Comparison of BRFSS Data Between Home-Based Care Providers and Health Care Support Workers in Clinical Environments in Washington State

Abstract

Background: The demand for home-based health care support providers (HB providers) is growing as the locus of care shifts to private homes. However, industry representative data of these workers are limited. Methods: Washington Behavioral Risk Factor Surveillance System (WA BRFSS) data from 2011 to 2016 were analyzed to compare HB providers ( n = 385) with health care support occupations not based in the home, non-HB providers ( n = 229), and all other occupations ( n = 32,011). Findings: More HB providers were overweight (4.2%, 95% confidence interval [CI] = [3.3%, 5.2%]) than non-HB providers and all other occupations. Significantly more HB providers had arthritis (33.2%, 95% CI = [27.0%, 39.4%]) and diabetes (9.4%, 95% CI = [5.7%, 13.2%]) than non-HB providers. Nearly twice as many HB providers currently smoked (31.3%, 95% CI = [24.2%, 38.4%]) than non-HB providers. Significantly more HB providers reported serious mental illness (6.8%, 95% CI = [2.8%, 10.7%]) than all other occupations (2.2%). Conclusion/Application to Practice: It is imperative to maintain good health in this home-based health care population as these workers are aging and their professional time becomes limited.

An Examination of Washington State Workers’ Compensation Claims for Home-Based Health Care Workers, 2006 to 2016: Part 1. Description of Claims and Claimants

“…5,7 A growing number of workers are in the fifties 1,5 and have been found to be older than non-home based health care workers. 6 Injury rates have been found to be higher in HBHC providers who are female, and older (50-65 years of age). 8 An early examination of workers' compensation claims (1995)(1996) of home health care workers found an injury incidence 1 Washington State Department of Labor and Industries, Tumwater, WA, USA 2 Washington State Department of Social and Health Services, Olympia, WA, USA rate that fell between nursing home workers and hospitalbased workers.…”

“…Home-based health care support workers in Washington State were more often found to be overweight, and suffer from arthritis and diabetes more frequently than non-home based support occupations. 6…”

“…3 Wipfli et al found that home health aides suffered work-related injuries at a rate 3 times higher than the national average for all occupations. 4 The workforce of homebased health care is predominantly female 1,[5][6][7] and immigrant. 5,7 A growing number of workers are in the fifties 1,5 and have been found to be older than non-home based health care workers.…”

“…Home-based health care support workers in Washington State were more often found to be overweight, and suffer from arthritis and diabetes more frequently than non-home based support occupations. 6 Workers' compensation claims data are a reliable data source for conducting injury and illness surveillance, though the generalizability of its findings may be limited to individual states due to state-specific workers' compensation regulations, such as coverage and reporting requirements, and administrative practices. 19 And despite the acknowledgment that workers' compensation systems underestimate the actual prevalence of occupational injuries, [20][21][22][23] its data are an important component to occupational research and prevention efforts.…”

“…As a group, until recently, workplace safety and health in HBHC has not received the same consideration as clinical health care (CHC). Studies comparing HBHC care to more traditional health care in hospitals and nursing homes have found some differences between demographics, injury types and rates, 6,[25][26][27] and such, the efficacy of care practices, workplace policies, and programs developed in the clinical setting is not clear in the home setting. 28 In order to understand this, identification of the similarities and differences in injuries and illnesses suffered by home-based health care and clinical health care providers is needed.…”