Racial/Ethnic Disparities in Healthcare Worker Experiences During the COVID-19 Pandemic: An Analysis of the HERO Registry

Lusk, Jay B; Xu, Haolin; Thomas, Laine; Cohen, Lauren W.; Hernandez, Adrian F.; Forrest, Christopher B.; Michtalik, Henry J.; Turner, Kisha Batey; O’Brien, Emily C.; Barrett, Nadine

doi:10.1016/j.eclinm.2022.101314

Cited by 14 publications

(10 citation statements)

References 32 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The registry and this analysis (ClinicalTrials.gov Identifier NCT04342806) was funded by the Patient-Centered Outcomes Research Institute (PCORI) and was approved by the WIRB-Copernicus Group Institutional Review Board (WCG IRB). Characteristics of the registry and assessment tools have been described previously [15,16]. Written informed consent was obtained from all participants.…”

Section: Methodsmentioning

confidence: 99%

Association between characteristics of employing healthcare facilities and healthcare worker infection rates and psychosocial experiences during the COVID-19 pandemic

Lusk,

Manandhar,

Thomas

et al. 2024

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

Background Healthcare facility characteristics, such as ownership, size, and location, have been associated with patient outcomes. However, it is not known whether the outcomes of healthcare workers are associated with the characteristics of their employing healthcare facilities, particularly during the COVID-19 pandemic. Methods This was an analysis of a nationwide registry of healthcare workers (the Healthcare Worker Exposure Response and Outcomes (HERO) registry). Participants were surveyed on their personal, employment, and medical characteristics, as well as our primary study outcomes of COVID-19 infection, access to personal protective equipment, and burnout. Participants from healthcare sites with at least ten respondents were included, and these sites were linked to American Hospital Association data to extract information about sites, including number of beds, teaching status, urban/rural location, and for-profit status. Generalized estimating equations were used to estimate linear regression models for the unadjusted and adjusted associations between healthcare facility characteristics and outcomes. Results A total of 8,941 healthcare workers from 97 clinical sites were included in the study. After adjustment for participant demographics, healthcare role, and medical comorbidities, facility for-profit status was associated with greater odds of COVID-19 diagnosis (aOR 1.76, 95% CI 1.02–3.03, p = .042). Micropolitan location was associated with decreased odds of COVID-19 infection after adjustment (aOR = 0.42, 95% CI 0.24, 0.71, p = .002. For-profit facility status was associated with decreased odds of burnout after adjustment (aOR = 0.53, 95% CI 0.29–0.98), p = .044). Conclusions For-profit status of employing healthcare facilities was associated with greater odds of COVID-19 diagnosis but decreased odds of burnout after adjustment for demographics, healthcare role, and medical comorbidities. Future research to understand the relationship between facility ownership status and healthcare outcomes is needed to promote wellbeing in the healthcare workforce. Trial registration The registry was prospectively registered: ClinicalTrials.gov Identifier (trial registration number) NCT04342806, submitted April 8, 2020.

show abstract

Section: Methodsmentioning

confidence: 99%

Association between characteristics of employing healthcare facilities and healthcare worker infection rates and psychosocial experiences during the COVID-19 pandemic

Lusk,

Manandhar,

Thomas

et al. 2024

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…[2][3][4][5] In addition to demographic characteristics, inequities in COVID-19 outcomes have also been attributed to disparities in access to health care, testing, vaccination, and COVID-19 treatments; local societal norms and culture; and systemic bias. [6][7][8] COVID-19 testing was initially a challenge because the availability of tests were limited. 9 Once testing was made more widely available, the timeliness of testing subsequently became a critical factor; identification of a positive test allows for modification of behaviors (eg, isolation and quarantine), contact tracing, and receipt of treatment as part of effective public health strategies for reducing community-level spread of the infection and improving population-based outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…In addition to demographic characteristics, inequities in COVID-19 outcomes have also been attributed to disparities in access to health care, testing, vaccination, and COVID-19 treatments; local societal norms and culture; and systemic bias . COVID-19 testing was initially a challenge because the availability of tests were limited .…”

Section: Introductionmentioning

confidence: 99%

Race, Ethnicity, and Delayed Time to COVID-19 Testing Among US Health Care Workers

Baymon,

Vakkalanka,

Krishnadasan

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceAccess to COVID-19 testing is critical to reducing transmission and supporting early treatment decisions; when made accessible, the timeliness of testing may also be an important metric in mitigating community spread of the infection. While disparities in transmission and outcomes of COVID-19 have been well documented, the extent of timeliness of testing and the association with demographic factors is unclear.ObjectivesTo evaluate demographic factors associated with delayed COVID-19 testing among health care personnel (HCP) during the COVID-19 pandemic.Design, Setting, and ParticipantsThis cross-sectional study used data from the Preventing Emerging Infections Through Vaccine Effectiveness Testing study, a multicenter, test-negative, case-control vaccine effectiveness study that enrolled HCP who had COVID-19 symptoms and testing between December 2020 and April 2022. Data analysis was conducted from March 2022 to Junne 2023.ExposureDisplaying COVID-19–like symptoms and polymerase chain reaction testing occurring from the first day symptoms occurred up to 14 days after symptoms occurred.Main Outcomes and MeasuresVariables of interest included patient demographics (sex, age, and clinical comorbidities) and COVID-19 characteristics (vaccination status and COVID-19 wave). The primary outcome was time from symptom onset to COVID-19 testing, which was defined as early testing (≤2 days) or delayed testing (≥3 days). Associations of demographic characteristics with delayed testing were measured while adjusting for clinical comorbidities, COVID-19 characteristics, and test site using multivariable modeling to estimate relative risks and 95% CIs.ResultsA total of 5551 HCP (4859 female [82.9%]; 1954 aged 25-34 years [35.2%]; 4233 non-Hispanic White [76.3%], 370 non-Hispanic Black [6.7%], and 324 non-Hispanic Asian [5.8%]) were included in the final analysis. Overall, 2060 participants (37.1%) reported delayed testing and 3491 (62.9%) reported early testing. Compared with non-Hispanic White HCP, delayed testing was higher among non-Hispanic Black HCP (adjusted risk ratio, 1.18; 95%CI, 1.10-1.27) and for non-Hispanic HCP of other races (adjusted risk ratio, 1.17; 95% CI, 1.03-1.33). Sex and age were not associated with delayed testing. Compared with clinical HCP with graduate degrees, all other professional and educational groups had significantly delayed testing.Conclusions and RelevanceIn this cross-sectional study of HCP, compared with non-Hispanic White HCP and clinical HCP with graduate degrees, non-Hispanic Black HCP, non-Hispanic HCP of other races, and HCP all other professional and education backgrounds were more likely to have delayed COVID-19 testing. These findings suggest that time to testing may serve as a valuable metric in evaluating sociodemographic disparities in the response to COVID-19 and future health mitigation strategies.

show abstract

“…11 In the early phases of the pandemic, BIPOC workers were more likely to work in settings with higher exposure to COVID, 18 receive assignments that exposed them to COVID, 21 have inadequate access to personal protective equipment, 18,21 and have lower testing rates after exposure. 22 BIPOC RNs' higher exposure to and infection from COVID led to periods where they could not work due to their own quarantine and recovery as well as caregiving of affected family members, 20 all of which were likely to impact an RN's ability to return to their previous work hours and/or setting. 21 All types of BIPOC healthcare workers are more likely to be working in low-income jobs and may be financially unable to leave a job despite inadequate protections and high infection risks.…”

mentioning

confidence: 99%

COVID-19 Related Job Outcomes for Nurses of Color in the United States

et al. 2023

View full text Add to dashboard Cite

The purpose of this study was to examine factors associated with negative job outcomes for nurses during the initial phase of the COVID-19 pandemic, with a focus on nurses of color. The study used data from 3,782 nurses in the Current Population Survey to examine the relationship between nurse characteristics and COVID-19-related inability to work or look for work during May through December 2020. The analysis showed that race and gender did not significantly impact nurses’ job outcomes. The odds of a negative impact were increased by age (1.5% per year, p < .05), having a child in the home (43%, p < .01), having no spouse present (36%, p < .01), and working in an outpatient role (48%, p < .001). While race alone was not linked to negative outcomes, nurses of color had higher rates of other factors that were associated with negative outcomes, indicating a need for a more nuanced examination of their work and life contexts and job outcomes throughout the pandemic.

show abstract

Racial/Ethnic Disparities in Healthcare Worker Experiences During the COVID-19 Pandemic: An Analysis of the HERO Registry

Cited by 14 publications

References 32 publications

Association between characteristics of employing healthcare facilities and healthcare worker infection rates and psychosocial experiences during the COVID-19 pandemic

Association between characteristics of employing healthcare facilities and healthcare worker infection rates and psychosocial experiences during the COVID-19 pandemic

Race, Ethnicity, and Delayed Time to COVID-19 Testing Among US Health Care Workers

COVID-19 Related Job Outcomes for Nurses of Color in the United States

Contact Info

Product

Resources

About