What explains the socioeconomic status-health gradient? Evidence from workplace COVID-19 infections

Abstract

This paper studies the contribution of the workplace to the SES-health gradient. Our analysis is based on a unique dataset that tracks various health outcomes and workplace risks among healthcare workers during the first four months of the coronavirus 2019 (COVID-19) pandemic. The setting provides an exceptional opportunity to test for work-related disparities in health, while controlling for confounding determinants of the SES-health gradient. We find that low-SES nurses were systematically more likely to contract COVID-19 as a result of workplace exposure. These differentials existed in all healthcare institutions, but were particularly large in non-hospital settings. In contrast, we find no relationship between SES and nonwork-related infection rates. The differences in workplace infection rates are substantially larger than those implied by standard ‘task-based’ indices of transmission risk, and cannot be attributable to easily identifiable metrics of workplace risk. Together, our results show how subtle differences in work conditions or job duties can substantially contribute to the SES-health gradient.