Visiting and Office Home Care Workers’ Occupational Health:
An Analysis of Workplace Flexibility and Worker Insecurity
Measures Associated with Emotional and Physical Health
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The home health care sector in Canada experienced major restructuring in the
mid-1990s creating a variety of flexibilities for organizations and insecurities for
workers. This paper examines the emotional and physical health consequences of
employer flexibilities and worker insecurities on home health care workers. For
emotional health the focus is on stress and for physical health the focus is on selfreported
musculoskeletal disorders. Data come from our survey of home health care
workers in a mid-sized city in Ontario, Canada. Data are analyzed separately for 990
visiting and 300 office workers.
For visiting workers, results showed that none of the ‘objective’
flexibility/insecurity measures are associated with stress or musculoskeletal disorders
controlling for other factors. However, ‘subjective’ flexibility/insecurity factors, i.e.
feelings of job insecurity and labour market insecurity, are significantly and positively
associated with stress. When stress is included in the analysis, for visiting workers stress
mediates the effects of ‘subjective’ flexibility/insecurity with musculoskeletal disorders.
For office workers, none of the objective flexibility/insecurity factors are associated with
stress but subjective flexibility/insecurity factor of feelings of job insecurity is positively
and significantly associated with stress. For office home care workers, work on call is
negatively and significantly associated with musculoskeletal disorders. Feeling job
insecurity is mediated through stress in affecting musculoskeletal disorders. Feeling
labour market insecurity is significantly and positively associated with musculoskeletal
disorders for office home care workers. Decision-makers in home care field are
recommended to pay attention to insecurities felt by workers to reduce occupational
health problems of stress and musculoskeletal disorders.