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. 2022 Mar 5:45:101314.
doi: 10.1016/j.eclinm.2022.101314. eCollection 2022 Mar.

Racial/Ethnic Disparities in Healthcare Worker Experiences During the COVID-19 Pandemic: An Analysis of the HERO Registry

Jay B Lusk  1   2 , Haolin Xu  3 , Laine E Thomas  3 , Lauren W Cohen  3 , Adrian F Hernandez  3 , Christopher B Forrest  4 , Henry J Michtalik  5 , Kisha Batey Turner  6 , Emily C O'Brien  3 , Nadine J Barrett  7 ; HERO Research Program
Affiliations

Racial/Ethnic Disparities in Healthcare Worker Experiences During the COVID-19 Pandemic: An Analysis of the HERO Registry

Jay B Lusk et al. EClinicalMedicine. .

Abstract

Background: The extent to which healthcare worker (HCWs) experiences during the COVID-19 pandemic vary by race or ethnicity after adjustment for confounding factors is not currently known.

Methods: We performed an observational prospective cohort study of 24,769 healthcare workers from 50 U.S. states and the District of Columbia, enrolled between April 10, 2020 and June 30, 2021, and evaluated participant experiences during the COVID-19 pandemic, including testing, diagnosis with COVID-19, emotional experiences, burnout, and interest in vaccines and vaccine clinical trials.

Findings: After adjustment for professional role, medical history, and community characteristics, Black and Asian participants were less likely to receive SARS-CoV-2 viral testing (adjusted odds ratio (aOR) 0·82 [0·70, 0·96], p=0·012 and aOR 0·77 [0·67, 0·89], p<0·001 respectively) than White participants. Hispanic participants were more likely to have evidence of COVID-19 infection (aOR 1·23 (1·00, 1·50, p=0·048). Black and Asian participants were less likely to report interest in a COVID-19 vaccine (aOR 0·11 [0·05, 0·25], p<0·001 and aOR 0·48 [0·27, 0·85] p=0·012). Black participants were less likely to report interest in participating in a COVID-19 vaccine trial (aOR = 0·39 [0·28, 0·54], p<0·001). Black participants were also less likely to report 3 or more daily emotional impacts of COVID-19 (aOR = 0·66 [0·53, 0·82], p=<0·001). Black participants were additionally less likely to report burnout (aOR = 0·66 ([0·49, 0·95], p=0·025).

Interpretation: In a large, national study of healthcare workers, after adjustment for individual and community characteristics, race/ethnicity disparities in COVID-19 outcomes persist. Future work is urgently needed to understand precise mechanisms behind these disparities and to develop and implement targeted interventions to improve health equity for healthcare workers.

Funding: This work was funded by the Patient-Centered Outcomes Research Institute (PCORI), Contract # COVID-19-2020-001.

Keywords: Burnout; COVID-19; Coronavirus; Emotional experiences; Ethnic disparities; Ethnicity; Health equity; Healthcare worker shortage; Healthcare workers; Nursing shortage; Physician shortage; Race; Racial disparities; SARS-CoV-2; Structural racism; Systemic racism; Testing; Vaccine hesitancy; Vaccine interest.

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Conflict of interest statement

Christopher B Forrest receives grants from NIH PCORI AHRQ FDA CDC and royalties from Johns Hopkins University for the ACG case-mix software system. This tool was not used in the present study. Emily O'Brien declares PCORI grant funding to her institution for the HERO Registry and Pfizer grant funding to her institution. Laine Thomas declares PCORI Payment to her institution. Adrian F. Hernandez reports grants from Pfizer Inc. and Merck as well as consulting fees from Merck. All other authors have nothing to declare.

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