Introduction
Throughout states, well being and long-term care employees and residents have been the primary teams supplied COVID-19 vaccines, according to federal suggestions. Earlier KFF evaluation estimated that, nationwide, 19.7 million adults work in well being and long-term care settings, of which roughly 15.5 million are estimated to have direct affected person contact and be included within the preliminary precedence group for vaccination. Media studies recommend that the preliminary vaccination efforts have been slower than anticipated and that some well being care employees who’ve been supplied the vaccine have chosen to not get vaccinated, notably amongst workers in long-term care amenities. Extra data is required to know why some well being care employees are declining the vaccine, though there are anecdotal studies of considerations about security and/or unintended effects. KFF survey knowledge present that roughly three in ten well being care employees (29%) categorical hesitancy about getting the COVID-19 vaccine and that, amongst all adults, ranges of vaccine hesitancy and causes for hesitancy differ throughout demographic teams.
This evaluation gives an outline of demographic traits and medical insurance protection of well being care employees with direct affected person contact, together with these working in hospital and long-term care settings, who could also be most vulnerable to affected person contact with somebody with coronavirus as a result of focus of instances in these amenities. Elevated understanding of who these well being care employees are might help inform vaccination efforts and forestall disparities in vaccination amongst this group.
Findings
Desk 1 presents knowledge on race/ethnicity, citizenship standing, intercourse, age, training, poverty standing and medical insurance protection for the 15.5 million well being and long-term care employees who’re estimated to have direct affected person contact. It additionally consists of separate knowledge for these working in hospitals and long-term care amenities, who account for 37% and 25% of well being care employees with direct affected person contact, respectively.
General, the info present that, though most of those well being care employees are White (59%) and residents (95%), 41% are individuals of shade and 5% are noncitizens. The bulk are ladies (77%), and almost one in 4 (23%) are age 55 or older. Most have accomplished at the very least some faculty (80%), and, reflecting that they’re all employed, few are low-income (17%) and almost all have medical insurance protection (93%). Hospital employees largely mirror these total patterns, though they’ve increased ranges of training, earnings, and well being protection. Employees in long-term care settings embody increased shares of individuals of shade (52%), non-citizens (8%), ladies (84%), and employees age 55 or above (27%) and have decrease ranges of instructional attainment, decrease incomes, and better uninsured charges in comparison with the general inhabitants of well being care employees with direct affected person contact. Extra detailed findings embody:
Race/ethnicity. Roughly six in ten well being care employees with direct affected person contact are White (59%), whereas the remaining 41% are individuals of shade, together with 17% who’re Black, 14% who’re Hispanic, and eight% who’re Asian (Determine 1). Amongst these working in long-term care settings, over half (52%) are individuals of shade, together with over one in 4 (28%) who’re Black.
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Citizenship Standing. The big majority of well being care employees with direct affected person contact are residents (95%), whereas 5% are noncitizens (Determine 1). Nevertheless, the share who’re noncitizens is increased, at 8%, amongst these working in long-term care settings.
Intercourse. Over three-quarters (77%) of well being care employees with direct affected person contact are ladies, and this share rises to 84% amongst these working in long-term care settings.
Age. Practically 1 / 4 (23%) of well being care employees with direct affected person contact are age 55 or older, whereas 4 in ten (41%) are age 35-54 and over one-third (35%) are beneath age 35. These working in long-term care settings embody a barely increased share of employees age 55 or above (27%), whereas these working in hospital settings have a barely decrease share of employees age 55 and older (21%).
Training. Eight in ten of well being care employees with direct affected person contact have accomplished at the very least some faculty, together with 45% who’ve a bachelor’s diploma of upper (Determine 1). Training ranges are increased amongst hospital employees, with almost 9 in ten (88%) finishing at the very least some faculty, together with over half (54%) who’ve a bachelor’s diploma or increased. In distinction, amongst these working in long-term care, six in ten have accomplished some faculty, with solely 20% having a bachelor’s diploma or increased and 10% having lower than a highschool training.
Poverty Standing. General, 17% of well being care employees with direct affected person contact are low-income (family earnings lower than 200% of the federal poverty degree (FPL)), with solely 5% with family earnings beneath the poverty degree (Determine 1). Over half (54%) have earnings at 400% FPL or increased. These working in hospitals usually have increased incomes, with almost two-thirds (64%) having family earnings at 400% FPL or increased. Family earnings is decrease amongst these working in long-term care, the place one-third (33%) are low-income, together with 11% who’ve family earnings beneath poverty.
Well being Insurance coverage Protection. Lower than one in ten (7%) well being care employees with direct affected person contact are uninsured (Determine 1). Practically eight in ten (79%) have non-public medical insurance protection, 10% are lined by Medicaid, and 4% have Medicare protection. Protection charges are increased amongst these working in hospitals, with solely 3% uninsured and 90% having non-public protection. In distinction, protection charges amongst these working in long-term care are decrease, with 14% uninsured. Furthermore, they’ve increased charges of Medicaid protection (21%) and decrease charges of personal insurance coverage (60%).
Whole | Working in Hospitals | Working in Lengthy-Time period Care | |
Whole (tens of millions) | 15.5 | 5.8 | 3.8 |
Race/Ethnicity | |||
White | 58.6% | 61.0% | 48.0% |
Black | 16.6% | 14.9% | 27.9% |
Hispanic | 13.8% | 11.9% | 15.1% |
Asian | 8.0% | 9.4% | 5.9% |
American Indian or Alaska Native | 0.5% | 0.4% | 0.6% |
Native Hawaiian or Different Pacific Islander | 0.2% | 0.2% | 0.2% |
A number of Races | 2.2% | 2.2% | 2.4% |
Citizenship Standing | |||
Citizen | 94.8% | 95.7% | 91.7% |
Noncitizen | 5.2% | 4.3% | 8.3% |
Intercourse | |||
Male | 22.6% | 23.6% | 15.7% |
Feminine | 77.4% | 76.4% | 84.3% |
Age | |||
19-25 | 11.1% | 9.8% | 12.5% |
26-34 | 23.9% | 26.3% | 18.8% |
35-54 | 41.8% | 42.5% | 40.8% |
55-64 | 16.9% | 17.1% | 19.2% |
65+ | 5.9% | 4.1% | 7.7% |
Training | |||
Lower than highschool | 3.9% | 2.1% | 9.8% |
Highschool graduate | 16.0% | 9.8% | 29.7% |
Some faculty | 35.6% | 33.7% | 40.0% |
Bachelor’s or increased | 44.6% | 54.4% | 20.5% |
Federal Poverty Degree (FPL) | |||
<100% FPL | 5.4% | 2.8% | 11.5% |
100-199% FPL | 12.0% | 7.5% | 21.5% |
200%-399% FPL | 28.7% | 25.6% | 34.9% |
400%+ FPL | 54.0% | 64.0% | 32.2% |
Well being Protection | |||
Uninsured | 7.2% | 3.1% | 13.6% |
Personal | 78.5% | 89.6% | 59.6% |
Medicaid/Different Public | 10.2% | 5.2% | 20.9% |
Medicare | 4.0% | 2.0% | 5.8% |
Notes: Totals might not sum to 100% as a result of rounding. Individuals of Hispanic origin could also be of any race however are categorized as Hispanic; different teams are non-Hispanic. Medicaid/Different Public consists of these lined by Medicaid, Medical Help, Youngsters’s Well being Insurance coverage Plan (CHIP) or any form of government-assistance plan for these with low incomes or a incapacity; individuals who have each Medicaid and one other kind of protection, equivalent to twin eligibles who’re additionally lined by Medicare; and folks lined below the army or Veterans Administration. Personal consists of these lined by way of a present or former employer or union, both as policyholder or as dependent and people lined by a coverage bought instantly from an insurance coverage firm, both as policyholder or as dependent Supply: KFF Evaluation based mostly on 2019 American Group Survey |
Dialogue
Elevated understanding of who well being care employees with direct affected person contact are might help inform vaccination efforts and forestall disparities in vaccination amongst this group. In sum, these findings present that the roughly 15.5 million well being care employees with direct affected person contact are a racially various workforce. They’re predominantly feminine, with most between ages 35-54. Most have accomplished at the very least some faculty and, reflecting their employment, few are low-income, and the big majority have medical insurance. Nevertheless, these working in long-term care settings usually tend to be Black and have decrease ranges of training, earnings, and insurance coverage protection, which can have implications for entry to the COVID-19 vaccine and willingness to get vaccinated.
KFF survey knowledge present, as of December 2020, roughly one in three grownup well being care employees (29%) stated they in all probability or undoubtedly wouldn’t get vaccinated, just like the share amongst adults total (27%). Knowledge additionally present that ranges of vaccine hesitancy differ throughout demographic teams. For instance, adults age 30-49 and Black adults have comparatively excessive ranges of hesitancy, whereas adults ages 65 and older report larger willingness to get the vaccine. Hesitancy varies amongst well being care employees in comparable methods. For instance, an earlier KFF/The Undefeated survey discovered that, amongst adults who’re well being care employees or who stay in a family with a healthcare employee, Black adults had been a lot much less prone to say they might undoubtedly get vaccinated in comparison with White adults (24% vs. 46%). Furthermore, totally different teams have totally different causes for vaccine hesitancy. For instance, amongst adults total who say they in all probability or undoubtedly gained’t get vaccinated, Black adults are extra doubtless than White adults to quote considerations about unintended effects and the novelty of the vaccine, and about half of Black adults on this group cite worries they could get COVID-19 from the vaccine or that they don’t belief vaccines typically as main causes.
Folks residing in immigrant households and people who find themselves uninsured can also have particular considerations which might make them much less prone to search vaccination. For instance, individuals residing in immigrant households might have considerations about potential unfavorable results on their or a member of the family’s immigration standing. People who find themselves uninsured are much less prone to have a longtime relationship with a well being care supplier and usually have larger considerations about potential prices of well being care.
Addressing considerations and potential entry limitations to vaccination amongst well being care employees might be notably vital since, as one of many first teams supplied the vaccination and a high trusted messenger for data on the COVID-19 vaccine, their experiences and take-up might assist inform most people’s attitudes and willingness to get the vaccine. Collectively these knowledge recommend that offering data to answer considerations about potential unintended effects and security of the vaccine is vital, notably amongst Black well being care employees. Clearly speaking that private data collected for vaccination can’t be used for immigration-related functions might assist scale back fears amongst noncitizen employees. Furthermore, making certain individuals know that they won’t face any prices related to the vaccine might scale back considerations amongst people who find themselves uninsured. Past offering training and data, making the vaccine simply accessible is vital. Whereas many well being care employees are in a position to entry the vaccine instantly by way of their employment web site, making certain it’s obtainable in ways in which accommodate employees’ various schedules, caregiving tasks, and transportation choices might help scale back potential entry limitations amongst those that have to receive it by way of pharmacies or group websites.