Vulnerabilities in workplace features for essential workers with breast cancer: Implications for the COVID-19 pandemic.

Abstract

The coronavirus pandemic has highlighted the health and financial vulnerabilities of essential workers, especially among women. The purpose of this study is to understand the workplace environment of essential workers. We used data from a prospective cohort study of disparities in employment outcomes among women undergoing breast cancer treatment between 2010-2018 in New York City. We characterized participants as essential or non-essential based on self-reported occupation/industry and New York State executive orders issued during the pandemic. We compared job benefits and perceptions of workplace environment between groups. There were 563 participants: 341 essential and 222 non-essential workers. Essential workers less frequently reported access to disability pay through work [n(%): 148 (58) versus 130 (73), p < 0.01]. Essential workers in unions had greater availability of sick leave and disability pay than non-unionized essential workers (86% versus 53%, p < 0.01, and 76% versus 46%, p < 0.01, respectively). Health insurance differed by essential worker status (p < 0.01): essential workers more frequently had public insurance (29% versus 18%). Surprisingly, in multivariable analyses controlling for age, race/ethnicity, income, education, chemotherapy receipt, and comfort with English, essential workers were less likely to say their employer had treated them unfairly (p < 0.01). However, minorities were less likely to say their employer was accommodating (p = 0.03) and more likely to say their employer had treated them unfairly (p < 0.01) than Non-Latina Whites. We identified vulnerabilities in workplace protections, particularly among essential workers not in unions. Minority women more often had negative perceptions of their work environment, possibly reflecting employer bias.