Study reveals the experience of support health care workers from underserved communities during COVID-19

A Rutgers study gives new insight into the experiences and perspectives of Black and Latinx people working in supportive health care roles during the COVID-19 pandemic.

The study is the first to focus on the experience of support health care workers from underserved communities during the pandemic. While nurses and physicians are the most recognized frontline workers, there are a variety of other roles in healthcare that are overshadowed and lower paid, such as certified nurse assistants, therapists, emergency medical service personnel and food services and custodial staff. This essential workforce comprises nearly 7 million people, most of whom are Black and Latinx women and live in the communities they serve.

The findings, which appear in the journal PLOS ONE, can be used to develop public health messages and strategies.

Researchers interviewed 17 Black or Latinx women in support health care roles in hospitals, nursing homes and home care sites from four counties in New Jersey with high rates of COVID-19 infections and deaths.

The study found that:

• The pandemic disrupted their work responsibilities and roles. Concerns ranged from changes in job duties, increased hours and learning new technology to changes in safety protocol and lack of personal protective equipment.
• They experienced testing irregularity; some participants reported frequent testing, while others were not required to take tests. Many took on the responsibility for testing themselves to keep their families safe.
• Participants experienced fear and uncertainties, including concerns about contracting COVID-19 and transmitting it to their families or losing their jobs or a portion of their income. They also expressed concerns about informing their employers about possible exposure and the resulting stigma among co-workers after testing positive.
• Their vaccine skepticism and decisions evolved over time. Initial concerns about vaccines ranged from questions on secondary effects, trials data and experiences of failed public health interventions in minority populations. Those who were opposed to vaccination reported their opinions changed after watching co-workers get vaccinated and from acquiring vaccine data from reliable sources. Participants also voiced concern about vaccine mandates and the implication for their current employment.

"Our findings illustrate the critical need for health systems to dedicate resources to improve the work conditions for this marginalized workforce, including offering resources that support resilience as well as addressing wages, physical conditions and mental demands, health, safety and well-being to retain them in their roles," said first author Zorimar Rivera-Núñez, an assistant professor at Rutgers School of Public Health.

"Transparent dialogue directly addressing questions and concerns about the COVID-19 vaccine by trusted entities or individuals may help to increase the number of vaccinated individuals within this workforce."

The study was conducted as part of NJ HEROES TOO (New Jersey Healthcare Essential Worker OutReach and Education Study – Testing Overlooked Occupations) in collaboration with 18 community-based organizations and four health care organizations, funded by the NIH Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) Initiative.