abstract: 'Background The COVID-19 pandemic has disproportionately impacted

  economically-disadvantaged populations in the United States (US).

  Precarious employment conditions may contribute to these disparities by

  impeding workers in such conditions from adopting COVID-19 mitigation

  measures to reduce infection risk. This study investigated the

  relationship between employment and economic conditions and the adoption

  of COVID-19 protective behaviors among US workers during the initial

  phase of the COVID-19 pandemic. Methods Employing a social media

  advertisement campaign, an online, self-administered survey was used to

  collect data from 2,845 working adults in April 2020. Hierarchical

  generalized linear models were performed to assess the differences in

  engagement with recommended protective behaviors based on employment and

  economic conditions, while controlling for knowledge and perceived

  threat of COVID-19, as would be predicted by the Health Belief Model

  (HBM). Results Essential workers had more precarious employment and

  economic conditions than non-essential workers: 67\% had variable

  income; 30\% did not have paid sick leave; 42\% had lost income due to

  COVID-19, and 15\% were food insecure. The adoption of protective

  behaviors was high in the sample: 77\% of participants avoided leaving

  home, and 93\% increased hand hygiene. Consistent with the HBM, COVID-19

  knowledge scores and perceived threat were positively associated with

  engaging in all protective behaviors. However, after controlling for

  these, essential workers were 60\% and 70\% less likely than

  non-essential workers, who by the nature of their jobs cannot stay at

  home, to stay at home and increase hand hygiene, respectively.

  Similarly, participants who could not afford to quarantine were 50\%

  less likely to avoid leaving home (AOR: 0.5; 95\% CI: 0.4, 0.6) than

  those who could, whereas there were no significant differences

  concerning hand hygiene. Conclusions Our findings are consistent with

  the accumulating evidence that the employment conditions of essential

  workers and other low-income earners are precarious, that they have

  experienced disproportionately higher rates of income loss during the

  initial phase of the COVID-19 pandemic and face significant barriers to

  adopting protective measures. Our findings underscore the importance and

  need of policy responses focusing on expanding social protection and

  benefits to prevent the further deepening of existing health disparities

  in the US.'
affiliation: 'Tozan, Y (Corresponding Author), NYU, Sch Global Publ Hlth, Global \&
  Environm Hlth Program, 708 Broadway, New York, NY 10003 USA.

  Capasso, Ariadna; Ali, Shahmir H.; DiClemente, Ralph J., NYU, Sch Global Publ Hlth,
  Dept Social \& Behav Sci, New York, NY 10003 USA.

  Kim, Sooyoung, NYU, Sch Global Publ Hlth, Dept Hlth Policy \& Management, New York,
  NY 10003 USA.

  Jones, Abbey M., NYU, Sch Global Publ Hlth, Dept Epidemiol, New York, NY 10003 USA.

  Tozan, Yesim, NYU, Sch Global Publ Hlth, Global \& Environm Hlth Program, 708 Broadway,
  New York, NY 10003 USA.'
article-number: '870'
author: Capasso, Ariadna and Kim, Sooyoung and Ali, Shahmir H. and Jones, Abbey M.
  and DiClemente, Ralph J. and Tozan, Yesim
author-email: tozan@nyu.edu
author_list:
- family: Capasso
  given: Ariadna
- family: Kim
  given: Sooyoung
- family: Ali
  given: Shahmir H.
- family: Jones
  given: Abbey M.
- family: DiClemente
  given: Ralph J.
- family: Tozan
  given: Yesim
da: '2023-09-28'
doi: 10.1186/s12889-022-13259-w
eissn: 1471-2458
files: []
journal: BMC PUBLIC HEALTH
keywords: 'COVID-19; Essential workers; Risk of infection; Health Belief Model;

  Employment conditions; Economic precarity; Precarious employment; Health

  disparities; Social determinants of health'
keywords-plus: BELIEF MODEL; SAMPLE; ACCESS; CARE
language: English
month: MAY 2
number: '1'
number-of-cited-references: '54'
orcid-numbers: Ali, Shahmir/0000-0002-0360-3507
papis_id: 4796cfaa5a57dcd5a7810a9ca74bf5c3
ref: Capasso2022employmentconditions
researcherid-numbers: Ali, Shahmir/G-4495-2018
times-cited: '3'
title: 'Employment conditions as barriers to the adoption of COVID-19 mitigation measures:
  how the COVID-19 pandemic may be deepening health disparities among low-income earners
  and essential workers in the United States'
type: Article
unique-id: WOS:000789819200007
usage-count-last-180-days: '0'
usage-count-since-2013: '4'
volume: '22'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2022'