Racial/Ethnic Disparities in Healthcare Worker Experiences During the COVID-19 Pandemic: An Analysis of the HERO Registry

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 center dot 82 [0 center dot 70, 0 center dot 96], p=0 center dot 012 and aOR 0 center dot 77 [0 center dot 67, 0 center dot 89], p < 0 center dot 001 respectively) than White participants. Hispanic participants were more likely to have evidence of COVID-19 infection (aOR 1 center dot 23 (1 center dot 00, 1 center dot 50, p=0 center dot 048). Black and Asian participants were less likely to report interest in a COVID-19 vaccine (aOR 0 center dot 11 [0 center dot 05, 0 center dot 25], p < 0 center dot 001 and aOR 0 center dot 48 [0 center dot 27, 0 center dot 85] p=0 center dot 012). Black participants were less likely to report interest in participating in a COVID-19 vaccine trial (aOR = 0 center dot 39 [0 center dot 28, 0 center dot 54], p < 0 center dot 001). Black participants were also less likely to report 3 or more daily emotional impacts of COVID-19 (aOR = 0 center dot 66 [0 center dot 53, 0 center dot 82], p=< 0 center dot 001). Black participants were additionally less likely to report burnout (aOR = 0 center dot 66 ([0 center dot 49, 0 center dot 95], p=0 center dot 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. Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)