$300K Grant to Study Home Health Aides’ Working Conditions

ITHACA, New York—The School of Industrial and Labor Relations (ILR School) and Weill Cornell Medicine School of Cornell University have received a $300,000 grant from the Robert Wood Johnson Foundation to administer a worker-focused survey of home health aides. It will allow for a comparison of homecare work in different institutional contexts, including the prevalence of labor unions in the north and limited collective representation in the south.

“This specific study will allow us not only to understand how home care workers contribute to patient care, but we’ll be able to look at some variation across northern states and southern states and get a better sense of what levers of power they can use in advancing their own needs and the needs of their patients,” said Ariel Avgar, the senior associate dean for outreach and sponsored research.

Through the survey, the research team will collect, document and compare critical dimensions of homecare workers’ roles, working conditions and sources, or lack of occupational power and voice.

The second objective guiding the study is the collection of high-quality empirical data assessing several core homecare work dimensions. First, the survey will examine the range of tasks performed by homecare workers. Second, the team will record working conditions—wages, workplace voice, training and support—and make comparisons across employer settings and regions. Finally, the survey will seek to assess the role institutional actors, such as unions, worker centers and community organizations, play in affecting both home care aides’ working conditions and the roles those institutions play in delivering patient care.

“It’s pretty simple,” said Madeline Sterling, associate professor of medicine at Weill Cornell Medicine. “The more we can understand about this workforce, the better off our patients will be. We know that they provide essential care in the home and are often with patients much longer than any doctor is. We also know that the conditions in which they provide care—their wages and benefits, organizational policies at their agencies, their voice on the health care team—are incredibly variable. We believe this project will advance our understanding of these factors across the country and can help us move the needle on programs and policies to improve the workers’ experience, which in turn can benefit their patients.”

The final objective of the study is to engage with community and advocacy organizations. Survey findings regarding home health aide working conditions, the role they play in delivering care, and sources of power, will then be used to inform the strategies that could be deployed by advocacy organizations, including unions. The researchers will provide the survey findings in a manner that guides concrete action, advocacy, policymaking and worker representation.

“A big part of this study will be utilizing the survey results to help us to support both advocacy groups and policymakers in making sure that the policies we have in place for home care work are effective, and that they’re based on evidence,” Avgar said. “The proposed policies will be based not on what we imagine homecare workers do for their patients, but on what we actually know that they do for their patients.”