Workers in critical occupations such as healthcare and food service were more likely to die during the first two years of the COVID-19 pandemic than other workers, according to a new study from the University of Minnesota.
The study also found that the death rate among workers of color in critical occupations was highest. The study differs from several previous COVID-19 surveys by using occupations to identify vulnerable populations, said Harshada Karnik, the study’s lead author.
The study, published last month in the American Journal of Public Health, looked at the “excess mortality rate” of Minnesota workers in “critical occupations.” Researchers tracked deaths of all kinds, not just COVID deaths, because the pandemic affected other parts of life and health care that could have contributed to mortality.
Excess mortality rate refers to “deaths in excess of what they would be in normal circumstances,” said Karnik, who works as a researcher at the University of Minnesota’s School of Public Health.
The study compared the differences in death rates from 2020 and 2021 to the death rate in 2017 through 2019, before the pandemic began.
The study also used the definition of “critical occupations” from the Cybersecurity and Infrastructure Security Agency to identify jobs that are critical to keeping the nation’s infrastructure afloat. These include jobs in healthcare, agriculture, food processing, and food service, among others.
In total, the excess mortality rate for critical workers in Minnesota was 3 deaths for every 10,000 people in 2020 and 4.5 deaths for every 10,000 people in 2021.
For critical workers of color, the excess mortality rate was 4.6 in 2020 and 5.6 in 2021. White critical workers, meanwhile, experienced excess mortality rates of 2.7 in 2020 and 4.4 in 2021.
One of the most glaring differences came in transportation and logistics workers in 2021. That year, workers of color in this industry experienced an excess mortality rate of 11.6 deaths per every 10,000 workers, while white workers in the same industry experienced an excess mortality rate of 0.7 deaths per 10,000 workers.
The study counted deaths from all causes using death certificates from the Minnesota Department of Health and population data from the U.S. Census Bureau’s American Community Surveys.
Karnik said the study included deaths of all causes instead of just COVID-19 related deaths, because not all COVID-19 deaths were properly recorded as such during the first several months of the pandemic. She added that indirect factors of the pandemic, such as overloaded hospitals, meant that many people suffering from other ailments like cancer or overdoses couldn’t get properly treated, likely influencing the increased excess mortality rate.
Statewide, COVID-19 was the third highest cause of death in 2020 and 2021 after cancer and heart disease, according to the Minnesota Department of Health and the U.S. Centers for Disease Control and Prevention.
The study did not examine the potential causes of the racial discrepancies in its findings. Seven University of Minnesota researchers spent two years conducting the study.
The findings that critical workers died at higher rates than noncritical workers and that critical workers of color died at higher rates than their white counterparts didn’t come as a surprise to the study’s authors. But other findings did, Karnik said.
Particularly, Karnik referred to how some critical jobs were more deadly than others. Food processing and food production work saw a higher excess mortality rate than healthcare and agricultural jobs, for example.
Food processing, which includes meatpackers and commercial bakery workers, saw the highest excess mortality rate overall at 9.2 for every 10,000 workers in 2020. Critical workers of color saw the highest excess mortality rates in the food processing, food service, construction, retail, and transportation industries.
Overall, the study found lower excess mortality rates from critical workers in the healthcare and first responder industries compared to other professions. Karnik said these findings suggest that some industries did a better job protecting their workers from COVID-19 through efforts like vaccination and providing personal protective equipment.
“What it means is that we have some sectors like food processing and food retail that can learn from the healthcare sector about protecting its workers,” Karnik said.
These findings have policy implications beyond the COVID-19 pandemic or even a future pandemic, Karnik added. Specifically, Karnik said public health policymakers can use this type of data to conduct place-based intervention, which is when decision makers provide services by connecting with people where they are, such as in the workplace.
“Let’s say there are public programs available where participation isn’t good,” she said. “One way to find people would be to reach them from their occupation. If we can identify where people are working, it’s easier to reach them with other services.”
The critical occupations analyzed in the study include the following industries:
- Healthcare
- Emergency and first responders
- Childcare
- All workers in K–12 schools
- Food processing
- Agriculture
- Transportation and logistics, which includes public transit, airport staff, and postal service, as well as logistics, delivery, and infrastructure transportation
- Manufacturing
- Construction
- Retail
