Essential, Yet Precarious, Mistreated, Sick and Medicalized: A Sequential Explanatory Mixed-Methods Study on Homecare...

Area of Science:

• Gerontology and Public Health
• Sociology of Work
• Migration Studies

Background:

• Homecare aides (HCAs) in Spain are understudied, facing precarious employment and vulnerable conditions.
• Existing research often overlooks the intersection of migrant status, gender, and precariousness in this workforce.
• Understanding these factors is crucial for improving the dignity and well-being of dependent individuals supported by HCAs.

Purpose of the Study:

• To characterize the employment, living conditions, health, and exposure to workplace violence and harassment among HCAs in Spain.
• To analyze inequalities in these factors, with a specific focus on migrant background as a key axis.
• To explore the lived experiences and underlying mechanisms contributing to HCA vulnerability.

Main Methods:

• Sequential explanatory mixed-methods study design.
• Quantitative data collected via an online respondent-driven sampling survey (n=324 HCAs).
• Qualitative data gathered through focus groups (n=3) and analyzed using qualitative content analysis, with findings triangulated.

Main Results:

• Precariousness extends beyond work, impacting daily life, social relationships, and health.
• Migrant HCAs reported poorer health, higher workplace violence exposure, and increased drug use.
• Qualitative data revealed physically demanding work, lack of resources, and broader gendered patterns of violence and sexual harassment.

Conclusions:

• A cycle of poverty, poor health, and workplace violence/discrimination affects HCAs, described as "poor and enslaved."
• Migration background exacerbates inequalities, but structural precariousness and gender dynamics create widespread vulnerability.
• Intersectional policies are urgently required to promote decent work and protect HCAs' health and rights.