Work organizational features associated with health behaviors among nursing home personnel

Obesity, cigarette smoking, and physical inactivity represent important and preventable health risks. However, many worksite health promotion programs to address them have limited scope and effectiveness; a particular concern is failure to engage lower-status workers, who are often at high risk. We report on the baseline data from a study of combined health promotion/occupational health programs in the long-term care (nursing home) sector. A standardized, self-administered questionnaire was distributed in 12 long-term care centers located in Maryland and New England to clinical employees, mostly nursing aides and nurses (92% women, 65% African-American, mean age 42 years, seniority 11 years). These workers reported exposure to psychological demands (88% of respondents), awkward postures (65%), poor safety climate (60%), lifting heavy loads (57%) and imbalance in work-family life (43%). The prevalences of obesity, physical inactivity and current smoking were 35%, 23% and 24%. Among these workers, the risk of “personal” health risks increased linearly with the number of job exposures such as low decision latitude, low co-worker support, lifting heavy loads, night work, and recent physical assault at work. For obesity, the odds ratios were 3+ for 2 or more exposures, up to 4.2 for workers with 4 or 5 exposures. Current smoking was more than 4 times more frequent for workers with 4 or 5 of similar job features. The risk of being physically inactive was 2.5 for multiple exposures. Worksite health promotion programs should take into account the effect of working conditions on the health and health behaviors of individual employees.