Findings and Lessons Learned from a Health Impact Assessment (HIA) of AB 889, the California Domestic Worker Bill of Rights

Health impact assessment (HIA) is a promising practice to systematically analyze potential health and equity impacts of proposed policies, plans, or projects. In the United States, HIA has been applied to proposed minimum wage and paid sick days laws, but had few applications to other labor policies.

In 2011, the San Francisco Department of Public Health (SFDPH) conducted a HIA of the Domestic Work Employee Equality, Fairness and Dignity Act (AB 889), state legislation that eliminates the exclusion of domestic workers from labor protections afforded other workers. The HIA focused on two of the twelve AB 889 provisions: sleep requirements for 24-hour caregivers and workers' compensation for currently excluded domestic workers.

The HIA considered evidence on the health value of proposed labor protections, the size and demographics of the California domestic worker population, their current working conditions and socio-economic vulnerabilities, and potential barriers to accessing those protections.

SFDPH found that many domestic workers work in isolated work environments, lack job training, and suffer from high rates of assault, back pain, overexertion, and other preventable occupational injuries. The HIA analysis found sufficient sleep reduces worker risk of pre-mature death, chronic disease, depression and occupational error, and access to workers' compensation can help prevent long-term disability and reduce job turnover. The synthesized research was used to predict the impacts of AB 889 on workers, clients and general population. This presentation will describe methods used, key findings, lessons learned and future opportunities to conduct similar labor HIAs on vulnerable worker populations.