Structural Discrimination in Pandemic Policy: Essential Protections for Essential Workers

Abstract

An inordinate number of low wage workers in essential industries are Black, Hispanic, or Latino, immigrants or refugees — groups beset by centuries of discrimination and burdened with disproportionate but preventable harms during the COVID-19 pandemic.

How Should Health Care Organizations Protect Personnel in Environmental Services and Related Fields?

“…1 During the COVID-19 pandemic, IPC guidance tended to emphasize the importance of adequate protections for some frontline workers but often neglected personnel in other key roles. 2,3 Workers in ESRF within hospitals are sometimes relegated to contractor status, which prohibits them from participating fully in an organization's employment benefits (eg, training, insurance, paid time off) and can entail receiving lower pay and not having their health and safety needs prioritized, despite their risk of COVID-19 infection being higher than that of frontline clinicians. 4 In addition to inequitable protection, many of these workers belong to historically disenfranchised groups, whose minoritized status can be compounded by lack of or inadequate insurance, limited paid time off, food insecurity, and housing instability.…”

“…21 These frontline workers were harmed by the lack of adequate worker protection policies, health care access, and preparedness efforts centered on their roles. 2,10,22,23 As a result, concerns about the health and safety of workers in ESRF were reactive, which had the effect of compounding existing health inequities and leaving many workers without essential protections that all workers who risk their health to do their job deserve. Despite a history of health injustice in previous pandemics and public health emergencies and calls from scholars to attend to health equity in pandemic planning, 18,24 the COVID-19 pandemic mirrored results from previous epidemics and pandemics, as workers in low-wage, frontline occupations suffered disproportionate risk of exposure and poor health outcomes.…”

Promoting Latinx health equity through community-engaged policy and practice reforms in North Carolina

“…Growing evidence during the COVID-19 pandemic reinforced the association between disparate health outcomes and structural racism among historically marginalized populations (1)(2)(3)(4). Populations who identify as Hispanic, Latino, or Latinx (herein Latinx) experienced disproportionate risk of COVID-19 disease burden, hospitalizations, and mortality compared to non-Hispanic, White populations (3,5,6).…”

“…Systemic exclusion occurs when communities experience continuous and compounded legal, regulatory, and political injustices that hinder a population's ability to achieve health and wellbeing. For example, Latinx community members disproportionately lack health insurance coverage and live in neighborhoods with limited or unreliable access to a pharmacy, public transportation, or broadband Internet (4,9,13,14). In addition, acculturative and socioeconomic stressors that stem from discriminatory immigratory practices, lack of stable employment, and racism contribute to declines in physical and mental wellbeing among Latinx populations (15).…”