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Health policy researcher Jessica A. Williams discussed how to prioritize health and wellbeing among low-wage health care workers in a Harvard Center for Population and Development Studies talk Wednesday afternoon.

The event was part of the School of Public Health’s Population Research Exchange program, a lecture series in which faculty members share their work on population science research in weekly seminars, workshops, and information sessions.

Williams, an associate professor of health policy and administration at Pennsylvania State University, focused her seminar on the effects of leadership commitment to the workers’ health and safety.

“The most interesting question to me, obviously, is whether or not people actually felt like this was reflected in the actions of the company,” she said of companies’ health and safety policies.

To answer this question, Williams examined the correlation between worker turnover at nursing homes and the degree to which facility leadership formally committed themselves to worker health and safety. Williams assigned each nursing home a “leadership score” based on this level of commitment.

“What we saw was that for nurses — so folks with an RN degree — nursing homes with low leadership had higher turnover than nursing homes with better leadership,” Williams said.

Even after controlling for several factors that could have influenced these findings — like bed count, the percent of residents on Medicaid, rural counties, county-level turnover, and staffing hours per patient — Williams found the same result.

“For places with above median leadership, they had lower turnover rates than places that had below median leadership, even after controlling for all of these other factors,” she said.

Williams said the study’s findings had wide confidence intervals, adding that “we might see something a little bit different” with a larger sample.

Later in the seminar, Williams explored the relationship between leadership commitment to worker health and safety and Covid-19 prevalence.

“We really saw that better leadership for workplace health and safety led to fewer resident cases, and a pretty big difference,” she said. According to Williams, leadership performing in the top 75th percentile led to only 19 cases, while worse leadership — in the bottom 25th percentile — led to around 44 cases.

To assess workplace health and safety in the scope of Covid-19 cases and pandemics generally, Williams also examined employee participation and collaboration, looking at “whether different groups in the organization collaborate on workplace health and safety across their different departments.”

Williams then transitioned into policy, highlighting reforms by the Biden administration to “improve quality and safety of these nursing facilities, protect residents and those who care for them.”

Addressing the scarcity of health care workers, Williams said “it’s a low-wage industry, but it has a lot of high turnover and difficulty attracting people because it’s low-wage.”

While other industries respond by raising wages, Williams said “nursing homes don’t seem to do that as well as other places,” due in part to their financial structure as well as “historically entrenched thoughts” about appropriate wages.

In looking toward the future, Williams asked attendees how conditions might be improved.

“We know the working environment in a lot of nursing homes is not good. It’s much worse since Covid-19,” Williams said. “And so what are people who run the nursing homes actually willing to do?”