspects of poorer health include low household income, cost barriers to medical care and history of depression.

The self-reported data was collected from nearly 3,000 home health care workers across 38 states and compared with those from health care aides and health care support workers not working in patients’ homes. Compared with both other groups – which carry similar job responsibilities – home health care workers had a much higher prevalence of conditions such as arthritis, high cholesterol and high blood pressure, and depression.

“We’ve seen, especially during the COVID pandemic, that this workforce provides essential, day-to-day care to older adults to keep them healthy at home,” said lead author Dr. Madeline Sterling, assistant professor of medicine at Weill Cornell Medicine. “But not a lot of research has investigated their own health. This data provided an opportunity to do that at a national level.”

With more than 2 million in their ranks – a number expected to increase 38% in the next three years alone – home health care workers are one of the fastest-growing workforces in the industry. The group comprises mostly women and minorities who are typically employed by home care agencies, providing hands-on personal and medically oriented care to older adults and those with disabilities and chronic conditions.

Sterling and her collaborators analyzed 2014 to 2018 data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey zeroing in on the prevalence of medical conditions, health behaviors and preventative health practices such as undergoing routine doctor visits, dental care or receiving flu vaccinations.

The findings are “a call to action” to create interventions and occupational health initiatives specifically focused on home health care workers, Sterling said. In addition to promoting higher wages and ensuring adequate health insurance among this workforce, programs that can screen workers for health risks and intervene on them, may be warranted.

“Hopefully this study will spur public health experts and policy makers to put such programs in place,” she said. “Right now, improving the health of these workers is not part of the conversation, and it should be.”