Region, ethnicity and deprivation linked to increase risk of dying from COVID-19

London School of Hygiene & Tropical Medicine

New study further evidence that occupations involving contact with COVID-19 patients or the public also at higher risk

Occupations such as security guards, taxi drivers and customer service workers have been linked with an increased risk of dying from COVID-19, in a new preliminary study.

However, the research, not yet peer reviewed, crucially estimates that these increased risks almost disappear when factors such as region, ethnicity and deprivation are taken into account. This suggests that differences in risk between occupations are a result of a complex mix of different circumstances, including factors outside of work as well as workplace exposures.

The research was led by a team from the London School of Hygiene & Tropical Medicine, the Office for National Statistics, and University of Manchester.

The article estimates occupational differences in COVID-19 mortality and investigates how much these differences change once adjusting for factors such as regional differences, ethnicity and education or non-workplace factors, like deprivation or pre-pandemic health.

The study involved linking the 2011 Census to deaths during 2020. This created a cohort of about 14 million people of working age, with detailed information on factors such as ethnicity and deprivation.

The study confirms previous findings that a number of occupations showed strongly increased risks for COVID-19 deaths, including security guards, taxi drivers, bus drivers, cleaners, and customer service workers. These occupations had risks of COVID-19 deaths of about 3-4 times greater than for managers. However, these relative risks reduced substantially to about 1.5 times higher after adjustment for region, deprivation and ethnicity.

Professor Neil Pearce from the London School of Hygiene & Tropical Medicine and senior author on the study said: “Workers in jobs with low pay and insecure conditions may live in crowded conditions at home, may need to use public transport, and may not be able to afford to self-isolate. Our work suggests that, for some jobs, these factors may be as important, or even more important for COVID-19 transmission than what happens at work.

“In contrast, occupations such as health care and social care still show increased risks even after adjustment for deprivation, indicating that for these jobs exposure to COVID-19 at work is still the main risk factor.”

Vahe Nafilyan from the Office for National Statistics and study lead author said: “For most occupations, factors such as your ethnicity, your education, how much you earn and where you live explained around 70% to 80% of the increased risk of dying. However, there was a notable exception for health professionals, where socio-economic factors did not explain the increased risk. This suggests workplace exposure was a bigger factor in the elevated risk of health professionals dying due to COVID-19.”

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