A quarter of health care workers at risk of poor COVID-19 outcomes


The front line of the COVID-19 pandemic is a dangerous place. A new study highlights just how many health care workers are at risk of poor outcomes.

Health care workers are the on the front line in the battle against COVID-19. A new study in the Annals of Internal Medicine found that roughly a quarter of those workers who had patient contact were at risk of poor outcomes if they became infected due to either age or an underlying health condition.1

The researchers used 2 in-person surveys that were nationally representative of the civilian, noninstitutionalized US population: the 2018 National Health Interview Survey and the March 2019 Current Population Survey.

The National Health Interview Survey was used to identify health personnel who reported direct patient contact and determine how many had risk factors for poor COVID-19 outcomes; lacked health insurance or paid sick leave; were unable to afford prescriptions in the past year; or were at least moderately worried about medical costs.

Using the survey data, investigators found that 3.66 million (26.6%) of health care workers who had patient contact were at risk of poor outcomes because of age or chronic conditions. Among workers at high risk, 7.5% lacked insurance, which included 20.8% who had a chronic lung condition other than asthma and 11.4% who had diabetes. Nearly 30% of health care workers at risk of poor outcomes had no paid sick leave.

The March 2019 Current Population Survey was used to identify people who worked in hospitals, nursing homes, and home care settings. The survey found that lack of insurance was low among hospital workers (3.1%), but uninsured rates among nursing home staff (11.5%) and home care workers (14.9%) exceeded the 9.1% uninsured rate found for the entire US population as a whole. Licensed practical nurses, registered nurses, and nurse aides were particularly affected.

The findings of the study underscore why the current shortage of personal protective equipment (PPE) for health care workers will have tragic consequences. The study also highlights the need for political action to address certain issues such as increasing pay for health care workers who are deemed essential but are in low-paying roles, as well as setting up no-cost health coverage during the pandemic. The researchers also stated that in some areas doctors and nurses have been pushing for pay increases for health care workers who are taking the same risks as they are, but are being paid far less.


1.    Himmelstein DU, Woolhandler S. Health insurance status and risk factors for poor outcomes with COVID-19 among US health care workers: a cross-sectional study. Ann Intern Med. April 28, 2020. Epub ahead of print. doi: 10.7326/M20-1874

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