Duijs highlights the outcome of the study through five care professionals portrayed. She defended her thesis 17 March 2023.
Many studies about problems in elder care focus on work pressure, staff shortages and administrative burden. But this study reveals the hidden and concealed reasons that put pressure on the health of care workers. Under the guidance of photographer Janine Schrijver, care workers and caregivers photographed their own lives and work in 2018 and 2019. From these, the employees selected the photos most appealing to them. In addition, the researchers and employees joined together in conversation with colleagues, policymakers and care organizations. The themes that clearly emerged were poverty, racism and discrimination. In the second phase of the study, between 2019-2021, the researchers from Amsterdam UMC conducted 153 interviews with healthcare workers and analyzed them.
The researchers were looking for how social inequalities trickle down to the workplace, particularly in care for the elderly. Duijs: "Poverty, discrimination and racism are not talked about enough in the care sector. We examined the impact of this on the health of care workers and on the choice to become self-employed." This not only looked at inequality between men and women, but also between people with and without money worries and between white people and people of color. For example, the study found that all paid caregivers suffer from the lack of appreciation for their work. In addition, it showed that the shorter-educated women in particular really get into a mess financially, especially if they also have to take care of someone at home. This is due to low wages combined with small contracts. It was also found that white male employees were more likely to be paid more than their female counterparts or more likely to be in managerial positions. Dark-skinned men had to work harder to get these benefits.
Low-paying jobs in elder care also make it difficult for employed people to make ends meet. The resulting financial worries can lead to a variety of other difficulties such as psychosocial problems or illness. Fear of poverty and debt is also often the reason for care workers to choose precarious self-employment. For example, a mother of a child with fragile health chose to continue as a self-employed worker. When the corona pandemic broke out, she had to choose between continuing to work unprotected with all the risks for her child, or temporarily not working and going into debt.
It also appeared that the self-employed worked more hours or continued to work when sick so as not to lose income. They experienced stress or were tired and exhausted. Being self-employed was not as good for their health. Researcher Petra Verdonk: "We see that self-employment takes people out of the picture, at least from care organizations or municipalities that are in a position to help. This issue deserves much more attention, especially with the current inflation and expected recession, nor can it be solved by care workers and care organizations alone. In this regard, it is worrisome that we spoke to several self-employed people of color who no longer dare to apply for allowances due to the allowance affair, such as the Tozo (Temporary bridging arrangement for self-employed workers) during the covid-19 pandemic."
With the study, we want to bring the often unmentioned causes of absenteeism and attrition to the attention of healthcare organizations and policy makers, in order to contribute to the improvement of working conditions. This is very important, especially now that the shortage of healthcare personnel is only increasing," Saskia Duijs said.
Source: AmsterdamUMC, image: Janine Schrijver
