Program > Saturday > 14:00 > Session 15. Sustainable RTW (3/3)

Paper: Understanding work disability among rural health-care workers – A literature review and environmental scan
Author(s) and Affiliation(s):
Renée-Louise Franche, Occupational Health & Safety Agency for Healthcare (OHSAH) in British Columbia; University of British Columbia, School of Population and Public Health; Simon Fraser University, Faculty of Health Sciences; Institute for Work & Health; University of Toronto, Department of Psychiatry & Dalla Lana School of Public Health
Eleanor Murray, Occupational Health & Safety Agency for Healthcare (OHSAH) in British Columbia
Aleck Ostry, University of Victoria, Department of Geography
Pamela Ratner, University of British Columbia, Department of Health Sciences & Epidemiology
Henry Harder, University of Northern British Columbia, Health Sciences Program
Shannon Wagner, University of Northern British Columbia, Health Sciences Program
Hasanat Alamgir, Occupational Health & Safety Agency for Healthcare (OHSAH) in British Columbia
Tony Gilligan, Occupational Health & Safety Agency for Healthcare (OHSAH) in British Columbia
Session : 15. Sustainable RTW (3/3)
Day/Time: Saturday at 14:00
Room: St. David Room, 3rd Floor
Objectives:

Approximately 20% of Canadian health-care workers work rurally (CIHI, 2007), yet disability management programs are developed in urban areas without attention to how they apply to rural workers. Work disability prevention research and rural health have remained studied in a compartmentalized fashion. We conducted a comprehensive literature review and an environmental scan to connect these fields and understand rural workers’ vulnerability to workplace injury and prolonged work absence, focusing on health-care workers.

Methods:

Three databases– Medline, CINAHL, and EMBASE – and relevant research centres and government agencies were searched to identify all relevant studies, in English, published between Jan 1, 2000 and Oct 6, 2009. Papers were included if they discussed occupational injury, work absence duration, disability management, or risk factors for disability prevention outcomes, among rural workers or if they compared rural and urban workers. Risk factors for workplace injury and prolonged work absence were identified based on expert knowledge in the field of work disability at large. This allowed inclusion of articles discussing known risk factors within the context of rural and urban differences, and not necessarily in relation to work disability outcomes. Between July and Nov 2009, we conducted an environmental scan with stakeholders and researchers identified through snowballing. Using semi-structured interviews, participants discussed workplace injury and/or work disability management among rural workers, depending on their area of expertise.

Results:

We identified 814 references – 9 discussing disability prevention outcomes, and 25 discussing risk factors. This limited and primarily non-Canadian evidence suggests high rates of injury among rural workers, which, together with work absence duration, may vary by occupation along a rural-urban continuum. We identified risk factors at the environmental-, worker-, job-, organizational-, worker compensation system, health-care access, and disability management process levels. Important methodological limitations were noted. Fifteen experts participated in the environmental scan, identifying health-care access issues, reduced availability of modified work, and distance management and policy-making structures as important challenges for disability prevention among rural workers.

Conclusions:

This review points to a glaring paucity of evidence, particularly from a Canadian context, on work disability prevention issues for workers in rural areas including in the health-care sector. Workplace violence, high workloads, lack of replacement staff, and challenges unique to rural contexts, such as distance and isolation were identified as key risk factors for poor disability outcomes in rural health-care workers. Further Canadian research, addressing methodological limitations of previous studies, is needed to document the disparities in work disability outcomes between rural and urban workers, as well as to understand the source and risk factors associated with these disparities.

References:

Canadian Institute for Health Information. Canada's Health Care Providers, 2007. Ottawa, Canadian Institute for Health Information.