Outbreaks of coronavirus disease 2019 (COVID-19) among food production workers may worsen the pandemic’s disproportionate effects on people of color and increase underlying health, economic, and social disparities, according to an analysis from the Kaiser Family Foundation (KFF).
Numerous COVID-19 outbreaks in meat and poultry processing plants erupted not long after cases emerged in the United States. On May 1, a study published by the Centers for Disease Control and Prevention (CDC) said that 19 states had reported 4913 cases and 20 deaths among approximately 130 000 workers at 115 meat and poultry processing facilities.
Such facilities have distinctive factors that affect workers’ risk for exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). These factors include prolonged closeness to other workers for long shifts of up to 12 hours, exposure to potentially contaminated shared surfaces (such as workstations or break room tables) or objects (such as tools), and close contact during transportation to and from work, such as in ride-share vans, carpools, or public transportation.
More recently, according to a report by Reuters, although social distancing may be less of an issue for agricultural workers who work outside harvesting fruits and vegetables in fields, facilities that package foods have conditions similar to those of meat and poultry processing plants and are emerging as hot spots for SARS-CoV-2 spread. In their review of data from county officials, Reuters found that the majority of the more than 600 cases of COVID-19 tallied by late May among agricultural workers in Yakima County, Washington, were workers in the apple industry and other packing operations or warehouses.
In the KFF analysis, Samantha Artiga, MHSA, and Matthew Rae, MPA, MPH, examined key characteristics of the 3.4 million people who work in US food production industries, including meat and poultry processors, seafood producers, fruit and vegetable producers, crop production, and other food manufacturing businesses. Their goal was to identify those who are affected by risks posed by COVID-19 and consider the health and financial implications of the pandemic to these workers and their communities.
Their findings indicate that COVID-19 outbreaks among food production workers “may exacerbate the disproportionate impact COVID-19 is having on people of color and widen underlying health, social, and economic disparities,” the authors noted.
The federal government has designated the food and agricultural sector as part of the “essential critical infrastructure,” industries that “have a special responsibility in these times to continue operations.” A Presidential Executive Order issued April 28 invoked the Defense Production Act to keep meat processing plants open. Moreover, on May 19, the US Department of Agriculture and the US Food and Drug Administration said the federal government could authorize similar actions to keep companies that manufacture, process, pack, hold, or grow or harvest food open and running.
The KFF analysis found that although the majority (51%) of food production workers are white and US citizens, this sector has disproportionately larger shares of Hispanic and noncitizen workers than in the US workforce overall. About one-third of food production workers are Hispanic (whereas Hispanic worker comprise about 17% of the US labor force overall), and 22% are noncitizens (compared with 8% of noncitizens in the US workforce overall). One in 4 food production workers is less than fluent in English.
Food production workers are more likely to work full time compared with all workers (82% vs 76%), the authors found. Despite this, compared with workers overall, they are also likelier to have a household income below 200% of the federal poverty level (29% vs 19%)—that is, an income (in 2020) of less than $12 760 for an individual or $26 200 for a family of 4. Food production workers are, compared with workers overall, also more likely to live in a rural area (29% vs 13%) and be uninsured (17% vs 10%).
“These findings show that many food production workers have limited ability to absorb income decreases, creating disincentives for them to miss work even if they feel ill and increasing the risk of them experiencing financial challenges if they do miss work,” the authors wrote.
The relatively high proportion of food production workers who are not US citizens face additional challenges: restrictions on eligibility to access public programs and federal financial subsidies, increased barriers to testing and treatment due to their relatively higher uninsured rate, and perhaps barriers to care because of fears related to immigration status.
Outbreaks among food production workers also may pose challenges to the rural communities where many of them live, especially because such areas have a relatively limited hospital capacity and populations that are older and more likely to be affected by underlying health conditions.
The authors also cite the importance of providing outreach and education to this diverse workforce in linguistically and culturally appropriate ways. The CDC advises periodic infection control and occupational safety and health training tailored to the literacy levels and preferred languages of workers and supervisors.
Addressing the needs of food production workers “may help protect the health and financial stability of workers themselves, but also plays a role in preventing widening of underlying racial and ethnic disparities in health, social, and economic factors given the diversity of the food production workforce,” the report noted.
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Joan Stephenson, PhD Joan Stephenson, PhD, is Consulting Editor for the Forum and JAMA and an award-winning independent writer and editor based in Chicago. She joined JAMA as a writer and editor for JAMA's Medical News & Perspectives department and subsequently served...