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Comparative Study
. 2020 Sep;36(9):689-702.
doi: 10.1177/0748233720970439.

Clinicians, cooks, and cashiers: Examining health equity and the COVID-19 risks to essential workers

Jennifer D Roberts  1 , Katherine L Dickinson  2 , Elizabeth Koebele  3 , Lindsay Neuberger  4 , Natalie Banacos  2 , Danielle Blanch-Hartigan  5 , Courtney Welton-Mitchell  2 , Thomas A Birkland  6
Affiliations
Comparative Study

Clinicians, cooks, and cashiers: Examining health equity and the COVID-19 risks to essential workers

Jennifer D Roberts et al. Toxicol Ind Health. 2020 Sep.

Abstract

In Spring/Summer 2020, most individuals living in the United States experienced several months of social distancing and stay-at-home orders because of the coronavirus (COVID-19) pandemic. Clinicians, restaurant cooks, cashiers, transit operators, and other essential workers (EWs), however, continued to work outside the home during this time in order to keep others alive and maintain a functioning society. In the United States, EWs are often low-income persons of color who are more likely to face socioeconomic vulnerabilities, systemic racism, and health inequities. To assess the various impacts of COVID-19 on EWs, an online survey was distributed to a representative sample of individuals residing in six states during May/June 2020. The sample included 990 individuals who identified as EWs and 736 nonessential workers (NWs). We assessed differences between EW and NW respondents according to three categories related to health equity and social determinants of health: (1) demographics (e.g. race/ethnicity); (2) COVID-19 exposure risk pathways (e.g. ability to social distance); and (3) COVID-19 risk perceptions (e.g. perceived risk of contracting COVID-19). EWs were more likely to be Black or Hispanic than NWs and also had lower incomes and education levels on average. Unsurprisingly, EWs were substantially more likely to report working outside the home and less likely to report social distancing and wearing masks indoors as compared to NWs. EWs also perceived a slightly greater risk of contracting COVID-19. These findings, which we discuss in the context of persistent structural inequalities, systemic racism, and health inequities within the United States, highlight ways in which COVID-19 exacerbates existing socioeconomic vulnerabilities faced by EWs.

Keywords: COVID-19; essential workers; health equity; social determinants of health.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
COVID-19 determinants of health model.
Figure 2.
Figure 2.
Work and occupations by essential worker status.
Figure 3.
Figure 3.
COVID-19 exposure risks (work location) by essential worker status.
Figure 4.
Figure 4.
COVID-19 exposure risks (social distance) by essential worker status.
Figure 5.
Figure 5.
COVID-19 exposure risks (mask-wearing) by essential worker status.
Figure 6.
Figure 6.
COVID-19 exposure risks (public transit) by essential worker status.
Figure 7.
Figure 7.
COVID-19 exposure risks (family care) by essential worker status.
Figure 8.
Figure 8.
COVID-19 risk perceptions (getting COVID-19) by essential worker status.
Figure 9.
Figure 9.
COVID-19 risk perceptions (getting ill from COVID-19) by essential worker status.
Figure 10.
Figure 10.
COVID-19 risk perceptions (dying from COVID-19) by essential worker status.
See this image and copyright information in PMC

References

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