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Latest Research

Study: 3.7 million frontline health workers have medical problems that raise their risk of dying from COVID-19

Many health care workers lack insurance and paid sick leave, more than 600,000 live in poverty

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FOR IMMEDIATE RELEASE: April 28, 2020
Contact: David Himmelstein, M.D., dhimmels@hunter.cuny.edu
Steffie Woolhandler, M.D., M.P.H., steffie_woolhandler@hms.harvard.edu

More than a quarter (26.6%) of America’s nearly 14 million patient-contact health personnel are at risk of severe illness or death from COVID-19 because of age or chronic conditions, a new study found. Researchers also reported high rates of uninsurance and poverty among frontline health workers, who are likely to be exposed to COVID-19 at work. 

According to a study published today in the Annals of Internal Medicine, millions of Americans whose health care jobs bring them into direct contact with patients have medical conditions like diabetes or heart disease that put them at high risk of death if they contract COVID-19. The study also found that 28.6% of all patient-contact personnel lack paid sick leave, including 1.12 million of those with underlying health problems. About 275,000 health care workers with high-risk conditions are also uninsured, including 11.4% of those with diabetes, and 20.8% of those with chronic lung disease. 

The study, conducted by researchers at the City University of New York (CUNY) at Hunter College and Harvard Medical School, analyzed data from two national surveys of thousands of health workers. The researchers identified personnel who work directly with patients, such as doctors, nurses, and nursing aides, and then determined how many of them were over 65 or had an underlying medical condition that puts them at high risk of severe illness and death from COVID-19, including heart disease, chronic lung disease, diabetes, severe obesity, moderate or severe asthma, and liver disease. The authors also analyzed Census data to determine health insurance coverage and incomes of workers in hospitals, home care agencies, and nursing homes.

The study found that among nursing home workers — a group at particularly high risk of COVID-19 infection — 11.5% are uninsured, compared to the national insurance rate of 9.1%. Home care workers, few of whom have access to personal protective equipment, have an even higher uninsurance rate of 14.9%. Researchers also found that more than 600,000 medical personnel have family incomes below the federal poverty line, which likely impairs their ability to maintain social distancing outside of work.

“Health care workers are being celebrated as heroes, but they’re denied the health coverage, sick leave benefits, and incomes they need to protect themselves and their families,” commented Dr. David U. Himmelstein, the study’s lead author who is a distinguished professor at CUNY’s Hunter College and a lecturer at Harvard Medical School. “The pandemic has illuminated how warped our economy and values have become. Financiers working in plush offices or luxury homes make billions shorting stocks. Meanwhile, many Americans doing the most essential and dangerous work, including health personnel, grocery workers, bus drivers, or delivery drivers, can’t make ends meet or afford medical care.”

Study co-author Dr. Steffie Woolhandler, an internist, distinguished professor at Hunter College, and co-founder of Physicians for a National Health Program, added, “While essential workers put themselves in harm’s way, Congress and the President are leaving many of them unprotected and impoverished. They’ve passed paltry measures to expand coverage for coronavirus testing and to shore up hospitals’ finances, but more than half a million health workers — and more than 30 million other Americans — remain uninsured. Our health insurance system is broken, and only Medicare for All can fix it.”    

“Health Insurance Status and Risk Factors for Poor Outcomes with COVID-19 Among U.S. Health Care Workers: A Cross-Sectional Study.” David U. Himmelstein, M.D., Steffie Woolhandler, M.D., M.P.H. Annals of Internal Medicine, April 28, 2020

Physicians for a National Health Program (PNHP) is a nonprofit organization whose 23,000 members advocate for single-payer Medicare-for All; PNHP played no role in funding or conducting this analysis.

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