Ethnic disparities in health & social care workers’ exposure, protection, and clinical management of the COVID-19 pandemic in the UK

Abstract

This paper examines determinants of ethnic disparities in workplace risks of COVID-19 among health and social care workers (HCWs) in the UK. This was undertaken to inform public health policy in the management of COVID-19 relating to health and social care provision. A cross-sectional survey was administered in July-August 2020 (n = 456) to elicit HCWs' experiences of COVID-19 management in the workplace and their perceptions of exposure, personal protection against infection, involvement in local clinical management, and other workplace hazards. Findings suggest minority ethnic HCWs were twice as likely as White HCWs to be in a patient-facing role (OR = 2.14, 95% CI:1.21; 3.78, P < 0.01) and twice as likely (63% vs 39%) to be caring for COVID-19 positive patients (OR = 2.68, 95% CI: 1.77; 4.06, P < 0.01). Those in nursing, were three times as likely to be redeployed to a COVID-19 care setting (OR = 3.33, 95%CI: 1.23; 9.02, P= 0.02). Minority ethnic HCWs within lower-and mid-level roles carried a higher burden of frontline clinical management of COVID-19 positive patients than their White counterparts. This study found evidence of ethnic disparities across several workplace hazards, with increased exposure to and less protection against infection, more responsibility for the clinical management of infection, and evidence of systemic racial bias in the disproportionate redeployment of minority ethnic nursing staff to COVID-19 areas. An NHS-wide review is required to assess procedural fairness, ensure safe practices now, and to avert future crises.

Pandemic preparedness with 20/20 vision: Applying an intersectional equity lens to health workforce planning

“…A recent study on workplace risks and protection from COVID‐19 in Health and Social Care in the UK reveals how minority ethnic workforce faced increased exposure to and less protection against infection and more responsibility for the clinical management of COVID‐19. The study also provided evidence of systemic racial bias in the disproportionate redeployment of minority ethnic nursing staff to COVID‐19 areas 25 . Certain occupational environments like long‐term care sector and nursing homes also predispose staff to higher risks of infection, with most of these workers being female and less protected 32 …”

“…The study also provided evidence of systemic racial bias in the disproportionate redeployment of minority ethnic nursing staff to COVID-19 areas. 25 Certain occupational environments like long-term care sector and nursing homes also predispose staff to higher risks of infection, with most of these workers being female and less protected. 32 Among different cadres, nurses, midwives and community health workers bear a disproportionate burden of patient and workplace violence including bullying.…”

Risk and protective factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers: A test-negative case–control study in Québec, Canada

“…13 Ethnic disparities in workplace COVID-19 exposures and less protection were reported from a UK survey conducted in summer 2020. 23 Although other characteristics identifying racial and linguistic minorities, like native language and being born abroad, were also independently associated with a 50% increase of infection risk, no association was found with the material deprivation index. This finding was also reported by a British study that simultaneously evaluated Black, Asian, and minority ethnicity and the Index of Multiple Deprivation score.…”

Occupational role and COVID-19 among foreign-born healthcare workers in Sweden: a registry-based study

“…8 Of all occupational groups, healthcare workers (HCWs) have been the worst hit by COVID-19, 9–12 and even in this sector, several reports suggest that foreign-born populations (compared to native-born individuals) and persons of non-White ethnic backgrounds (compared to individuals of white ethnic backgrounds) have been mostly affected. 10 , 13 , 14 While some suggest 10 , 15 , 16 that the overrepresentation of foreign-born HCWs in occupations (e.g. registered nurses, nursing assistants, home health aides) and clinical settings (e.g.…”