The impact of atypical employment on individual wellbeing: evidence from a panel of British workers

This study explores the relationship between individual wellbeing and atypical employment, which includes both temporary and part-time employment schemes. Individual wellbeing is measured in terms of subjective indicators of mental health, general health status, life satisfaction, and job satisfaction. It addresses four questions: (1) Are workers on a temporary contract more likely to report poor health and poor life and job satisfaction than those who are employed in permanent jobs? (2) Is this the case for part-time workers compared to those who are in a full-time job? (3) Do changes in employment profiles (e.g., from a fixed-term contract to a permanent job, or from part-time employment to full-time employment) affect individuals' health and life satisfaction? (4) Are there differences in such relationships between men and women? To answer these questions, logistic regression models were used to analyse a panel of almost 7000 male and female workers from the first 10 waves of the British Household Panel Survey, 1991-2000. Controlling for background characteristics, atypical employment does not appear to be associated with adverse health consequences for either men or women, when both health and employment are measured at the same time. However, there is evidence that job satisfaction is reduced for seasonal/casual workers and is higher for part-timers. Taking account of selection issues does not change the general picture: the chances of poor mental and physical health and low life satisfaction are unaffected by atypical employment and some of the effects of job satisfaction persist. In addition, very few employment transitions appear to be consequential for a worsening in health outcomes, which tends to be observed in the case of job satisfaction. Although the pattern of results suggests that atypical forms of employment do not have durable adverse health consequences on workers, public policies that aim at improving the working conditions of workers in weak bargaining positions should give special attention to equity issues, including the possible health effects of experience of work in atypical employment arrangements.     

Is precarious employment damaging to self-rated health? Results of propensity score matching methods,using longitudinal data in South Korea

We aimed to evaluate the health effects of precarious employment based on a counterfactual framework, using the Korea Labor and Income Panel Survey data. At the 4th wave (2001), information was obtained on 1991 male and 1378 female waged workers. Precarious work was defined on the basis of workers employed on a temporary or daily basis, part-time, or in a contingent (fixed short-term) job. The outcome was self-rated health with five response categories. Confounding factors included age, marital status, education, industry and occupation of current employment, household income, residential area, and prior health status. Propensity scores for each individual to be a precarious worker were calculated from logistic models including those covariates, and based on them, precarious workers were matched to non-precarious workers. Then, we examined the effects of precarious employment on health and explored the potential intermediary variables, using ordered logistic Generalized Estimating Equations models. All analyses were performed separately by gender. Precarious workers were found to be in a lower socioeconomic position and to have worse health status. Univariate matched analyses showed that precarious employment was associated with worse health in both men and women. By further controlling for socio-demographic covariates, the odds ratios were attenuated but remained significant. Job satisfaction, especially as related to job insecurity, and monthly wage further attenuated the effects. This suggests that to improve health status of precarious workers in Korea, policy strategies need to tackle the channeling of the socially disadvantaged into precarious jobs. Also, regulations to eliminate discrimination against precarious workers in working conditions or material reward should be introduced and enforced. There is no doubt that job insecurity, which is pervasive among workers in Korea, should be minimized by suspending market-oriented labor policies which rely on quantitative flexibility.     

徐州市环卫工人生活条件与工作满意度调查

目的 调查徐州市环卫工人生活条件与满意度,为针对性地改善徐州市环卫工人生活条件提供参考。 方法 在徐州市五个区各随机抽取100名环卫工人,采用面对面问卷调查法收集资料,分析不同条件、环境下工人对工作满意度的差异。 结果 接受调查的环卫工人中,年龄分布范围30~71岁,主要以中老年职工为主,50岁以下仅占10.8%,工龄大多在5年及以下。对工作满意、比较满意、一般、不满意的比例分别为21.6%、30.4%、26.2%、21.8%;不同文化水平、不同薪酬、拥有不同家庭关系的工人对环卫工作的满意度差异无统计学意义(P>0.05);而是否给予培训、是否展开健康教育、不同工作环境、不同日工作时长、与同事之间的关系不同、自我社会地位评价不同的工人对工作满意度差异均有统计学意义(P<0.01)。拥有各项福利、社会保障的工人对环卫工作满意度较高(P<0.01)。 结论 徐州市环卫工人劳动强度大,工作环境差,社会保障不健全,多种因素可能影响工人对职业的满意度。相关部门应加强对环卫工人的劳动、生活和社会保障的关注,并采取针对性的应对措施,提高环卫工人的生活质量。     

Selection from fixed term to permanent employment: prospective study on health,job satisfaction,and behavioural risks

STUDY OBJECTIVE: To examine health, job satisfaction, and behavioural risks as antecedents of selection from fixed term to permanent employment. DESIGN: Prospective cohort study of change in employment contract during a two year period. Self reported health, recorded sickness absence, job satisfaction, behavioural risks, demographics, and occupational characteristics were assessed at baseline. SETTING: Hospital staff in two Finnish hospital districts. PARTICIPANTS: A cohort of 526 hospital employees (54 men, 472 women) aged 20 to 58 years with a fixed term job contract at baseline. Main results: During the follow up period, 137 became permanently employed. Men, employees in higher positions, full time workers, and those with five to eight years in the employ of the hospital were more likely to become permanently employed. After adjusting for these factors, obtaining a permanent job contract was predicted by self rated good health (odds ratio (OR) 3.90; 95% confidence intervals (CI) 1.34 to 11.36), non-caseness of psychological distress (OR 1.80; 95% CI 1.01 to 3.20), high job satisfaction (OR 1.86; CI 1.17 to 2.94), and non-sedentary life style (OR 2.64; CI 1.29 to 5.41), compared with the rest of the cohort. CONCLUSIONS: Investigation of fixed term employees yields new information about selective mechanisms in employment mobility. Good health seems to promote the chances for a fixed term employee to reach a better labour market status. These results correspond to earlier research on selective mechanisms in other forms of employment mobility and provide a partial explanation for the socioeconomic gradient of health.     

Attraction and retention of qualified health workers to rural areas in Nigeria: a case study of four LGAs in Ogun State, Nigeria

INTRTODUCTION: A shortage of health workers is a major problem for Nigeria, especially in rural areas where more than 70% of the population live. At the primary care level, trained community health officers provide services normally reserved for doctors or medical specialists. The community health officers must therefore be supported and motivated to provide effective quality healthcare services. This study aimed to determine factors that will attract and retain rural and urban health workers to rural Nigerian communities, and to examine differences between the two groups. METHODS: A cross-sectional survey measured health workers' work experience, satisfaction with, and reasons for undertaking their current work; as well as reasons for leaving a work location. Data were also gathered on factors that attract health workers to rural settings and also retain them. RESULTS; Rural health workers were generally more likely to work in rural settings (62.5%) than their urban counterparts (16.5%). Major rural motivators for both groups included: assurances of better working conditions; effective and efficient support systems; opportunities for career development; financial incentives; better living conditions and family support systems. The main de-motivator was poor job satisfaction resulting from inadequate infrastructure. Rural health workers were particularly dissatisfied with career advancement opportunities. More urban than rural health workers expressed a wish to leave their current job due to poor job satisfaction resulting from poor working and living conditions and the lack of career advancement opportunities. CONCLUSIONS: Motivational factors for attraction to and retention in rural employment were similar for both groups although there were subtle differences. Addressing rural health manpower shortages will require the development of a comprehensive, evidence-based rural health manpower improvement strategy that incorporates a coordinated intersectoral approach, involving partnership with a range of stakeholders in rural health development.     

某劳动密集型电子企业员工职业倦怠及其影响因素分析

目的 分析某劳动密集型电子企业员工的职业倦怠状况及其影响因素,为制定预防员工职业倦怠策略提供科学依据。 方法 采用整群抽样方法抽取298名员工,采用一般情况调查表和职业倦怠问卷进行职业倦怠调查,对相关资料进行logistic回归分析。 结果 64.1%的员工有职业倦怠。单因素方差分析结果显示,不同年龄、婚姻状况、工龄、周工作时间、月收入员工的职业倦怠综合得分不同(P<0.01或0.05)。多因素logistic回归分析结果显示,流水线作业人员出现职业倦怠状况的危险性是非流水线作业人员的1.90倍,周工作时间≥ 56 h者出现职业倦怠的危险性是周工作时间<40 h者的3.32倍,而工龄≥ 10年的员工出现职业倦怠的危险性仅是工龄<5年者的0.37倍(P均<0.05或0.01)。 结论 该企业员工职业倦怠水平较高,应重点关注工龄短、流水线作业、周工作时间长的员工,采取有效的措施,促进这些人员的身心健康,减少职业倦怠的发生。     

Job satisfaction of health care staff employed at health centres in Turkey

The objective of the study was to identify job satisfaction levels and their causes among health care workers employed at public health centres. A survey was therefore carried out of health care workers in 21 health centres in Konya, Turkey. The Minnesota Satisfaction Questionnaire was used to investigate job satisfaction. The satisfaction score and proportion of those satisfied were determined according to demographic features. The percentage of satisfied health care workers was 60% and the satisfaction score was 3.8 +/- 0.5. Midwives had the lowest satisfaction scores. Working environment and income were the most important factors for dissatisfaction. There was no correlation between global satisfaction and other demographic variables. These results showed that the health care workers at public health centres in the province have low satisfaction scores. Improving working conditions and income may improve the overall quality of health care provision.     

Does employer-provided health insurance constrain labor supply adjustments to health shocks? New evidence on women diagnosed with breast cancer

Employment-contingent health insurance may create incentives for ill workers to remain employed at a sufficient level (usually full-time) to maintain access to health insurance coverage. We study employed married women, comparing the labor supply responses to new breast cancer diagnoses of women dependent on their own employment for health insurance with the responses of women who are less dependent on their own employment for health insurance, because of actual or potential access to health insurance through their spouse's employer. We find evidence that women who depend on their own job for health insurance reduce their labor supply by less after a diagnosis of breast cancer. In the estimates that best control for unobservables associated with health insurance status, the hours reduction for women who continue to work is 8 to 11% smaller. Women's subjective responses to questions about working more to maintain health insurance are consistent with the conclusions from observed behavior.     

A systematic review of working hours and mental health burden]

There is growing concern over the possible increase in mental health problems among Japanese workers. This trend is generally regarded as a reflection of Japan's prolonged economic depression and changes in working environment. In fact, claims for compensation for industrial accidents related to mental health diseases have been rapidly increasing in recent years. Working hours, personal-relationships, support from supervisors/co-workers, job demand, job control, and payment are known to affect workers mental health. In 2004, the Government announced a guideline to combat overwork and mental health problems at work places. This guideline articulates that long overtime working is a major indicator, and workers who work over 100 h overtime in a month should be encouraged to see an occupational physician. This guideline takes into account the practicalities of occupational health at work places and the empiric knowledge that long working hours might associate with workers mental health status. It may be reasonable to assume that long working hours affect workers health status both psychologically and physiologically, interacting with a variety of occupational factors, particularly job stress. However, the association between working hours and workers mental health status has not been fully clarified. The present article aimed to provide a systematic review of the association between working hours and mental health problems. The authors conducted a systematic review of the published literature on the association between working hours and mental health problems using PubMed. Of 131 abstracts and citations reviewed, 17 studies met the predefined criteria. Ten of these are longitudinal studies, and the others are cross-sectional studies. Seven of the 17 studies report statistically significant associations between working hours and mental health problems, while the others report no association. In addition, comparison among these studies is difficult because a variety of measurements of working hours were used. The present review found inconsistent results in the association between working hours and mental health burden.     

Job characteristics and problems related to home care services for the elderly. A comparison among employment categories in Sapporo

OBJECTIVE: The aims of this study were to describe job characteristics for daytime and shift workers in home care services for the elderly and to clarify health care in the work setting, social support, and job satisfaction and possibilities. METHODS: A self-reported questionnaire was given to 433 home care workers, both full time and part time (more than 15 hours), at 35 institutions that provide home care services to residents of Sapporo (return rate; 80.2%). The following issues were investigated: job content (physical care, assistance with housework, and advice), specialty, job satisfaction, possibilities, job training, health care and social support. The results were compared among employed types: full-time and part-time daytime and shift workers using the t-test or the Fisher's test. RESULTS: The participants demonstrated high dissatisfaction with wages, physical uneasiness themselves and limited social support from their supervisors. Especially full-time workers were dissatisfied with the payment, whereas part-time workers complained about insufficient attention to the prevention of lumbago. It was found that part-time daytime workers were given insufficient on-job-training and education for prevention of infection, and that full-time shift workers greatly wished to leave the employment. However, the home care workers were satisfied with their job itself and expected to continue their work. Furthermore, half of the part-time workers hoped to work full time. CONCLUSIONS: Health management and educational training for part-time workers may be necessary to improve the quality of care services and protection of health. Promotion of full time employment and reconsideration of working condition might be necessary to provide sufficient home care services.     

Predictors and consequences of unemployment in construction and forest work during a 5-year follow-up

OBJECTIVES: The study investigated whether indicators of health, work conditions, or life-style predict subsequent unemployment and also the unemployment consequences related to health or life-style. METHODS: A questionnaire was administered to 781 male construction and 877 male forest workers (aged 20-49 years and working at the beginning of the study) in 1989 and 1994. Employment status during follow-up was ranked into the following 4 categories according to the employment status and unemployment time: continuously employed, re-employed, short-term (< or = 24 months) unemployed and long-term (> or =24 months) unemployed. RESULTS: The following base-line factors were associated with long-term unemployment during follow-up among the construction workers: age >40 years, poor subjective health, smoking, frequent heavy use of alcohol, low job satisfaction, marital status (single), and unemployment during the year preceding the initial survey. Among the forest workers, age >40 years, frequent stress symptoms, and preceding unemployment entered the model. In addition smoking predicted unemployment among the forest workers with no preceding unemployment. The proportion of regular smokers decreased among the long-term unemployed. Physical exercise was more frequent at the time of follow-up than it was initially, particularly among the unemployed. Stress symptoms increased among the construction workers, but musculoskeletal symptoms decreased significantly among the long-term unemployed. Among the forest workers stress symptoms decreased among the continuously employed and re-employed persons, but musculoskeletal symptoms decreased significantly for them all. CONCLUSIONS: Unemployment among construction workers is to some extent dependent on life-style, health, and job satisfaction in addition to age, marital status, and unemployment history. For forest workers, unemployment is less determined by individual factors. Changes in distress and musculoskeletal symptoms are dependent on employment, particularly among construction workers.     

How do types of employment relate to health indicators? Findings from the Second European Survey on Working Conditions

STUDY OBJECTIVE: To investigate the associations of various types of employment with six self reported health indicators, taking into account the part played by demographic variables, individual working conditions and four ecological indicators at the country level. DESIGN: Cross sectional survey (structured interview) of a sample of the active population of 15 European countries aged 15 years or over. Main independent variables were nine types of employment categorised as follows: small employers, full and part time permanent employees, full and part time fixed term employees, full and part time sole traders and full and part time temporary contracts. Main outcome measures were three self reported health related outcomes (job satisfaction, health related absenteeism, and stress) and three self reported health problems (overall fatigue, backache, and muscular pains). Logistic regression and multilevel models were used in the analyses. SETTING: 15 countries of the European Union. PARTICIPANTS: 15 146 employed persons aged 15 or over. MAIN RESULTS: Precarious employment was consistently and positively associated with job dissatisfaction but negatively associated with absenteeism and stress (as compared with full time permanent workers). Fatigue, backache and muscular pains also tended to be positively associated with precarious employment, particularly with full time precarious employment. Small employers reported high percentages of stress and fatigue, but absenteeism was relatively low. Sole traders generally reported high percentages of all outcomes, except for absenteeism, which was low. For each type of employment (except temporary contracts), full time workers tended to report worse health outcomes than part time workers. Patterns were generally consistent across countries. Associations persisted after adjustment for individual level working conditions and were not modified by country level variables. CONCLUSIONS: This study is the first to examine the relations between various types of employment and six health related indicators for all 15 member states of the European Union. Suggestive patterns worthy of further exploration have been found. Standardised definitions of types of underemployment and health related outcomes, more potent epidemiological designs and the inclusion of socioeconomic information (for example, social security systems, incapacity benefit schemes) at the regional level are proposed for inclusion in further research.     

The impact of 'statutory duties' on mental health social workers in the UK

In the UK, applications for involuntary admission to psychiatric units are made mainly by specially trained approved social workers (ASWs). Proposed changes in the legislation will permit other professionals to undertake these statutory duties. This study aimed to examine how ASW status impacts upon work pattern and workload stresses by comparing ASWs with other mental health social workers who did not carry statutory responsibilities. A multimethod design was adopted that included a cross-sectional national survey of mental health social workers (n=237, including 162 ASWs), and a telephone survey of mental health service managers (n=60). Data were collected using a semistructured questionnaire and diary, the content of which was derived from focus-group work and standard measures. Features of job content, working patterns and conditions were described and their association with stress, burnout and job satisfaction examined. ASWs were older and had been qualified longer than non-ASWs. The working patterns and conditions of the two groups did not differ, although ASWs did more hours on duty. ASWs received less support at work, particularly from supervisors and their role afforded less decision latitude than that of non-ASWs. ASW status was related to an elevated GHQ score, particularly among males. Emotional exhaustion was very high (over two-thirds in both groups) but ASWs and non-ASWs did not differ in this or any other feature of burnout, only 8% of the sample were actually 'burnt-out', being more common among ASWs. ASWs were more dissatisfied and were more likely than non-ASWs to want to leave their job. Given that ASW status increased stress and job dissatisfaction, especially for men, and was related to a desire to leave one's current job, it seems likely that extending statutory duties to other professionals will increase levels of stress, burnout and dissatisfaction in these groups also. In turn, this might have consequences for staff recruitment and retention.     

Employee and job attributes as predictors of absenteeism in a national sample of workers: the importance of health and dangerous working conditions

This study reports on research which looks for employee and job characteristics which correlate with absenteeism. A large cross-sectional national probability sample of workers employed for at least 20 hr per week is analyzed (n = 1308). The dependent variable is the number of self-reported absences during the past 14 days. Thirty-seven independent variables are considered. Ordinary Least Squares (multiple regressions), two-limit Tobits, and two-part models are used to assess the statistical and practical significance of possible covariates. Statistically significant predictors included health variables such as being overweight, complaining of insomnia, and hazardous working conditions; job characteristics such as inflexible house; and personal variables such as being a mother with small children. Variables reflecting dangerous working conditions appear to be the strongest correlates of absenteeism. Notable variables which do not predict absenteeism include age, race, wages, and job satisfaction. Future research should direct attention toward workers' health and working conditions as covariates of absenteeism, since they are strongly significant in this study and have been neglected by most absenteeism investigators.     

Relationship between job stress contents, psychosocial factors and mental health status among university hospital nurses in Korea]

OBJECTIVES: The present study was intended to assess the mental health of nurses working for university hospitals and to establish which factors determine their mental health. METHODS: Self-administered questionnaires were given to 1,486 nurses employed in six participating hospitals located in Daejeon City and Chungnam Province between July 1st and August 31st, 2006. The questionnaire items included sociodemographic, job-related, and psychosocial factors, with job stress factors (JCQ) as independent variables and indices of mental health status (PWI, SDS and MFS) as dependent variables. For statistical analysis, the Chi-square test was used for categorical variables, with hierarchical multiple regression used for determining the factors effecting mental health. The influence of psychosocial and job-related factors on mental health status was assessed by covariance structure analysis. The statistical significance was set at p<0.05. RESULTS: The factors influencing mental health status among subject nurses included sociodemographic characteristics such as age, number of hours of sleep, number of hours of leisure, and subjective health status; job-related characteristics such as status, job satisfaction, job suitability, stresses such as demands of the job, autonomy, and coworker support; and psychosocial factors such as self-esteem, locus of control and type A behavior patterns. Psychosocial factors had the greatest impact on mental health. Covariance structure analysis determined that psychosocial factors affected job stress levels and mental health status, and that the lower job stress levels were associated with better mental health. CONCLUSIONS: Based on the study results, improvement of mental health status among nurses requires the development and application of programs to manage job stress factors and/or psychosocial factors as well as sociodemographic and job-related characteristics.     

Precarious employment and health: analysis of the Comprehensive National Survey in Japan

Recent studies suggest that unstable employment contracts may affect the health of workers. Many Japanese workers working full time in ostensibly permanent positions actually operate within unstable and precarious employment conditions. We compared the health status of Japanese workers with precarious employment contracts with that of permanent workers using the 2007 Comprehensive Survey of Living Conditions of the People on Health and Welfare (n=205,994). We classified their employment status as 'permanent' vs. 'precarious' (part-time, dispatch, or contract/non-regular) and compared their health conditions. Among both sexes, precarious workers were more likely than permanent workers to have poor self-rated health or more subjective symptoms, with more workers in full-time employment suffering from serious psychological distress (SPD) and more female workers who smoke. Using logistic regression, we identified a positive association between precarious employment and SPD and current smoking among workers engaged in full-time employment after adjusting for age, marital status, and work-related conditions. This study demonstrates that precarious employment contracts are associated with poor self-rated health, psychological distress, and tobacco use, especially among people working full-time jobs. These results suggest that engagement in full-time work under unstable employment status impairs workers' health.     

Quality of life of coal dust workers without pneumoconiosis in mainland China

The purpose of this cross-sectional study was to evaluate the quality of life (QOL) of coal dust workers without pneumoconiosis in mainland China. Three hundred five coal dust workers and 200 non-dust workers without pneumoconiosis from five coal mines in Shanxi province were enrolled in this study. The Chinese World Health Organization Quality of Life-brief version (WHOQOL-BREF) questionnaire was used. Socio-demographic, working, and health factors were also collected. Multiple stepwise regression analysis was used to identify significant factors related to the four domain scores of WHOQOL-BREF. All functional domains of the Chinese WHOQOL-BREF were significantly worse in coal dust workers compared to non-dust workers except for psychological health. For the physical domain of QOL, educational level, working hours, and work danger were the significant factors. In the psychological domain, types of job, welfare satisfaction, work danger, hobbies, smoking, one-child family, and marital status were the predictive factors. Working hours, welfare satisfaction, educational level, and birthplace were the predictive factors for the social domain of QOL. Finally, the predictors for the environmental domain of QOL were types of job, working hours, welfare satisfaction, work danger, self-reported social status, smoking, and drinking. Coal dust workers without pneumoconiosis had worse QOL than non-dust workers but their subjective feelings were positive. There were four distinct models for the various domains of QOL. Corresponding health policies could be developed to improve their QOL.     

Work and family life of childrearing women workers in Japan: comparison of non-regular employees with short working hours, non-regular employees with long working hours, and regular employees

This study assessed the working and family life characteristics, and the degree of domestic and work strain of female workers with different employment statuses and weekly working hours who are rearing children. Participants were the mothers of preschoolers in a large Japanese city. We classified the women into three groups according to the hours they worked and their employment conditions. The three groups were: non-regular employees working less than 30 h a week (n=136); non-regular employees working 30 h or more per week (n=141); and regular employees working 30 h or more a week (n=184). We compared among the groups the subjective values of work, financial difficulties, childcare and housework burdens, psychological effects, and strains such as work and family strain, work-family conflict, and work dissatisfaction. Regular employees were more likely to report job pressures and inflexible work schedules and to experience more strain related to work and family than non-regular employees. Non-regular employees were more likely to be facing financial difficulties. In particular, non-regular employees working longer hours tended to encounter socioeconomic difficulties and often lacked support from family and friends. Female workers with children may have different social backgrounds and different stressors according to their working hours and work status.     

Work-health relationships in middle-aged and elderly residents of a Jerusalem community.

Work-health relationships were examined cross-sectionally in 1886 men and women aged greater than or equal to 50 years in Jerusalem in 1985-1987, in the third round of a multipurpose longitudinal community health study. The main occupational variables were employment status, reasons for not working, and satisfaction with work. Sex and age were controlled in all comparisons. Workers were clearly healthier than nonworkers with respect to general, physical and emotional health, and people who had given up work were less healthy than those still working, whether they had stopped for health reasons, only because of their age, or only for extrinsic reasons (retrenchment or dismissal). Workers who expressed satisfaction with their work were healthier than others, the odds ratio in favour of good general health being 2.4 at 50-64 and 2.5 at greater than or equal to 65 years of age. The associations between job satisfaction and health remained apparent when education and origin were controlled. Multivariate analyses suggested that the associations were not spurious ones attributable to proneness to report both dissatisfaction and ill-health. Job dissatisfaction was not significantly associated with angina pectoris, possible myocardial infarction, or hypertension. Taken at their face value, the findings support the impact of job satisfaction or its determinants on the health of middle-aged and elderly men and women. The associations will be re-appraised in the longitudinal analysis of the study data.     

Working in clients' homes: the impact on the mental health and well-being of visiting home care workers

The purpose of this paper is to examine the effects of working in clients' homes on the mental health and well-being of visiting home care workers. This paper reports the results of a survey of 674 visiting staff from three non-profit home care agencies in a medium-sized city in Ontario, Canada. Survey results are also complimented by data from 9 focus groups with 50 employees. For purposes of this study, home care workers include visiting therapists, nurses, and home support workers. Mental health and well-being is measured by three dependent variables: stress; job stress; and intrinsic job satisfaction. Multiple least squared regression analyses show several structural, emotional, physical, and organizational working conditions associated with the health and well-being of visiting home care workers. Overall, results show that workload, difficult clients, clients who take advantage of workers, sexual harassment, safety hazards, a repetitious job, and work-related injuries are associated with poorer health. Being fairly paid, having good benefits, emotional labour, organizational support, control over work, and peer support are associated with better health. Results suggest that policy change is needed to encourage healthier work environments for employees who work in clients' homes.