COVID-19 Risks and Impacts Among Health Care Workers by Race/Ethnicity

Health care workers face potential COVID-19 exposure through their job. Data suggest that at least 200,000 health care workers have been infected with coronavirus as of November 2020, but this estimate likely vastly underestimates the number affected due to major gaps in data collection. Data further show that people of color account for the majority of COVID-19 cases and deaths known among health care workers, and that they are more likely to be in health care worker roles and settings that have particularly high risks of workplace exposure. This analysis provides greater insight into COVID-19 risks and impacts among health care workers and how they vary by race and ethnicity. It is based on a KFF analysis of 2019 American Community Survey and publicly available information on COVID-19 impacts among health care workers (see Methods for more details). It finds:

In 2019, there were over 18.6 million people working in the health care industry across a range of occupations and settings. Overall, 60% of health care workers were White and 40% were people of color, including 16% who were Black, 13% who were Hispanic, and 7% who were Asian. However, the racial/ethnic composition of health care workers varied across occupations and settings. Black and Hispanic health care workers made up relatively larger shares of aides and personal care workers and direct contact support workers. Black and Hispanic workers also accounted for larger shares of health care workers in home health care, and Black workers made up a relatively larger share of workers in skilled nursing facility or other residential care settings.

People of color account for the majority of COVID-19 cases and/or deaths known among health care workers for which race/ethnicity data are available. The Centers for Disease Control and Prevention (CDC) reported over 200,000 cases and just over 790 deaths among health care personnel as of November 9, 2020. However, this estimate likely vastly underestimates the number of health care workers affected as health care personnel status was known for only a quarter (25%) of total cases. CDC further found that, as of July 2020, more than half (53%) of confirmed cases among health care personnel were among people of color, including 26% who were Black, 12% who were Hispanic, and 9% who were Asian. Data collected by states, the media, and other organizations similarly find that people of color account for the majority of COVID-19 cases and/or deaths known among health care workers.

Research suggests that health care workers face increased risks of coronavirus exposure and infection, with certain health care workers facing particularly high risks that disproportionately affect people of color. Studies show that health care workers are at increased risk for exposure and infection relative to the general population, with particularly high risks for health care workers who provide direct patient care, work in inpatient hospital or residential or long-term care settings, are in nursing or direct support staff roles, or do not have adequate access to PPE.¹ Research further suggests that, among health care workers, people of color are more likely to report reuse of or inadequate access to PPE and to work in clinical settings with greater exposure to patients with COVID-19. CDC analysis of antibody evidence of previous infection among health care personnel further found higher rates of seropositivity among people or color compared to their White counterparts (9.7% vs. 4.4%), suggesting higher rates of previous infection.

A recent KFF/The Undefeated Survey suggests that the pandemic is taking a disproportionate toll on health care workers, especially Black health care workers and their families. It finds that health care workers are more likely than others to worry about being exposed to the virus through the workplace, to know someone who has died from the virus, to say it has negatively impacted family relationships, and to report someone in their household lost a job or experienced a cutback in hours or income due to the pandemic. Black health care workers and their families are particularly likely to report certain impacts, including knowing someone who has died from the virus and a negative impact on their ability to pay for basic needs.

KFF/The Undefeated Survey data also show that, while health care workers are more likely than others to say they would definitely get a COVID-19 vaccine, substantial shares express vaccine hesitancy, particularly among Black health care workers and their families. Overall, 54% of health care workers say they would definitely get vaccinated if it was available for fee and determined safe and effective by scientists, compared to 33% of adults who do not have a health care worker in their household. However, among adults who are health care workers or who live in a household with a healthcare worker, Black adults are much less likely to say they would definitely get vaccinated compared to White adults (24% vs. 46%), mirroring greater vaccine hesitancy among Black adults more broadly.

Together these findings highlight the importance of focusing on health care workers as part of response efforts to help protect against COVID-19 infection and spread. They can also help target response efforts and distribution of treatments and vaccines as they become available to prioritize health care workers who are facing the highest risks of exposure and infection. Targeting these efforts will also have important implications for health disparities given the disproportionate risks and impacts among health care workers who are people of color, which may compound broader increased health and economic risks that are contributing to the pandemic’s disproportionate toll on people of color overall. This analysis also shows that there remain significant gaps in data to understand COVID-19 impacts by industry and occupation. Increased data would allow for better understanding of work-related risks and outbreaks to help guide response efforts and resources going forward.