Racial disparities among essential workers could be a key reason that Black Americans are more likely than whites to contract and die of the coronavirus, according to a new University of Utah analysis. It found that Blacks disproportionately work in nine vital occupations that increase their exposure to SARs-CoV-2, the virus that causes COVID-19.
A greater percentage of Blacks work in jobs that present a greater risk of coming into contact with the virus on a daily basis, according to the findings in a special issue of World Medical & Health Policy.
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After analyzing demographic job data, the results showed that Blacks were nearly three times more likely than whites to work in healthcare support roles such as nursing assistants or orderlies. They were twice as likely to work in transportation jobs such as bus drivers, movers and taxi drivers.
Black Americans were also more likely to serve in seven other occupations deemed essential during the pandemic: food preparation, building and grounds maintenance, police and protective services, personal care (for example, as childcare workers or hair stylists), office and administrative support, production (e.g. assemblers, painters or machinists), and social work and community services.
The authors correlated these job classifications with COVID-19 deaths in 26 states and D.C., concluding that all of these jobs placed workers at higher risk of infection and death from the novel disease. Police and protective services, healthcare support, transportation and food preparation were among those occupations most closely correlated with coronavirus deaths.
This strongly implies that Blacks are more likely to be exposed to COVID-19 on the job than whites, and also could help explain why Blacks, who only represent 6% of the population in Wisconsin, accounted for more than 36% of the state's coronavirus deaths.
Smaller but notably disproportionate COVID-19 death rates were found in other states such as California, New York, New Jersey and Tennessee. But the largest disparities were detected in the Midwest, where Blacks accounted for 30%-40% of coronavirus deaths in Kansas, Missouri, Michigan and Illinois, yet represented less than 15% of the populations in these states. As of April, Blacks comprise 12% of the population nationwide but 21% of COVID-19 deaths.
Since essential workers could potentially bring diseases home from work and inadvertently spread it to family members, adhering to social distancing and other safety guidelines – while more difficult – is especially important for such workers.
Among its limitations, the analysis did not account for racial differences at the county or regional level within states due to a lack of access to public and desegregated data. It could also have been affected by the timing of the onset of COVID-19 in various states, as well as how rapidly states adopted social distancing policies. Still, the authors believe their findings are critical for enabling timely public health strategies for pandemics moving forward.
THE LARGER TREND
University of Utah's exploration of coronavirus deaths isn't the first to suggest that Blacks and other minority groups are disproportionately affected. Just last month, the University of Minnesota found that Black, Hispanic, Native American and Alaskan Native populations are more likely than white to be hospitalized for contracting the virus.
When compared to the populations of each state, people identified as being African American or Black were hospitalized at higher rates than those who were white in all 12 states reporting data, with Ohio (32% hospitalizations and 13% population), Minnesota (24.9% hospitalizations and 6.8% population), and Indiana (28.1% hospitalizations and 9.8% population) having the largest disparities.
Racial disparities in healthcare are becoming an issue in the 2020 presidential election. In late August, Sen. Kamala Harris, the first Black woman nominated by a major party for the vice presidency, said during the National Democratic Convention that the disproportionate number of COVID-19 deaths among minorities is the effect of structural racism, with inequities from education and technology to job security and transportation.
In July, the Centers for Disease Control and Prevention said long-standing systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19.
The CDC defined racial and ethnic minority groups as including people of color with a wide variety of backgrounds and experiences who may have similar social determinants of health that have historically prevented them from having fair opportunities for economic, physical and emotional health.