Undervalued and Overstretched

Allied health-care workers — professionals who work in collaboration with doctors and nurses, such as lab technologists, counsellors, and paramedics — make up approximately one-third to one-half the health-care workforce in Alberta. They enable the delivery of health care throughout the system — in the community, in tertiary care centres, and in acute care centres. Allied health-care workers are currently navigating the uncertainties of the redesign of Alberta Health Services.

We conducted a study to examine pay inequities, experiences of workplace discrimination, job-related stress, and retention within the allied health-care workforce. We also asked the workers to reflect on the proposed AHS changes. We summarize our findings below.

Pay Inequities

We found pay inequities within the allied health-care workforce due to gender, disability status, and visible minority status. Once we account for age, education, and length of time in the profession, women make less than men, people with disabilities make less than those without disabilities, and visible minorities make less than non-visible minorities.

Everyday Discrimination

Allied health-care workers in Alberta report experiencing very high rates of discrimination at work, including being treated with less courtesy or respect than other people, being treated as though they are not as smart as other people, and being threatened or harassed. Over 80% of allied health-care workers report experiencing discrimination at work at least a few times a year, with 52% reporting monthly, 32% reporting weekly, and 15% reporting daily experiences of discrimination on the job. Professions that report the highest frequency of discrimination include paramedics, administrative support staff, lab assistants, pharmacy technicians, and medical radiation technicians. Remarkably, 13% of respondents say that discrimination is ‘just part of the job.’

Employment Discrimination

Employment discrimination (experiences of being unfairly not hired, not promoted, or fired) is reported by 40% of respondents. Individuals with higher levels of education report less employment discrimination, but older individuals and those who identify as having a disability report higher levels. Professions that report the highest levels of employment discrimination include addictions counsellors, administrative support workers, advanced care paramedics, and lab assistants.

Stress

Allied health-care workers report extremely high levels of job-related stress. Over 70% state that their job is very stressful, 75% state that their job is emotionally draining, and 45% state that they are overwhelmed by the demands of their job. Those who identify as having a disability report higher levels of job stress on all measures. The professions that score the highest when asked if their job is stressful and if their job is emotionally draining are acute care paramedics, family counsellors, primary care paramedics, mental health therapists, addictions counsellors, social workers, and pharmacy technicians.

Retention

Over 35% of allied health-care workers report that they often think about quitting their jobs. Those with higher levels of education are less likely to think about quitting. Those who identify as having a disability are both more likely to often think about quitting and more likely to be looking for a job outside the organization within the next year, controlling for other demographic variables. Pharmacy technicians, paramedics, administrative support workers, lab assistants, lab technologists, family counsellors, and addictions counsellors all report high levels of thinking about quitting, and a high likelihood of looking for a job outside the organization in the next year.

Proposed Changes to the Provincial Health-Care System

The opinions of allied health-care workers about the proposed changes to the provincial health-care system are overwhelmingly negative. Health-care workers are worried about the lack of involvement of  front-line workers in planning and implementing the changes, which they believe will lead to increased complexity and fragmentation of services.

Recommendations

Section 10 of this report provides a set of recommendations (overall and occupation-specific) that aim to improve pay equity, reduce discrimination, alleviate job-related stress, and ensure meaningful worker participation in health-care system reforms in Alberta. Included are the following recommendations:

1. 1. Conduct further studies to document pay inequities (carried out by unions, professional organizations, or academic partners), and make pay adjustments as necessary.
   2. Implement standardized and transparent pay scales throughout the health-care system.
   3. Implement robust anti-discrimination policies with clear reporting guidelines and clear consequences for violations.
   4. Introduce training on workplace rights and unconscious bias, particularly around ableism.
   5. Reduce workload burden by increasing staffing levels and improving resource allocation.
   6. Prioritize mental health support and wellness initiatives for all health-care workers.
   7. Establish a formal provincial advisory council composed of allied health-care workers to provide input to Alberta Health and Alberta Health Services on policy changes.
   8. Create internal task forces within each of the new agencies responsible for acute care, primary care, continuing care and assisted living, and mental health and addictions care to assess the impact of health-care system changes on employees and develop mitigation strategies.