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Racial disparities in job strain among American and immigrant long-term care workers.

Hurtado-DA; Sabbath-EL; Ertel-KA; Buxton-OM; Berkman-LF
Int Nurs Rev 2012 Jun; 59(2):237-244
BACKGROUND: Nursing homes are occupational settings, with an increasing minority and immigrant workforce where several psychosocial stressors intersect. AIM: This study aimed to examine racial/ethnic differences in job strain between Black (n = 127) and White (n = 110) immigrant and American direct-care workers at nursing homes (total n = 237). METHODS: Cross-sectional study with data collected at four nursing homes in Massachusetts during 2006-2007. We contrasted Black and White workers within higher-skilled occupations such as registered nurses or licensed practical nurses (n = 82) and lower-skilled staff such as certified nursing assistants (CNAs, n = 155). RESULTS: Almost all Black workers (96%) were immigrants. After adjusting for demographic and occupational characteristics, Black employees were more likely to report job strain, compared with Whites [relative risk (RR): 2.9, 95% confidence interval (CI) 1.3 to 6.6]. Analyses stratified by occupation showed that Black CNAs were more likely to report job strain, compared with White CNAs (RR: 3.1, 95% CI: 1.0 to 9.4). Black workers were also more likely to report low control (RR: 2.1, 95% CI: 1.1 to 4.0). Additionally, Black workers earned $2.58 less per hour and worked 7.1 more hours per week on average, controlling for potential confounders. CONCLUSION: Black immigrant workers were 2.9 times more likely to report job strain than White workers, with greater differences among CNAs. These findings may reflect differential organizational or individual characteristics but also interpersonal or institutional racial/ethnic discrimination. Further research should consider the role of race/ethnicity in shaping patterns of occupational stress.
Nursing; Nurses; Sociological-factors; Psychological-factors; Stress; Medical-personnel; Job-stress; Health-care-personnel; Author Keywords: Emigrants and Immigrants; Long-term Care; Nursing Homes; Nursing Staff; Race Relations; United States of America; Work Stress
David A. Hurtado, Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Ave, 7th Floor, Kresge Building, Boston, MA 02115
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Cooperative Agreement
Fiscal Year
NTIS Accession No.
NTIS Price
Identifying No.
Cooperative-Agreement-Number-U01-OH-008788; B10242012
Issue of Publication
Source Name
International Nursing Review
Performing Organization
Portland State University