Abstract
Black and Latinx individuals, and in particular women, comprise an essential health care workforce often serving in support roles such as nursing assistants and dietary service staff. Compared to physicians and nurses, they are underpaid and potentially undervalued, yet play a critical role in health systems. This study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic from the perspective of Black and Latinx health care workers in support roles (referred to here as HCWs). From December 2020 to February 2021, we conducted 2 group interviews (n = 9, 1 group in English and 1 group in Spanish language) and 8 individual interviews (1 in Spanish and 7 in English) with HCWs. Participants were members of a high-risk workforce as well as of communities that suffered disproportionately during the pandemic. Overall, they described disruptive changes in responsibilities and roles at work. These disruptions were intensified by the constant fear of contracting COVID-19 themselves and infecting their family members. HCWs with direct patient care responsibilities reported reduced opportunities for personal connection with patients. Perspectives on vaccines reportedly changed over time, and were influenced by peers' vaccination and information from trusted sources. The pandemic has exposed the stress endured by an essential workforce that plays a critical role in healthcare. As such, healthcare systems need to dedicate resources to improve the work conditions for this marginalized workforce including offering resources that support resilience. Overall working conditions and, wages must be largely improved to ensure their wellbeing and retain them in their roles to manage the next public health emergency. The role of HCWs serving as ambassadors to provide accurate information on COVID-19 and vaccination among their coworkers and communities also warrants further study.
Highlights
As of June 2021, the United States continues to have the highest number of coronavirus disease 2019 (COVID-19) cases and deaths in the world
We identified three key themes that provide insight into the dual experiences of health care workers (HCW) as high-risk workers and members of marginalized communities during the COVID-19 pandemic: (1) Profound impact of the pandemic on job responsibilities, work settings, and personal connections, (2) Fear and uncertainties caused by the pandemic; and, (3) Shifts in testing frequency and vaccine attitudes as the pandemic evolved
HCWs described the substantial impacts of the pandemic on their personal lives
Summary
As of June 2021, the United States continues to have the highest number of coronavirus disease 2019 (COVID-19) cases and deaths in the world. While nurses and physicians are the most recognized frontline workers, there are a variety of other roles in healthcare including certified nurse assistants, therapists, emergency medical service personnel, dietary and food services staff, and administrative staff, among others, referred to here as health care workers (HCW) [5]. HCWs work alongside physicians and nurses but are less recognized and lower paid. This essential workforce comprises nearly 7 million people in low-paid jobs including healthcare support workers (e.g., dietary aids), direct care workers (e.g., certified nursing assistants), and healthcare service workers (e.g., hospital janitor staff) [6]. In the U.S, the vast majority of support HCWs are women (>80%) and they are disproportionately Black and Latinx [7, 8]
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