“Compared to white health-care workers, health-care workers that identify as Black, Asian, Hispanic, or other minority groups have an over two-fold higher risk testing positive for COVID-19,” says Andrew T. Chan, MD, MPH, a professor at Harvard Medical School and corresponding and senior author of the study. “In addition, those health-care workers also reported a higher risk of having inadequate access to personal protective equipment, including gloves, gowns, eye shields, and also reported working in care settings that were considered higher risk in terms of working more in inpatient settings, nursing home, and having more contact with patients that were suspected or confirmed to have COVID-19.”
Researchers conducted a prospective, observational cohort study using the COVID Symptom Study app that was designed by health science company Zoe Global in collaboration with Massachusetts General Hospital and King’s College London. The study used data from 2,135,190 participants in the U.S. and the UK collected between March 24 and April 23, 2020. Of this cohort, nearly 100,000 people (4.7 percent) identified as front-line health-care workers. Dr. Chan hopes this research will help push the health-care system in a better, more inclusive direction.
“Our research, I think, for the first time really documents the inequity that health-care workers of color face,” he says. “You would expect that within our health-care system that there is a recognition that people who care for patients of COVID are at risk and you would expect that the physicians, nurses, and other workers that care for those patients should be treated equitably. But our data suggests that’s not the case.”
Given shortages of personal protective equipment, 27.7 percent of non-Hispanic white health-care workers reported having to reuse or just had inadequate access to the necessary equipment. That number is 36.7 percent for health-care workers of color.
“The fact that health care workers of color have lower access to personal protective equipment I think underscores that there are systemic inequities in the health care system,” says Dr. Chan. “Because those health care workers are working in hospitals and other care settings which are less well resourced. And as a result, may have less access to personal protective equipment.”
Additionally, under-protected workers are more likely to be working in high-risk settings. That, coupled with unreliable access to PPE leads to more cases among health-care workers of color. Non-Hispanic white health-care workers were 3.5 times more likely to test positive for COVID-19 than the general public, even after adjusting for the fact that health-care workers are tested at higher rates. Health-care workers of color are nearly 5 times more likely to test positive than the general public.
“Health care workers of color are more likely to be coming into contact with patients with COVID-19 and I think that has to do with the communities they serve,” says Dr. Chan. “The disparities reflect multiple aspects of the health-care system which are reflections of overlying systemic racism, which is the fact that they’re working in care settings that are under-resourced, they have less access to personal protective equipment, and they’re also taking care of patients in their own communities, which are more likely to have COVID-19.”
Although this study used data collected in March and April, Dr. Chan highlights that the study app is still available for download and the data is still being used. “We are encouraging people to continue joining the study, and sharing information because the more people that participate, the more informative the data will be,” says Dr. Chan. Anyone can join whether symptomatic or not. “It’s actually designed for people who are feeling well to join and capture over time if they started to develop symptoms.” The COVID Symptom Study app is available to download on both Apple and Android devices.
Continuing this research will help make the health-care system equal for all.
“The systemic inequities in our society have been exposed by COVID-19, but obviously have been there for a long time and will persist well beyond COVID-19 and potentially will impact and do impact other health outcomes,” says Dr. Chan. “It’s important for people to start to tackle this problem with an eye toward addressing it for the immediate crisis that we’re in, but also with the hope that it will be the foundation for lasting change that will have an impact on the delivery of health care for the future.”