Contingent Workers in Long-Term Care
Jopson, Andrew Dutdut
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Background: The rise of contingent work arrangements in the U.S. has generated unease about the American workforce. A recent study estimated that healthcare now accounts for more than one in five contingent workers. Unfortunately, little is known about the extent contingent work arrangements may be occurring in fast-growing, low-wage supportive health occupations in long-term care such as, home health aides and home care aides. As the U.S. population ages and the healthcare sector becomes the largest employment, it is important to understand how these employment arrangements may jeopardize or support the health workforce. Objective: This descriptive study focuses on identifying occupations in long-term care with the highest proportion of contingent workers. We compare home health aides and home care aides in contingent and traditional work arrangements to determine predictors of being in a contingent work arrangement. Methods: We used data from the Current Population Survey (CPS) March 2016 Annual Social and Economic Supplement (ASEC). Two occupational categories (nursing, psychiatric, and home health aides and personal and home care aides) were restricted by work setting (home health care services) to identify home health aides and home care aides. We identified workers in contingent work arrangements as those who identified as self-employed. Other responses were coded as workers in traditional employment. Descriptive and regression analyses were conducted to compare workers in different employment arrangements within the same occupation. Population weights provided by the U.S. Census Bureau and Bureau of Labor Statistics were used to extrapolate the findings. Results: Of the estimated 564,528 home health aides, 11.18% were in contingent work arrangements. Similarly, 11.22% of the estimated 385,973 home care aides are in contingent work arrangements 11.22% were contingent workers. Home health aides were 15.4% (p < 0.05) less likely to be in a contingent work arrangement if they had a child in the household and 20.9% (p < 0.01) and 15.6% (p < 0.05) less likely to be in a contingent work arrangement if they were between the ages of 35 and 44 or between the ages of 55 and 64. In contrast, home care aides were 28.5% (p < 0.01) more likely to be in a contingent work arrangement if they were between the ages of 55 and 64. Conclusion: This study identified home health aides and home care aides as occupations in long-term care settings with the highest proportion of contingent workers. Our results contribute to a growing body of evidence describing contingent workers in specific industries and occupations and what characteristics influence entry into alternative work arrangements. Our focus on two of the fastest growing occupations in the U.S. labor force show that contingent work arrangements affect workers who are already vulnerable to low wages and limited benefits. Our findings warrant future research on these types of arrangements among long-term care occupations.
- Health services