Excess mortality associated with the COVID-19 pandemic among Californians 18–65 years of age, by occupational sector and occupation: March through November 2020
Open accessPublished version of a preprint
Abstract
Background: Though SARS-CoV-2 outbreaks have been documented in occupational settings and in-person essential work has been suspected as a risk factor for COVID-19, occupational differences in excess mortality have, to date, not been examined. Such information could point to opportunities for intervention, such as vaccine prioritization or regulations to enforce safer work environments. Methods and findings: Using autoregressive integrated moving average models and California Department of Public Health data representing 356,188 decedents 18–65 years of age who died between January 1, 2016 and November 30, 2020, we estimated pandemic-related excess mortality by occupational sector and occupation, with additional stratification of the sector analysis by race/ethnicity. During these first 9 months of the COVID-19 pandemic, working-age adults experienced 11,628 more deaths than expected, corresponding to 22% relative excess and 46 excess deaths per 100,000 living individuals. Sectors with the highest relative and per-capita excess mortality were food/agriculture (39% relative excess; 75 excess deaths per 100,000), transportation/logistics (31%; 91 per 100,000), manufacturing (24%; 61 per 100,000), and facilities (23%; 83 per 100,000). Across racial and ethnic groups, Latino working-age Californians experienced the highest relative excess mortality (37%) with the highest excess mortality among Latino workers in food and agriculture (59%; 97 per 100,000). Black working-age Californians had the highest per-capita excess mortality (110 per 100,000), with relative excess mortality highest among transportation/logistics workers (36%). Asian working-age Californians had lower excess mortality overall, but notable relative excess mortality among health/emergency workers (37%), while White Californians had high per-capita excess deaths among facilities workers (70 per 100,000). Conclusions: Certain occupational sectors are associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through vaccination and strict enforcement of health orders in workplace settings.
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Black and Hispanic workers in low-wage, often consumer-facing, positions have notably high rates of COVID-19 mortality.
“Black and Hispanic workers in low-wage, often consumer-facing, positions, have notably high rates of COVID-19 mortality [6].”
From Parental and Other Caregiver Loss Due to COVID-19 in the United States: Prevalence by Race, State, Relationship, and Child Age (2023) · cites this paper as [6]
The Results report notably high pandemic-related excess mortality among Black and Latino Californians in several occupational sectors, and the Discussion notes that essential sectors include many low-wage workers. The study does not establish mortality rates specifically for low-wage, consumer-facing Black and Hispanic workers; it measures excess deaths during the pandemic rather than COVID-19 deaths specifically. The passages supplied do not provide page numbers. (LLM, conf=0.84)
Experimental — accuracy not yet measuredCaregiver loss is even more heavily concentrated in vulnerable populations than shown in our results.
“Our ability to observe more specific geographic and demographic disparities is constrained by the limitations of available data, but we can infer from other analyses that caregiver loss is even more heavily concentrated in vulnerable populations than shown in our results.”
From Parental and Other Caregiver Loss Due to COVID-19 in the United States: Prevalence by Race, State, Relationship, and Child Age (2023) · cites this paper as [6]
The Results and Discussion report disproportionate excess mortality among Black and Latino working-age Californians and workers in several essential sectors. The paper does not measure caregiver loss or compare its concentration in vulnerable populations with the citing authors’ results, so it supports the inference’s mortality premise but not the stated conclusion. (LLM, conf=0.78)
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Cites
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Occupation and risk of severe COVID-19: prospective cohort study of 120,075 UK Biobank participantsPreprint
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“In addition, Black and Hispanic workers in low-wage, often consumer-facing, positions, have notably high rates of COVID-19 mortality [6].”
Background
- Authors
- Chen, Y.-H., Glymour, M., Riley, A., Balmes, J., Duchowny, K., Harrison, R., Matthay, E., & Bibbins-Domingo, K.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Chen, Yea-Hung
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2021-06-04
- Volume
- 16
- Issue
- 6
- Pages
- e0252454
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC8177528
- OpenAlex
- W3164915915
- Cited by
- 267
- References
- 16
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 32 · 2023: 54 · 2022: 85 · 2021: 71
- FWCI
- 23.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- medRxiv (acceptedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- UCSF Chancellors Fund
- Topics
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Challenges
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 pandemic, excess mortality, occupational differences, occupational sectors, occupation, working-age adults, racial and ethnic disparities, industrial workers, essential work, California, COVID-19 vaccine prioritization, occupational safety regulations, Latino workers, Black workers, Asian workers, white workers, health equity
- MeSH terms
- COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, California, Ethnicity, Female, Humans, Male, Middle Aged, Occupations, Racial Groups, Pandemics
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