In a recent study posted to the medRxiv* pre-print server, researchers assessed the risk of coronavirus disease 2019 (COVID-19) mortality in individuals working in essential sectors of America.
Studies have reported increased COVID-19 severity among individuals working in essential sectors. However, for the United States (US) population, evidence on the differences in risk of severe COVID-19 based on demographic variability is lacking.
A previous study on COVID-19 mortality in California showed that the per-capita COVID-19 mortality was higher among workers of essential sectors such as manufacturing, agriculture, emergencies, facilities, and logistics/transportation.
Study: COVID-19 mortality among working-age Americans in 46 states, by industry and occupation. Image Credit: Eldar Nurkovic / Shutterstock
About the study
In the present study, researchers evaluated the risk of per capita COVID-19 mortality in the essential workers of America by occupation and industry using population size estimates from the American Community Survey of 2020.
This study was conducted to expand the breadth of the previous Californian study. They also evaluated the differences in age-standardized per-capita COVID-19 mortality based on demographic factors such as sex, age, and race variability.
Data on COVID-19 mortality in 2020 for 29- to 64-year-old-non-military US residents of 46 states was provided by the National Center for Health Statistics. However, data were unavailable for four states: Iowa, Arizona, Rhode Island, and North Carolina. Thus, residents of these states and Puerto Rico, and the District of Columbia were excluded from the study.
The industries and occupations were defined using the National Health Interview Survey and the US Census codes, which were present in the obtained data. Occupations with ≥100 reported COVID-19 deaths were included in the analysis.
The industries were classified as essential and non-essential based on the pandemic-era definitions followed in the California study. The industries classified as non-essential were arts, recreation and entertainment; education; insurance and finance; management; information; other services; technical and scientific services; real estate, leasing, and rental; and others.
Per-capita COVID-19 mortality by industry (essential or not essential) and age, United States (46 states), 2020.
A total of 48,030 COVID-19 deaths were reported among non-military American individuals whose industry and occupation were known. This represented 25.1 COVID-19 deaths per 100,000 working individuals.
A 1.89-fold more significant per-capita COVID-19 mortality was noted among workers of essential sectors compared to non-essential workers, representing an absolute discrepancy of 14.7 per 100,000 working individuals.
The industries with the highest per-capita COVID-19 mortality were as follows: food and accommodation services (45 per 100,000); warehousing and transportation (43.4 per 100,000); forestry, agriculture, hunting, and fishing (42.3 per 100,000); construction (38.7 per 100,000); and mining (40 per 100,000).
Per-capita COVID-19 mortality by industry (essential or not essential), age group, sex, and highest level of educational attainment, United States (46 states), 2020.
The per-capita COVID-19 mortality of agricultural workers (essential working individuals) was 2.6-fold greater than non-essential workers, representing an absolute discrepancy of 25.8 per 100,000. The other essential occupations with high per-capita COVID-19 mortality were as follows: construction workers (107.4 per 100,000); head cooks and chefs (104.7 per 100,000); clergy (83 per 100,000); sewing-machine users (76.6 per 100,000); and operators of printing-press (85.5 per 100,000).
In addition, a high number of COVID-19 deaths were reported for occupations such as truck drivers and sales workers (2,299); building cleaners and janitors (1,426); registered nurses (862); salespersons (1,043); K–12 teachers (808); retail sales supervisors (900); managers (763); carpenters (565); housekeeping cleaners and maids (660); and personal care assistants (659). However, these occupations were not listed among the top 25 occupations with the highest age-standardized per-capita COVID-19 mortality.
The per-capita COVID-19 mortality was higher among essential workers of any age. For both the groups, it had a linear relation with the individual’s age. This indicates that essential workers of any age were more prone to severe COVID-19 compared to workers of non-essential sectors and across ages, the risk of COVID-19 deaths was highest among the elderly.
The per-capita COVID-19 mortality of essential workers and workers of non-essential sectors was highest for the 45 to 49 years age group (2.1). However, the per-capita COVID-19 mortality differences among the two types of workers were most prominent in the 60 to 64-year age group (67.2). This indicates that most occupational COVID-19 deaths were noted among 45 to 49-year-olds. However, on the whole, the elderly population above 60 years was most prone to COVID-19 deaths.
On stratifying by race, Hispanic essential workers and non-Hispanic Blacks were at a greater risk of COVID-19 mortality. Sex did not significantly impact the per-capita COVID-19 mortality.
Overall, the study findings were commensurate with those of the California study and indicated that a higher degree of COVID-19 protection must be provided to essential workers with adequate ventilation in workplaces. The authors also believed that increasing paid sick leaves and decreasing crowding would decrease the risk of COVID-19 mortality.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
- COVID-19 mortality among working-age Americans in 46 states, by industry and occupation. Yea-Hung Chen, Ruijia Chen, Marie-Laure Charpignon, Mathew V Kiang, Alicia R Riley, Maria Glymour, Kirsten Bibbins-Domingo, Andrew C Stokes, medRxiv pre-print 2022, DOI: https://doi.org/10.1101/2022.03.29.22273085, https://www.medrxiv.org/content/10.1101/2022.03.29.22273085v1