Impacts of economic inequality on healthcare worker safety at the onset of the COVID-19 pandemic : cross-sectional analysis of a global survey

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dc.contributor.authorHarrigan, Sean P
dc.contributor.authorTsang, Vivian W L
dc.contributor.authorYassi, Annalee
dc.contributor.authorZungu, Muzimkhulu
dc.contributor.authorSpiegel, Jerry M
dc.date.accessioned2022-10-18T11:47:55Z
dc.date.available2022-10-18T11:47:55Z
dc.date.issued2022-09-06
dc.description.abstractObjectives To assess the extent to which protection of healthcare workers (HCWs) as COVID-19 emerged was associated with economic inequality among and within countries. Design Cross-sectional analysis of associations of perceptions of workplace risk acceptability and mitigation measure adequacy with indicators of respondents’ respective country’s economic income level (World Bank assessment) and degree of within-country inequality (Gini index). Setting A global self-administered online survey. Participants 4977 HCWs and healthcare delivery stakeholders from 161 countries responded to health and safety risk questions and a subset of 4076 (81.2%) answered mitigation measure questions. The majority (65%) of study participants were female. Results While the levels of risk being experienced at the pandemic’s onset were consistently deemed as unacceptable across all groupings, participants from countries with less income inequality were somewhat less likely to report unacceptable levels of risk to HCWs regarding both workplace environment (OR=0.92, p=0.012) and workplace organisational factors (OR=0.93, p=0.017) compared with counterparts in more unequal national settings. In contrast, considerable variation existed in the degree to which mitigation measures were considered adequate. Adjusting for other influences through a logistic regression analysis, respondents from lower middle-income and low-income countries were comparatively much more likely to assess both occupational health and safety (OR=10.91, p≤0.001) and infection prevention and control (IPC) (OR=6.61, p=0.001) protection measures as inadequate, despite much higher COVID-19 rates in wealthier countries at the time of the survey. Greater within-country income inequality was also associated with perceptions of less adequate IPC measures (OR=0.94, p=0.025). These associations remained significant when accounting for country-level differences in occupational and gender composition of respondents, including specifically when only female care providers, our study’s largest and most at-risk subpopulation, were examined. Conclusions Economic inequality threatens resilience of health systems that rely on health workers working safely to provide needed care during emerging pandemics.en
dc.format.mimetypeapplication/pdf
dc.identifier.urihttp://hdl.handle.net/10625/61578
dc.language.isoen
dc.publisherBMJ Openen
dc.relation.journalBMJ Open
dc.relation.urihttp://dx.doi.org/10.1136/bmjopen-2022-064804
dc.subjectCOVID-19en
dc.subjectECONOMIC DISPARITYen
dc.subjectHEALTHCARE WORKERSen
dc.subjectRISKen
dc.subjectWORKING CONDITIONSen
dc.subjectPANDEMICen
dc.subjectGLOBALen
dc.titleImpacts of economic inequality on healthcare worker safety at the onset of the COVID-19 pandemic : cross-sectional analysis of a global surveyen
dc.typeJournal Articleen
idrc.copyright.holder©2022, HARRIGAN SEAN , TSANG VWL , YASSI ANNALEE , ZUNGU MUZIMKHULU , SPIEGEL JERRY M.
idrc.copyright.oapermissionsourceCC BY 4.0en
idrc.dspace.accessOpen Accessen
idrc.project.componentnumber109552001
idrc.project.number109552
idrc.project.titleProtecting Healthcare workers from COVID-19en
idrc.rims.adhocgroupIDRC SUPPORTEDen

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