August 30, 2010 — As the United States’ workforce grows more diverse, an increasing number of Americans are balancing work and family responsibilities. In a paper appearing in a recent issue of the Journal of Occupational Health Psychology, Harvard School of Public Health professor Lisa Berkman and colleagues draw attention to the effects that workplace policies toward this issue can have on employees’ health. Through interviews with managers at four Massachusetts nursing homes, and surveys and medical data collected from their employees, the researchers found that employees whose managers were less supportive of their needs to balance home and work responsibilities slept less (29 minutes/day) than employees whose managers were more flexible. They also were more than twice as likely to have two or more risk factors for cardiovascular disease (CVD).
“This is one of the very first studies to show that a manager’s behavior and the kinds of practices and attitudes she or he has in terms of flexibility with work and family issues has an impact on the health of workers,” said Berkman, director of the Harvard Center for Population and Development Studies, and Thomas D. Cabot Professor of Public Policy and of Epidemiology. “In the next phase of this study we are exploring whether modifying workplace practices towards work family issues will improve not only the health of the workers and their families but also of the workplace itself by reducing turnover.”
The researchers invited all employees and their managers at four Massachusetts nursing homes to participate, with about 400 employees and managers completing the study. Employees were surveyed about their experiences with workplace policies and informal practices and had their risk of CVD assessed by blood cholesterol, high blood sugar or diabetes, blood pressure and hypertension, body-mass index, and tobacco consumption. Their sleeping patterns were monitored using a non-invasive wrist device. Through interviews, managers were rated on their flexibility and creativity in managing employee work-family issues.
The researchers found that managers who, for example, were open to adjusting employees’ schedules to suit their family or home needs, or discussing family leave with job security, were an important resource for employees. In contrast, managers who rated low on work-family openness and creativity appeared to have a negative effect on their employees’ health.
Direct patient care workers who had managers with less supportive practices toward work/family balance were more at risk for CVD than workers in other positions who had similar managers. Since this is a rapidly growing sector in health care, if these findings are replicated, special attention should be paid to training the managers of direct care workers in supportive work family policies, according to the researchers. Since many of these managers are promoted on the basis of their clinical care skills, the findings indicate a need for training in management practices.
Sleeping patterns did not differ for health care and non-health care workers. Employees in both job categories got less sleep if they worked for managers who scored low on work-family openness and creativity.
Nursing homes were chosen for the study as they are small businesses that employ lower wage and racially and ethnically diverse workforces. Study participants had a mean age of 41 years and were 85 percent women. They were predominantly low-wage employees, with a mean hourly wage of $15.73. The employees were from diverse backgrounds, with about 60 percent from Black, Hispanic, or another minority groups. About eight percent of the interviews were conducted in Haitian Creole. Just over half of employees had a child under 18 in the household. More than a quarter had two or more CVD risk factors.
“With the demographic transition and the aging of our society, there will be both more employees who are likely to be older and in need of job flexibility as well as more older people in long-term care,” the researchers wrote. “Flexibility on the job may well translate into increases in health and well-being for employees and their families. Although we did not study other industries here, we suspect that job flexibility, especially for low-wage workers, may have benefits across multiple industries.”
— Amy Roeder
photo: Ned Brown