skip to main content


Title: Clinicians, cooks, and cashiers: Examining health equity and the COVID-19 risks to essential workers
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.  more » « less
Award ID(s):
2030316
NSF-PAR ID:
10231828
Author(s) / Creator(s):
; ; ; ; ; ; ;
Date Published:
Journal Name:
Toxicology and Industrial Health
Volume:
36
Issue:
9
ISSN:
0748-2337
Page Range / eLocation ID:
689 to 702
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. Nabi, Mohammad Hayatun (Ed.)
    Background

    Although research shows that the Covid-19 pandemic has led to declines in mental health, the existing research has not identified the pathways through which this decline happens.

    Aims

    The current study identifies the distinct pathways through which COVID-induced stressors (i.e., social distancing, disease risk, and financial stressors) trigger mental distress and examines the causal impact of these stressors on mental distress.

    Methods

    We combined evidence of objective pandemic-related stressors collected at the county level (e.g., lack of social contact, infection rates, and unemployment rates) with self-reported survey data from over 11.5 million adult respondents in the United States collected daily for eight months. We used mediation analysis to examine the extent to which the objective stressors influenced mental health by influencing individual respondents’ behavior and fears.

    Results

    County-level, day-to-day social distancing predicted significantly greater mental distress, both directly and indirectly through its effects on individual social contacts, worries about getting ill, and concerns about finances. Economic hardships were indirectly linked to increased mental distress by elevating people’s concerns about their household’s finances. Disease threats were both directly linked to mental distress and indirectly through its effects on individual worries about getting ill. Although one might expect that social distancing from people outside the home would have a greater influence on people who live alone, sub-analyses based on household composition do not support this expectation.

    Conclusion

    This research provides evidence consistent with the thesis that the COVID-19 pandemic harmed the mental well-being of adults in the United States and identifies specific stressors associated with the pandemic that are responsible for increasing mental distress.

     
    more » « less
  2. Green spaces are beneficial for physical and mental health, especially during and after disasters. The COVID-19 pandemic, however, created a trade-off: parks could be therapeutic but also could expose people to infection. This paradox posed inequities as marginalized populations often have less access to parks and were hit harder by the pandemic. We combined cellphone-generated mobility data with demographic indicators, a neighborhood survey, and local infection rates to examine how residents of Boston, MA, navigated this trade-off in April–August 2020. We hypothesized that they adopted strategies for mitigating infection exposure—including fewer park visits and prioritizing parks that might have lower infection risk, including larger parks with more opportunity for social distancing and parks near home with fewer unfamiliar faces—but that marginalized populations would have less opportunity to do so. We also introduce a novel measure of exposure per visit based on the volume of other visitors, infection rates, and park size. Bostonians made fewer park visits relative to 2019 and prioritized larger parks and parks closer to home. These strategies varied by community. Experiences of the pandemic were influential, as communities that perceived greater risk or had more infections made more park visits, likely because they were a relatively safe activity. Communities with more infections tended to avoid nearby parks. Inequities were also apparent. Communities with more Black residents and infections had greater infection exposure per visit even when controlling for the types of parks visited, highlighting difficulties in escaping the challenges of the pandemic.

     
    more » « less
  3. null (Ed.)
    Abstract The objective of this study is to examine the transmission risk of COVID-19 based on cross-county population co-location data from Facebook. The rapid spread of COVID-19 in the United States has imposed a major threat to public health, the real economy, and human well-being. With the absence of effective vaccines, the preventive actions of social distancing, travel reduction and stay-at-home orders are recognized as essential non-pharmacologic approaches to control the infection and spatial spread of COVID-19. Prior studies demonstrated that human movement and mobility drove the spatiotemporal distribution of COVID-19 in China. Little is known, however, about the patterns and effects of co-location reduction on cross-county transmission risk of COVID-19. This study utilizes Facebook co-location data for all counties in the United States from March to early May 2020 for conducting spatial network analysis where nodes represent counties and edge weights are associated with the co-location probability of populations of the counties. The analysis examines the synchronicity and time lag between travel reduction and pandemic growth trajectory to evaluate the efficacy of social distancing in ceasing the population co-location probabilities, and subsequently the growth in weekly new cases across counties. The results show that the mitigation effects of co-location reduction appear in the growth of weekly new confirmed cases with one week of delay. The analysis categorizes counties based on the number of confirmed COVID-19 cases and examines co-location patterns within and across groups. Significant segregation is found among different county groups. The results suggest that within-group co-location probabilities (e.g., co-location probabilities among counties with high numbers of cases) remain stable, and social distancing policies primarily resulted in reduced cross-group co-location probabilities (due to travel reduction from counties with large number of cases to counties with low numbers of cases). These findings could have important practical implications for local governments to inform their intervention measures for monitoring and reducing the spread of COVID-19, as well as for adoption in future pandemics. Public policy, economic forecasting, and epidemic modeling need to account for population co-location patterns in evaluating transmission risk of COVID-19 across counties. 
    more » « less
  4. COVID-19 variants continue to create public health danger impacting mortality and morbidity across the United States. The spillover effects of COVID-19 on the economy and social institutions pose a significant threat to broader wellbeing, including the food security of millions across the country. We aim to explore whether the context of place matters above and beyond individual and social vulnerabilities for food insecurity. To do so, we employ a multi-level framework using data from a survey of over 10,000 U.S. adults from March 2020 with American Community Survey (ACS) and John Hopkins COVID Dashboard county-level data. We find nearly two in five respondents were food insecure by March of 2020 with disparities across race, nativity, the presence of children in the home, unemployment, and age. Furthermore, we note that individuals living in more disadvantaged communities were more likely to report food insecurity above and beyond individual and social vulnerabilities. Overall, food insecurity is driven by complex, multi-level dynamics that remain a pressing public health concern for the current—but also future—public health crisis. 
    more » « less
  5. null (Ed.)
    CONTEXT With the onset of the COVID-19 pandemic, and the resulting response from universities, engineering students find themselves in an unprecedented situation. In addition to stressors related to the curriculum, residential students across the United States are being asked to relocate away from campus and engage in distance learning. At the same time, social distancing requirements are limiting students’ ability to socialize, procure food and supplies, exercise, and remain employed and financially solvent. Some students will fall ill while others face the prospect of sick family members, and even deaths in the family. Prior research suggests that individuals living through this pandemic are likely to face stress, uncertainty, and fear that affects their mental health and academic performance for years to come. PURPOSE OR GOAL The purpose of this study was to understand the ways in which the COVID-19 pandemic is affecting engineering students’ mental wellness, specifically stress, and how the effects differ for different groups of students. The research questions addressed are: 1) What effects has the pandemic had on baseline stress levels, and how do those vary by demographic group? 2) What effects has the pandemic had on quality of life, such as sleep habits and financial security, and how do those vary by demographic group? METHODS An online survey was conducted in the United States in May and June of 2020. More than 800 4-year engineering students who represented many engineering disciplines and universities responded. The survey used a modified version of the Holmes-Rahe Social Readjustment Rating Scale, which is a widely used and validated instrument to measure the effects of certain life events on stress. The data was analysed to determine the average increase in stress levels for students resulting from COVID-19, and which demographic groups have seen the most negative impact. We also report on which stress-inducing life-events were experienced most. OUTCOMES Latinx individuals and international students report statistically significantly higher levels of stress than the baseline population. Engineering students from other historically excluded identities, however,are not facing statistically significantly worse stress than their peers from historically over represented identities. Veterans fare better than the majority population on this metric.The data also indicates that different groups are more likely to experience different negative life-events because of COVID. CONCLUSIONS No previous research has examined the impacts of a global pandemic on engineering student stress and mental wellness. Our findings show that stress and mental wellness need to be understood intersectionally and that some underrepresented groups are disproportionately impacted by COVID-19. Understanding the impacts on students can help universities strategize and allocate limited resources most effectively to support student success. KEYWORDS Mental wellness; COVID-19; stress 
    more » « less