COVID-19 Risk by Workers' Occupation and Industry in the United States, 2020‒2021

Abstract

Objectives. To assess the risk of COVID-19 by occupation and industry in the United States. Methods. Using the 2020-2021 National Health Interview Survey, we estimated the risk of having had a diagnosis of COVID-19 by workers' industry and occupation, with and without adjustment for confounders. We also examined COVID-19 period prevalence by the number of workers in a household. Results. Relative to workers in other industries and occupations, those in the industry "health care and social assistance" (adjusted prevalence ratio = 1.23; 95% confidence interval = 1.11, 1.37), or in the occupations "health practitioners and technical," "health care support," or "protective services" had elevated risks of COVID-19. However, compared with nonworkers, workers in 12 of 21 industries and 11 of 23 occupations (e.g., manufacturing, food preparation, and sales) were at elevated risk. COVID-19 prevalence rose with each additional worker in a household. Conclusions. Workers in several industries and occupations with public-facing roles and adults in households with multiple workers had elevated risk of COVID-19. Public Health Implications. Stronger workplace protections, paid sick leave, and better health care access might mitigate working families' risks from this and future pandemics. (Am J Public Health. 2023;113(6):647-656. https://doi.org/10.2105/AJPH.2023.307249).

FIGURE 1—

Percentage of Workers With COVID-19 by Industry: National Health Interview Survey, United States, 2020‒2021 Note. CI = confidence interval. Sample size was n = 28 267. The solid vertical line indicates average COVID-19 infection rate among nonworkers. The dashed vertical line indicates COVID-19 infection rate among all workers. The full description for “waste management and remediation services” is “administrative and support and waste management and remediation services.”

FIGURE 2—

Percentage of Workers With COVID-19 by Occupation: National Health Interview Survey, United States, 2020‒2021 Note. CI = confidence interval. Sample size was n = 28 267. The solid vertical line indicates average COVID-19 infection rate among nonworkers. The dashed vertical line indicates COVID-19 infection rate among all workers.

FIGURE 3—

Risk of COVID-19 Diagnosis by Occupation (a) Unadjusted and (b) Adjusted: National Health Interview Survey, United States, 2020‒2021 Note. CI = confidence interval; PR = prevalence ratio. Adjusted for age (18‒24, 25‒34, 35‒44, 45‒54, 55‒64, and ≥ 65 years), gender (male, female), household size (1, 2, 3, 4, 5, and ≥ 6), and family income (< 100%, 100%–199%, 200%–299%, 300%–399%, 400%–499%, and ≥ 500% of federal poverty level according to US Census Bureau thresholds). Sample size for adjusted analyses was n = 28 172. The reference group for all prevalence ratios is adults working in all other occupations, indicated by the dashed vertical line.

FIGURE 3—

Continued

FIGURE 4—

Risk of COVID-19 Diagnosis Among Adults by Number of Working Household Adults (a) Unadjusted and (b) Adjusted: National Health Interview Survey, United States, 2020‒2021 Note. CI = confidence interval; PR = prevalence ratio. Sample size was n = 46 245. Adjusted for age (18‒24, 25‒34, 35‒44, 45‒54, 55‒64, and ≥ 65 years), gender (male, female), household size (1, 2, 3, 4, 5, and ≥ 6), and family income (< 100%, 100%–199%, 200%–299%, 300%–399%, 400%–499%, and ≥ 500% of federal poverty level according to US Census Bureau thresholds). Sample size for adjusted analyses was n = 46 142.