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Racial disparities in job strain among American and immigrant long-term care workers
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    Nursing homes are occupational settings, with an increasing minority and immigrant workforce where several psychosocial stressors intersect.


    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).


    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 (RNs) or Licensed Practical Nurses (LPNs, n=82) and lower-skilled staff such as Certified Nursing Assistants (CNAs, n=155).


    Almost all Black workers (96 percent) were immigrants. After adjusting for demographic and occupational characteristics, Black employees were more likely to report job strain, compared to Whites (Relative Risk [RR]: 2.9, 95% CI 1.3 to 6.6). Analyses stratified by occupation showed that Black CNAs were more likely to report job strain, compared to 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.


    Black immigrant workers were 2.9 times more likely to report job strain than Whites, with greater differences among CNAs. These differences may reflect organizational and job characteristics, individual characteristics, or potentially interpersonal or institutional racial or ethnic discrimination. Further research should consider the role of race/ethnicity in shaping patterns of occupational stress.

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  • Funding:
    R01 HL107240/HL/NHLBI NIH HHS/United States
    R01HL107240/HL/NHLBI NIH HHS/United States
    U01 AG027669/AG/NIA NIH HHS/United States
    U01 HD051217/HD/NICHD NIH HHS/United States
    U01 HD051218/HD/NICHD NIH HHS/United States
    U01 HD051256/HD/NICHD NIH HHS/United States
    U01 HD051276/HD/NICHD NIH HHS/United States
    U01 HD059773/HD/NICHD NIH HHS/United States
    U01AG027669/AG/NIA NIH HHS/United States
    U01HD051217/HD/NICHD NIH HHS/United States
    U01HD051218/HD/NICHD NIH HHS/United States
    U01HD051256/HD/NICHD NIH HHS/United States
    U01HD051276/HD/NICHD NIH HHS/United States
    U01HD059773/HD/NICHD NIH HHS/United States
    U01OH008788/OH/NIOSH CDC HHS/United States
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