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Objective During the height of the COVID-19 pandemic, personal support workers (PSWs) were heralded as healthcare ‘heroes’ as many of them cared for high-risk, vulnerable older populations, and worked in long-term care, which experienced a high number of COVID-19 outbreaks and deaths. While essential to the healthcare workforce, there is little understanding of PSW working conditions during the pandemic. The aim of our study was to examine the working conditions (including job security, work policies, and personal experiences) for PSWs in the Greater Toronto Area during the COVID-19 pandemic from the perspectives of PSWs. Methods This study used a mixed-methods design. From June to December 2020, we conducted a survey of 634 PSWs to understand their working conditions during the COVID-19 pandemic. Semi-structured interviews with 31 survey respondents were conducted from February to May 2021 to understand in greater depth how working conditions were impacting the well-being of PSWs. Results We found PSWs faced a range of challenges related to COVID-19, including anxiety about contracting COVID-19, reduced work hours, taking leaves of absences, concerns about job security, and losing childcare. While the COVID-19 pandemic highlighted the PSW workforce and their importance to the healthcare system (especially in the long-term care system), pre-existing poor work conditions of insecure jobs with no paid sick days and benefits exacerbated COVID-19–related challenges. Despite these hardships, PSWs were able to rely on their mental resilience and passion for their profession to cope with challenges. Conclusion Significant changes need to be made to improve PSW working conditions. Better compensation, increased job security, decreased workload burden, and mental health supports are needed. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-022-00643-7.

vidence shows an ongoing close relationship between poverty and health. 1 Children living in poverty are at increased risk of mortality and poor health, including increased rates of unintentional injury, homicide, poor vision, and iron deficiency anemia. 2 One in 5 children in Canada lived in poverty before the COVID-19 pandemic and this number is projected to rise over at least the next 5 years. 1 Between February and August 2020, the unemployment rate rose from 5.6% to 10.2%, with the lowest income groups the most severely impacted. 3 In the early stages of the pandemic, the rate of food insecurity among families with children was 19.2%, almost double the rate in 2018. 4 Closing schools to inperson learning is expected to have widened pre-existing disparities in education and to have disproportionately impacted children and families who were already experiencing inequities in access to Internet and computers and who have abusive or unstable home environments. 5 Practitioners and policy makers must anticipate that the COVID-19 pandemic will likely have longterm implications for health and well-being. The disproportionate burden of the pandemic on children experiencing unmet social needs warrants a call to action to imagine new models of care integration. In this commentary, we will outline the problem of disparate health and social care systems, review 3 main models of health and social care integration, and propose 4 key components to better integrate health and social care for children in Canada.This article has been peer reviewed.

Background Persistent income inequality, the increase in precarious employment, the inadequacy of many welfare systems, and economic impact of the COVID-19 pandemic have increased interest in Basic Income (BI) interventions. Ensuring that social interventions, such as BI, are evaluated appropriately is key to ensuring their overall effectiveness. This systematic review therefore aims to report on available methods and domains of assessment, which have been used to evaluate BI interventions. These findings will assist in informing future program and research development and implementation. Methods Studies were identified through systematic searches of the indexed and grey literature (Databases included: Scopus, Embase, Medline, CINAHL, Web of Science, ProQuest databases, EBSCOhost Research Databases, and PsycINFO), hand-searching reference lists of included studies, and recommendations from experts. Citations were independently reviewed by two study team members. We included studies that reported on methods used to evaluate the impact of BI, incorporated primary data from an observational or experimental study, or were a protocol for a future BI study. We extracted information on the BI intervention, context and evaluation method. Results 86 eligible articles reported on 10 distinct BI interventions from the last six decades. Workforce participation was the most common outcome of interest among BI evaluations in the 1960–1980 era. During the 2000s, studies of BI expanded to include outcomes related to health, educational attainment, housing and other key facets of life impacted by individuals’ income. Many BI interventions were tested in randomized controlled trials with data collected through surveys at multiple time points. Conclusions Over the last two decades, the assessment of the impact of BI interventions has evolved to include a wide array of outcomes. This shift in evaluation outcomes reflects the current hypothesis that investing in BI can result in lower spending on health and social care. Methods of evaluation ranged but emphasized the use of randomization, surveys, and existing data sources (i.e., administrative data). Our findings can inform future BI intervention studies and interventions by providing an overview of how previous BI interventions have been evaluated and commenting on the effectiveness of these methods. Registration This systematic review was registered with PROSPERO (CRD 42016051218).

Jobs in health care have traditionally been secure. 1 Over the past 30 years, however, disparities in pay and work conditions have grown between registered professionals (e.g., physicians, nurses) and other staff in health care whose jobs are part-time, temporary, on contract and not unionized (e.g., housekeeping, clerical, security). One particularly disadvantaged group are personal support workers (PSWs), also called health care aides, patient care assistants, home support workers or home care attendants. 2,3 Personal support workers help older individuals and people with disabilities with their activities of daily living in their own home or in institutions. 4 Aging populations in Canada and a move to discharge people quickly from acute care to the community have driven up the demand for PSWs, who now represent about 10% of all health workers. [5][6][7][8] Despite their important role within health care systems in Canada, PSWs continue to face the risk of precarious employment, which is associated with adverse health and psychosocial conditions. 6 In Ontario, PSWs are not formally regulated