Health and Safety for Home Healthcare Workers: Politics, Policy and Public Health for a Unique Worker Population

As the size of the elderly population continues to expand, the provision of good quality in-home supportive services is essential to allowing the elderly to continue living independently. Consequently the size of the home health care workforce has more than doubled in the past decade and is projected to be one of the fastest growing occupations through 2014. According to the 2000 Census, homecare workers are 90% women, half minorities, and one quarter speak a language other than English at home. Homecare workers face numerous physical and psychosocial hazards such as high risks of injuries, exposure to blood born pathogens, heavy workloads, low wages, communication barriers with their consumers, and workplace violence. They work in less standardized, predictable, or controllable settings. Given the unique characteristics of the workers and workplace, health and safety research with homecare workers is particularly challenging and requires innovative approaches to research, interventions and public health policies. Over the past few years, the National Institute for Occupational Safety and Health has funded several research projects to address home health care safety and health. These projects were aimed at assessing the role of workplace exposures on mental health, documenting and preventing exposures to blood-borne pathogens; and developing linguistically and culturally appropriate intervention materials and programs. This session will present the main findings and the lessons learned from several of these projects with particular emphasis on issues of the uniqueness of homecare workers, methodological challenges, and the political/policy implications of health and safety programs for home healthcare workers.