Patient care aides: Differences in healthcare coverage, health-related behaviors, and health outcomes in a low-wage workforce by healthcare setting

Objectives Patient care aides, who provide basic care to patients in a variety of healthcare settings, have been observed to have higher prevalences of adverse health metrics than the general US workforce. However, few studies have examined how healthcare access and health behaviors and outcomes among patient care aides differ by work setting (home health, nursing home, and hospital). Methods Data from the 2013 to 2016 Behavioral Risk Factor Surveillance System were used to assess the prevalences of healthcare access, health-related behaviors, and health outcomes among patient care aides in different work settings, and among nurses (licensed vocational/practical and registered). Adjusted prevalence ratios were used to compare prevalences for healthcare workers to those for nonhealthcare clerical workers. Results Overall, patient care aides are a low-wage workforce with high prevalences of multiple adverse health metrics and low prevalences of positive health behaviors compared to clerical workers. Results differed by work setting. Home health aides had the lowest income levels and most adverse results for multiple metrics; nursing home aides had better healthcare access and somewhat better health outcomes. Most metrics were best (though still quite poor) for hospital aides, who showed few significant differences from clerical workers. Conclusions These results show the need to focus resources on the patient care aide workforce, particularly those in home health. While some needs of nursing home aides, such as improving influenza vaccination coverage and reducing the prevalence of arthritis-related conditions, would benefit from standardized workplace interventions, alternate, workplace-specific approaches are needed for home health aides.