COVID-19 and the Health and Wellbeing of Vulnerable Service Sector Workers across the Life Course

摘要 新冠肺炎大流行引发的健康和经济冲击交织在一起，在 服务业。服务业的劳动力很多，近20%的美国劳动力受雇于零售业， 食品杂货、食品服务和相关行业，主要是低收入和不成比例的妇女和 有色人种。这些未得到充分服务的工人在最初的大规模失业浪潮中首当其冲， 对整个生命过程中的健康差距可能造成可怕的后果。然而，经济危机却迎难而上。 通过扩大安全网，本可以缓冲健康后果。对于那些继续受雇的人来说， 许多人发现自己处于疫情的最前线，为杂货店、药店和药房配备人员 中锋。这些工人遵守缓解冠状病毒的做法，包括在以下情况下呆在家里 生病和接种疫苗，决定了大流行的进一步进程。针对弱势社区住宅 老年人和其他弱势成年人，在整个过程中，去杂货店和药店仍然是必不可少的 大流行等都是经常发生的风险来源。居住在社区的老年服务人员的风险取决于 这既取决于他们自己对缓解策略的坚持，也取决于他们年轻同事的坚持。然而，在这方面有一个差距 了解经济危机如何影响这些未得到充分服务的工人的健康，以及如何坚持 到冠状病毒缓解策略在他们的工作场所发挥作用，特别是对年长的工人。为了填补这些空白， 我们建议使用我们从161,619小时服务部门收集的新数据作为轮班项目的PI 2017至2022年间接受调查的工人，包括最近下岗或继续工作的83,720名工人 这项工作和在大流行期间进行的调查，以及计划到2023年的数据收集。我们建议使用 这些数据实现了三个关键目标。首先，我们将Shift Project微观数据与以下位置的上下文数据进行匹配 从新来源的多个层面构建工作场所风险环境、公司政策、当地的衡量标准 委托，和新冠肺炎费率。我们将准备一份符合公平的统一、完整的数据文件 鼓励发现和使用数据的标准。其次，我们估计了经济混乱的影响 关于未得到充分服务的工人的健康，扩大的安全网在缓冲工人免受伤害方面的作用 这些冲击的后果，以及这些动态对年龄较大的员工有何不同。第三，我们研究了 遵守冠状病毒缓解做法的预测因素。独一无二的是，我们结合了公司和机构- 风险环境和政策的级别预测因素，以及个人和监管级别的预测因素 检查影响是如何随年龄变化的。总之，我们建议协调、链接和传播创新和及时的 针对服务不足且易受新冠肺炎冲击影响的人口亚群的大规模数据 对公共卫生有相当大的相关性，并产生关于工作流离失所和 健康和在整个生命过程中在工作场所遵守缓解做法的多层次预测因素。

ABSTRACT The COVID-19 pandemic precipitated intermingled health and economic shocks, which were felt deeply in the service-sector. The service-sector workforce is large, with nearly 20% of the U.S. workforce employed in retail, grocery, food service and related sectors, and is predominantly low-income and disproportionately women and people of color. These underserved workers bore the brunt of the initial wave of mass unemployment, with potentially dire consequences for health disparities across the life course. However, the economic crisis was met by a safety net expansion that could have buffered the health consequences. For those who remained employed, many found themselves on the frontlines of the pandemic, staffing grocery stores, pharmacies, and fulfillment centers. These workers’ adherence to coronavirus mitigation practices, including masking, staying home when sick, and getting vaccinated, shaped the further course of the pandemic. For vulnerable community-dwelling older adults and other vulnerable adults, visits to grocery stores and pharmacies remained essential throughout the pandemic and so were a regular source of risk. Community-dwelling older service workers’ risks depended on both their own adherence to mitigation strategies and that of their younger co-workers. Yet, there is a gap in knowledge about how the economic crisis affected the health of these underserved workers and how adherence to coronavirus mitigation strategies played out in their workplaces, especially for older workers. To fill these gaps, we propose to draw on novel data we collected as PIs of The Shift Project from 161,619 hourly service-sector workers surveyed between 2017 and 2022, including 83,720 workers who were recently laid-off, or remained on the job and surveyed during the pandemic, as well as planned data collection through 2023. We propose to use this data to accomplish three key aims. First, we match the Shift Project micro-data with contextual data at multiple levels from novel sources to construct measures of workplace risk environment, company policies, local mandates, and COVID-19 rates. We will prepare a harmonized and integrated data file that meets FAIR standards to encourage discovery and use of the data. Second, we estimate the effects of economic disruption on the health of underserved workers, the role of the expanded safety net in buffering workers against harmful consequences of these shocks, and how these dynamics varied for older workers. Third, we examine the predictors of adherence to coronavirus mitigation practices. Uniquely, we incorporate firm and establishment- level predictors of risk environments and policies alongside individual-level and regulatory predictors and examine how effects vary by age. In sum, we propose to harmonize, link, and disseminate innovative and timely large-scale data for a population subgroup that is underserved and vulnerable to COVID-19 shocks and in a setting of considerable relevance for public health, and to generate rigorous evidence on job displacement and health and on multi-level predictors of adherence to mitigation practices in the workplace across the life course.