U.S. frontline workers and COVID-19 inequities

Abstract

We overcome a lack of frontline worker status information in most COVID-19 data repositories to document the extent to which occupation has contributed to COVID-19 disparities in the United States. Using national data from over a million U.S. respondents to a Facebook-Carnegie Mellon University survey administered from September 2020 to March 2021, we estimated the likelihoods of frontline workers, compared to non-frontline workers, 1) to ever test positive for SARs-Cov-2 and 2) to test positive for SARs-Cov-2 within the past two weeks. Net of other covariates including education level, county-level political environment, and rural residence, both healthcare and non-healthcare frontline workers had higher odds of having ever tested positive for SARs-Cov-2 across the study time period. Similarly, non-healthcare frontline workers were more likely to test positive in the previous 14 days. Conversely, healthcare frontline workers were less likely to have recently tested positive. Our findings suggest that occupational exposure has played an independent role in the uneven spread of the virus. In particular, non-healthcare frontline workers have experienced sustained higher risk of testing positive for SARs-Cov-2 compared to non-frontline workers. Alongside more worker protections, future COVID-19 and other highly infectious disease response strategies must be augmented by a more robust recognition of the role that structural factors, such as the highly stratified U.S. occupational landscape, have played in the uneven toll of the COVID-19 pandemic.