The literature shows significant racial and ethnic disparities in the rate of COVID-19 cases, hospitalizations, and mortality [3, 23, 29,30,31]. Although differences in pre-existing health conditions and access to health care services explain some of the racial disparities in COVID-19 hospitalization and mortality rates, additional factors might be contributing to the current high racial and ethnic disparity in COVID-19 infection rates. Understanding the root causes of this disparity would help focus efforts to reduce the transmission of the virus and mitigate its disproportionate impact on disadvantaged groups.
Occupation can contribute to the disproportionately high exposure of certain racial and ethnic groups to COVID-19 through at least three different ways. First, workers in certain occupations are often exposed to infection or disease in their workplaces. The findings of this study showed scores of ≥ 50 for exposure to disease or infection at work in these three-digit level occupations: occupational therapy and physical therapy assistants and aides; healthcare diagnosis or treatment practitioners; health technologists and technicians; other healthcare support workers; funeral service workers; and supervisors of protective service workers. These are expected results as most of the healthcare workers are occupationally exposed to different types of infectious diseases while performing their duties [32]. During March and April 2020, 9 million workers were employed in the above six occupations. This number is lower than the 14.4 million workers (10% of the total workforce) reported by Baker et al. [15]. This could be partly because of methodological differences in measuring this risk. Also note that in the March and April 2020 CPS data, information on race and ethnicity was not reported for more than 10% of the workforce, and I also excluded the “office and administrative support” occupation from the analysis because it has a two-digit SOC code.
The descriptive statistics showed that the share of Black workers in these occupations with high potential risk for exposure to disease or infection at work was 32.6% higher than their share in the total workforce. In comparison, the share of Hispanic and Asian workers in these occupations was lower than their share in the total workforce. The results also showed that in occupations where Black workers were overrepresented, the mean score for potential risk of exposure to disease and infection at work was 38.3% higher than the mean score for all occupations. The regression results also showed that in occupations where Black workers were overrepresented, the expected score for potential risk of exposure to disease and infection at work was 2.3 times higher than in occupations where they were underrepresented. Using BLS 2019 employment data, Hawkins [25] found that the percentage of Black or African-American workers employed in occupations with frequent exposure to infections was 31%, 13%, and 30% higher than for White, Asian, and Hispanic workers, respectively. The results of this study are not directly comparable to Hawkins’ results because whereas Hawkins measured the percentage of different ethnic and racial groups employed in each occupation, I measured the share of different racial and ethnic groups employed in each occupation in relation to their share in the total workforce. I also used more recent data (March and April 2020 instead of 2019) and a different approach to measure the potential exposure risks to COVID-19. Using National Health Interview data, Asfaw [33] also showed that 15.8% of non-Hispanic Black women volunteered or worked in health care settings, compared with 12.8%, 12.3%, and 9.6% of non-Hispanic Asian women, non-Hispanic White women, and Hispanic women, respectively, during 2016–2018.
Second, although physical distancing is one of the most important strategies for protecting workers during the pandemic, having the infrastructure necessary to maintain the required physical distancing varies significantly across different occupations. Consequently, some workers may not be able to perform their day-to-day activities while maintaining the required distance between themselves and their co-workers and customers [34, 35]. Availability of space, intensity of work, room temperature, and other related factors affect the ability of workers to maintain physical distancing. In some occupations such as meat processing [36], home health and personal care services, social and community services, and firefighting, there is very limited or no space to implement physical distancing. Moreover, some occupations require frequent physical or face-to-face interactions with customers. Using O*Net data, Leibovici et al. [37] estimated the distribution of contact-intensive occupations by number of hours worked and total labor income. Their results showed that one-fifth of US workers were employed in high-contact-intensity occupations and one-half in medium-contact-intensity occupations. Moreover, workers in some of these occupations may not have access to personal protective equipment (PPE) and proper training on how to use it. Consequently, workers in these occupations might have a higher risk of exposure to infectious diseases such as COVID-19 [15, 38].
The results of this study showed that in the following 10 occupations, the mean score for potential risk of inability to maintain physical distancing was ≥ 50: protective service, law enforcement, occupational therapy, food preparation and serving, special education teachers, healthcare diagnose or practitioners, health technicians, social workers, protective service, and firefighting and prevention. In these occupations, the share of Asian workers was 31.3% lower than their share in the total workforce, whereas the share of Black workers was 53.8% higher than their share in the total workforce. In occupations where Black workers were overrepresented, the mean score for potential risk of inability to maintain physical distancing at work was 11.2% higher than the mean score for all occupations. Hawkins [25] showed that the percentage of Black or African American workers employed in occupations with frequent close proximity to others was 16%, 13%, and 12% higher than the percentage of White, Asian, and Hispanic workers, respectively. In this study, Asian workers were less likely to be employed in occupations where the score of inability to maintain physical distancing was very high.
Third, in response to COVID-19, some workers were able to perform their job remotely without major problems. The ability of workers to perform their jobs regularly from home varies by occupation. Jobs in some occupations cannot be performed remotely because it is practically impossible to perform the tasks at home. As a result, workers in some occupations are required to report to their workplaces and have little or no option of working remotely [15, 38, 39]. Using the O*Net ‘work context’ and ‘work activities’ data, Dingel and Neiman [38] estimated that only 37% of jobs in the USA can be performed at home. Using the 2018 US BLS employment and O*Net data, Baker showed that only a quarter of US workers were employed in occupations that could be done from home [40]. Mongey et al. [41] linked the BLS O*Net data with the CPS and Panel Study of Income Dynamics data to identify occupations that could be seriously affected by social distancing. Their results showed that workers with jobs that cannot be performed remotely or that require a high degree of face-to-face interactions are more likely to be vulnerable to economic impacts due to COVID-19. Lu [42] visually presented COVID-19 occupational risks and ability to work from home by mean annual income, using O*Net data. The study ranked occupations by their COVID-19 risk score and showed that only 9.2% of workers in the bottom 25% income percentile can work from home.
The results of this study showed that 29 occupations (out of 83 three-digit level occupations) had scores of ≥ 50 for potential risk of inability to work from home. Some of these occupations include extraction; construction (helpers and other trades); forest, conservation, and logging; vehicle and mobile equipment (mechanics, installers, and repairers); water transportation; material moving; building cleaning and pest control; metal and plastic woodwork, food processing, and installation (maintenance and repair). More than 33 million workers were employed in these occupations during the study period. Hispanic workers were more exposed to the potential risk of inability to work from home than any other racial and ethnic group. Hispanic workers’ share in occupations with scores of ≥ 50 for potential risk of inability to work from home was 42% higher than their share in the total workforce. The descriptive analysis showed that in occupations where Hispanic workers were overrepresented the mean potential risk for inability to work from home was 31% higher than mean score for all occupations. The regression analysis also showed that, in occupations where Hispanic workers were overrepresented, the mean score for potential risk of inability to work from home was more than 1.6 times higher than in occupations where they were underrepresented. Using May 2020–February 2021 CPS data, BLS showed that 41% of Asian workers teleworked at some point in the last 4 weeks because of the COVID-19 pandemic compared to 21% of White, 18% Black, and 14% Hispanic workers. These results showed that, despite its several limitations [43], the O*Net data can be used to study potential occupational risks.
Overall, Black workers were overrepresented in occupations with high potential risk of exposure to disease and infection at work and high potential risk of inability to maintain physical distancing at work, relative to their share in the total workforce. Hispanic workers were overrepresented in occupations where the risk of inability to work from home was high relative to their share in the total workforce. Asian workers, relative to their share in the total workforce, were overrepresented in occupations where the potential risk of inability to work from home was low. All these results showed that Black and Hispanic workers accounted for a disproportionate share of employment in high potential COVID-19 exposure risk occupations, relative to their share in the total workforce; this finding underscores the role occupation might play in the current high infection rate of these groups.
These results supported the recent findings that certain racial and ethnic minority workers were disproportionately employed in occupations with high COVID-19 exposure risks [17, 25]. Using 2019 BLS employment data, the percentage of different racial and ethnic groups employed in essential industries, and the frequency of exposure to infections and close proximity to others, Hawkins [20] showed that people of color, especially Blacks, were more likely to be employed in industries classified as essential and in occupations with high risk of exposure to infections and close proximity to others. The results also align with the list of essential occupations (health care, funeral services, law enforcement, social workers, teachers, food preparation and serving) identified by CDC as high risk for exposure to COVID-19 at work [44].
The results of this study could have far-reaching implications because these workers are more likely to spread the disease to their racial and ethnic communities [45]. This effect can also be intensified because these racial and ethnic minority groups are more likely to live in poor and crowded neighborhoods and rely on public transportation to go to work and for their day-to-day activities [36, 46]. A recent study showed that non-Hispanic Black and Hispanic children had 30.0% and 46.4% higher risk of COVID-19 infection than non-Hispanic White children [47]. Studies have also shown that occupation type is highly correlated with access to paid sick leave and presenteeism [15, 46, 48,49,50], which are major factors for the spread of influenza-like illness [51].
The results of this study should be interpreted with caution. First, although I used employment data during the pandemic and the O*Net data released in 2020, I did not have information on different measures taken by employers and employees such as installing physical barriers, social distancing, and using PPE in response to the pandemic. For instance, because of the rise of online learning during the COVID-19 pandemic, the risk of infection for schoolteachers would be relatively lower than teaching in person. The unemployment and labor force changes during the first 2 months of the pandemic could impact the percentages employed in different occupations since April 2020, especially given differential impacts of the recession by race and ethnicity [52]. The O*NET data may not also capture job experience for certain racial and ethnic minority groups [53]. Second, CPS does not report racial and ethnic information for occupations that do not meet publication criteria (small number of observations). In the March and April 2020 CPS data, information on race and ethnicity was not reported for over 10% of the total workforce. However, this would not affect the results of the study in any significant way, as the missing number of workers were almost equally distributed across the four racial and ethnic groups considered in the study. There was less than a one percentage point difference in the share of the four racial and ethnic groups considered in this study compared to the share reported by BLS for the year 2020 aggregated data [44]. Third, I used data aggregated at three-digit level occupations, which might camouflage disparities in the proportion of different racial groups employed in occupations with high potential risk of exposure to COVID-19, such as meat packing, nursing, occupational therapy, and corrections. For instance, in meat packing occupations Hispanic workers constituted 44% of the total workforce [54]. Fourth, the overrepresentation variable indicates whether the share of each racial and ethnic group in different occupations was higher than its share in the total workforce but does not measure the magnitude of the difference. Finally, I did not control for additional factors such as education, income, and other socio-economic variables.