Racial and ethnic differentials in COVID-19-related job exposures by occupational standing in the US

Abstract

Researchers and journalists have argued that work-related factors may be partly responsible for disproportionate COVID-19 infection and death rates among vulnerable groups. We evaluate these claims by examining racial and ethnic differences in the likelihood of work-related exposure to COVID-19. We extend previous studies by considering 12 racial and ethnic groups and five types of potential occupational exposure to the virus: exposure to infection, physical proximity to others, face-to-face discussions, interactions with external customers and the public, and working indoors. Most importantly, we stratify our results by occupational status, defined as the proportion of workers within each occupation with some college education. This measure serves as a proxy for whether workplaces and workers employ significant COVID-19-related risk reduction strategies. We use the 2018 American Community Survey to identify recent workers by occupation, and link 409 occupations to information on work context from the Occupational Information Network to identify potential COVID-related risk factors. We then examine the racial/ethnic distribution of all frontline workers and frontline workers at highest potential risk of COVID-19, by occupational status and by sex. The results indicate that, contrary to expectation, White frontline workers are often overrepresented in high-risk jobs while Black and Latino frontline workers are generally underrepresented in these jobs. However, disaggregation of the results by occupational status shows that, in contrast to Whites and several Asian groups, Latino and Black frontline workers are overrepresented in lower status occupations overall and in lower status occupations associated with high risk, and are thus less likely to have adequate COVID-19 protections. Our findings suggest that greater work exposures likely contribute to a higher prevalence of COVID-19 among Latino and Black adults and underscore the need for measures to reduce potential exposure for workers in low status occupations and for the development of programs outside the workplace.

COVID-19 and Essential Workers: A Narrative Review of Health Outcomes and Moral Injury

“…While many businesses began to close and numerous workers lost their jobs, those who remained working began to face a new set of challenges that often differed by social and economic class [ 1 , 2 ]. For example, some middle- and upper-income workers, such as those working in the technology industry, were able to transition from working in an office to working from home, whereas workers in many so-called essential industries, who often receive lower wages, were not afforded the same work-from-home opportunity [ 2 ], placing them at greater risk for exposure to COVID-19 [ 3 , 4 , 5 , 6 ].…”

Repeated Antigen-Based Rapid Diagnostic Testing for Estimating the Coronavirus Disease 2019 Prevalence from the Perspective of the Workers’ Vulnerability before and during the Lockdown

“…In accordance with the present results, the food production/processing sector has been identified by European Centre for Disease Prevention and Control (ECDC) as a potential hotspot for COVID-19 clusters or outbreaks [ 10 ]. Several distinct job characteristics could expose individuals to a high risk of contracting COVID-19, such as exposure to the virus due to the proximity to others, face-to-face discussions, and interactions with external customers or the public [ 11 , 12 , 13 , 14 ]. While there are certainly employers in the food/catering industry who provide high-quality jobs, by and large, the sector consists of very low-wage jobs with few benefits, and many restaurant workers live in poverty or near-poverty [ 15 , 16 , 17 ].…”

“…The existing body of research supports a relationship between social class and health and found that substantive health disparities exist between different occupational statuses, as occupation is undoubtedly the bedrock for class differentiation in modern societies [ 18 ]. It has been recently documented that low-status workers are less likely to demand risk reduction equipment and infection control measures or have the bargaining power to obtain it [ 12 ]. Low-status workers are also less likely to be perceived as valuable and hard to replace by their employers, understand COVID-19 transmission routes, and comply with risk reduction strategies or implement their own [ 12 ].…”

“…It has been recently documented that low-status workers are less likely to demand risk reduction equipment and infection control measures or have the bargaining power to obtain it [ 12 ]. Low-status workers are also less likely to be perceived as valuable and hard to replace by their employers, understand COVID-19 transmission routes, and comply with risk reduction strategies or implement their own [ 12 ].…”

“…However, despite the high risks often faced by physicians, nurses, and other health personnel, workers in lower status jobs are generally more likely to be exposed to COVID-19 in the workplace than those in higher status occupations, as previously mentioned [ 19 ]. Higher-status workers have better access to risk mitigation measures, such as frequent sanitation, enforced distancing, personal protective equipment, and better ventilating and air filtration systems [ 12 , 13 , 14 ].…”