Recognizing careworkers’ contributions to improving the social determinants of health: A call for supporting healthy carework

Workers engaged in reproductive labor—the caring work that maintains society and supports its growth—contribute to societal health while also enduring the harms of precarious labor and substantial work stress. How can we conceptualize the effects of reproductive labor on workers and society simultaneously? In this commentary, we analyze four types of more relational and less relational careworkers—homeless shelter workers, school food workers, home care aides, and household cleaners—during the COVID-19 pandemic. We then make a case for a new model of societal health that recognizes the contributions of careworkers and healthy carework. Our model includes multi-sectoral social policies supporting both worker health and societal health and acknowledges several dimensions of work stress for careworkers that have received insufficient attention. Ultimately, we argue that the effects of reproductive labor on workers and society must be considered jointly, a recognition that offers an urgent vision for repairing and advancing societal health.

The educational needs of Canadian homeless shelter workers related to traumatic brain injury

BACKGROUND: Traumatic brain injury (TBI) has a higher prevalence in the homeless population. Caregivers to individuals who have TBIs may require better education surrounding screening, diagnosis and management of this disease to tailor interventions to their clients’ needs. OBJECTIVE: To assess the insight and educational needs of homeless care providers in recognizing and dealing with clients who had experienced a TBI. METHODS: A survey assessing the point of views of homeless care providers across Canada regarding their level of confidence in identifying and managing symptoms of TBI. RESULTS: Eight-eight completed surveys were included. Overall, frontline workers expressed a moderate level of confidence in identifying and managing TBI, stating that educational initiatives in this context would be of high value to themselves and their clients. CONCLUSIONS: Frontline workers to homeless clients rate their educational needs on the identification and management of TBI to be high such that educational initiatives for shelter workers across Canada may be beneficial to increase their knowledge in identifying and managing the TBI-related symptoms. Improved education would not only benefit frontline workers but may also have a positive effect on health outcomes for their clients.

Social Workers in Animal Shelters: A Strategy Toward Reducing Occupational Stress Among Animal Shelter Workers

Animal shelter workers (ASWs) are at disproportionate risk of moral injury, secondary trauma, compassion fatigue, and burn-out. While there is an emerging body of literature developing on understanding the nuances of these experiences for ASWs, little work has been done on developing strategies to ameliorate occupational stressors and the negative effects of such for ASWs. Within this paper, occupational risks and protective factors for ASWs are summarized, and the emergence of social work within animal shelter settings as one strategy for helping to ameliorate the occupational stress experienced by ASWs is delineated.

Occupational exposures and mitigation strategies among homeless shelter workers at risk of COVID-19

Objective To describe the work environment and COVID-19 mitigation measures for homeless shelter workers and assess occupational risk factors for COVID-19. Methods Between June 9-August 10, 2020, we conducted a self-administered survey among homeless shelter workers in Washington, Massachusetts, Utah, Maryland, and Georgia. We calculated frequencies for work environment, personal protective equipment use, and SARS-CoV-2 testing history. We used generalized linear models to produce unadjusted prevalence ratios (PR) to assess risk factors for SARS-CoV-2 infection. Results Of the 106 respondents, 43.4% reported frequent close contact with clients; 75% were worried about work-related SARS-CoV-2 infections; 15% reported testing positive. Close contact with clients was associated with testing positive for SARS-CoV-2 (PR 3.97, 95%CI 1.06, 14.93). Conclusions Homeless shelter workers may be at risk of being exposed to individuals with COVID-19 during the course of their work. Frequent close contact with clients was associated with SARS-CoV-2 infection. Protecting these critical essential workers by implementing mitigation measures and prioritizing for COVID-19 vaccination is imperative during the pandemic.

Exploring the use of Hotels as Alternative Housing by Domestic Violence Shelters During COVID-19

Domestic violence shelters present a unique context within the congregate living sector in the context of the COVID-19 pandemic. Shelters supporting women during the pandemic had to change service delivery models to include housing women in hotels to adhere to government restrictions and ensure women, and their children, were not homeless. The purpose of this study was to explore the impact of hotel use as alternative housing for women experiencing domestic violence during the COVID-19 pandemic in Ontario, Canada. We used interpretive description methodology, including in-depth interviews with 8 women using shelter services, 26 shelter workers and 5 focus groups with 24 executive directors of women’s shelters and other organizations who serve women who have experienced domestic violence. We identified and explored three main tensions in housing women at hotels compared to shelters: 1) autonomy/independence versus support, 2) a better option, the only option, and/or a safety concern, and 3) adequacy of hotels as housing. Drawbacks and benefits of the use of hotels as housing for women in the context of domestic violence are explored and recommendations are highlighted.

Children in domestic violence shelters: Does the feminist perspective collapse?

Summary Even though an extensive body of literature on children has swept the field of domestic violence in the last 30 years, little is known about how domestic violence shelter workers understand children’s situations and how they intervene with them. This article seeks to address this gap in the literature, and presents the results of a study conducted with 48 advocates in the province of Québec (Canada). Findings The data suggest that most of the participants adopt a child-centred perspective and consider the children in their own right during their stay. The accounts of the participants’ practices also reveal that they perceive children as being vulnerable and at-risk. With a moderate emphasis on vulnerability and risk, the participants tend to support the children alongside their mothers, while associating potential risks with the behaviour of the perpetrator of domestic violence. However, with a strong focus on vulnerability and risk, participants tend to cast aside the perpetrators’ behaviour and monitor the women-as-mothers during their stay while associating potential risk with their [in]actions under the circumstances. This can lead to mother-blaming, surveillance and more authoritarian interactions. Applications The understanding of children living with domestic violence needs to remain rooted in a feminist analysis of violence against women in order to avoid some of the issues highlighted in the article. Furthermore, studies that seek to shed light on best social work practices when working with children in alliance with their mothers from a feminist perspective are crucially needed.

SARS-CoV-2 antibody prevalence among homeless people, sex workers and shelter workers in Denmark: a nationwide cross-sectional study

Background People experiencing homelessness (PEH) and associated shelter workers may be at higher risk of infection with 'Severe acute respiratory syndrome coronavirus 2' (SARS-CoV-2). The aim of this study was to determine the prevalence of SARS-CoV-2 among PEH and shelter workers in Denmark. Design and methods In November 2020, we conducted a nationwide cross-sectional seroprevalence study among PEH and shelter workers at 21 recruitment sites in Denmark. The assessment included a point-of-care test for antibodies against SARS-CoV-2, followed by a questionnaire. The seroprevalence was compared to that of geographically matched blood donors considered as a proxy for the background population, tested using a total Ig ELISA assay. Results We included 827 participants in the study, of whom 819 provided their SARS-CoV-2 antibody results. Of those, 628 were PEH (median age 50.8 (IQR 40.9-59.1) years, 35.5% female) and 191 were shelter workers (median age 46.6 (IQR 36.1-55.0) years and 74.5% female). The overall seroprevalence was 6.7% and was similar among PEH and shelter workers (6.8% vs 6.3%, p=0.87); and 12% among all participants who engaged in sex work. The overall participant seroprevalence was significantly higher than that of the background population (2,9%, p <0.001). Participants engaging in sex work had a significantly increased risk of seropositivity compared to other participants (95% CI: 0.86-2.36, p=0.02). Seropositive and seronegative participants reported a similar presence of at least one SARS-CoV-2 associated symptom (49% and 54%, respectively). Interpretations The prevalence of SARS-CoV-2 antibodies was more than twice as high among PEH and associated shelter workers, compared to the background population. The subset of the study participants who were also sex workers were at particularly high risk of COVID-19 infection. Funding Tryg and HelseFonden.

Occupational exposures and mitigation strategies among homeless shelter workers at risk of COVID-19

ObjectiveTo describe the work environment and COVID-19 mitigation measures for homeless shelter workers and to assess occupational risk factors for COVID-19 infectionMethodsBetween June 9 and August 10, 2020, we conducted a self-administered, web-based survey among homeless shelter workers in Washington, Massachusetts, Utah, Maryland, and Georgia, in shelters where at least 1 staff person had tested positive for SARS-CoV-2. We calculated frequencies for demographics, work environment, personal protective equipment use, and SARS-CoV-2 testing history. We used generalized linear models with a binary outcome (COVID-19 positivity) and a log link, clustered by shelter network, to produce unadjusted prevalence ratios (PR) for demographics, work environment, and mitigation measures.ResultsOf the 106 respondents, 43.4% reported frequent close contact with clients and 85.8% reported wearing a mask most or all of the time; 75% reported being worried about being infected with SARS-CoV-2 at work; 15% reported testing positive for SARS-CoV-2. Of those who reported testing positive for SARS-CoV-2, 80% (12/15) believed they were infected at work. Frequent close contact with clients was significantly associated with testing positive for SARS-CoV-2 (PR 3.97, 95% CI 1.06, 14.93).ConclusionsHomeless shelter workers may be at higher risk of being infected with SARS-CoV-2 during the course of their work.