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Racial/Ethnic Disparities in Healthcare Worker Experiences During the COVID-19 Pandemic: An Analysis of the HERO Registry.
Lusk, Jay B; Xu, Haolin; Thomas, Laine E; Cohen, Lauren W; Hernandez, Adrian F; Forrest, Christopher B; Michtalik, Henry J; Turner, Kisha Batey; O'Brien, Emily C; Barrett, Nadine J.
  • Lusk JB; Duke University School of Medicine, Durham, NC, USA.
  • Xu H; Duke University Fuqua School of Business, Durham, NC, USA.
  • Thomas LE; Duke Clinical Research Institute, Duke University, Durham, NC, USA.
  • Cohen LW; Duke Clinical Research Institute, Duke University, Durham, NC, USA.
  • Hernandez AF; Duke Clinical Research Institute, Duke University, Durham, NC, USA.
  • Forrest CB; Duke Clinical Research Institute, Duke University, Durham, NC, USA.
  • Michtalik HJ; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
  • Turner KB; Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • O'Brien EC; Vanderbilt University Medical Center, Nashville, TN, USA.
  • Barrett NJ; Duke Clinical Research Institute, Duke University, Durham, NC, USA.
EClinicalMedicine ; 45: 101314, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1828404
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

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Topics: Vaccines Language: English Journal: EClinicalMedicine Year: 2022 Document Type: Article Affiliation country: J.eclinm.2022.101314

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Topics: Vaccines Language: English Journal: EClinicalMedicine Year: 2022 Document Type: Article Affiliation country: J.eclinm.2022.101314