Economic Security during the COVID-19 Pandemic: A Healthy Work Design and Well-being Perspective

The COVID-19 pandemic is adversely affecting worker well-being in many ways, including through decreased economic security. Economic aspects of overall health and well-being, along with physical, psychological, and social aspects, are a fundamental focus of the NIOSH Healthy Work Design and Well-being Program (HWD). The mission of HWD is to protect and advance worker safety, health, and well-being by improving the design of work, management practices, and the physical and psychosocial work environment. HWD partners with industry, labor, trade associations, professional organizations, and academia to better understand the ways in which the design of work affects overall health and well-being, and how it can be improved to enable workers to thrive and contribute productively at work, at home, and in society. (Click here to learn more.) This is one in a series of HWD-sponsored blogs on issues related to the pandemic.

While there is no standard definition of economic security, it has been defined to include having adequate income and assets, access to benefits such as paid leave and health insurance, and some control over job content and the opportunity to build a career (Hacker, 2018). Another definition includes individual and collective rights (such as worker rights protected by law and the right to be represented by trade unions), the opportunity for income-earning activities, protection of income-earning work, working conditions that are safe and promote well-being, and the opportunity to gain and retain skills (ILO, 2004). Regardless of how it is defined, economic security is a critical determinant of worker well-being.

NIOSH-sponsored research continues to highlight several ways economic security affects worker well-being, illustrating the holistic perspective of HWD. NIOSH

• assesses health and well-being outcomes for workers and their family members (e.g., seeking medical care), employers, and co-workers (e.g., contracting infections at work),
• links traditional occupational safety and health outcomes (e.g., occupational injuries) with economic factors (e.g., access to paid sick leave), and
• links economic factors (e.g., unemployment, job security, low wages, access to benefits such as paid leave and health insurance) to adverse health and psychological outcomes (e.g., stress, engagement), occupations associated with a high risk of injury, and the design of work arrangements.

Some examples of NIOSH-sponsored research findings that highlight the importance of economic security among workers include:

• Unemployment adversely affects worker health and is a major source of psychological stress (Ray and Sauter, 2012).
• Job security improves worker engagement, which in turn improves their productivity and the health of organizations and communities (Asfaw and Chang, 2019).
• Low wages limit the funds available for food, shelter, and healthcare and adversely affect self-esteem and job satisfaction (Leigh and De Vogli, 2016).
• Access to paid sick leave affects the ability of workers and their families to seek medical care (Asfaw and Colopy, 2017), workers’ ability to take time off to recuperate from illness and avoid occupational injuries (Asfaw et al., 2012), and their ability to reduce the spread of infections at work (Asfaw et al., 2017).
• Fewer than half of workers in agriculture, forestry, fishing, and construction industries had access to paid sick leave in 2018 (Asfaw et al., 2019).
• The percentage of all workers without health insurance decreased from 17.5% in 2010 to 10.9% in 2015. However, in 2015, workers in non-standard work arrangements, such as independent contractors, those working for temporary staffing agencies, and those working “on-call,” were less likely to have health insurance (21% or above) than workers with regular, permanent work arrangements (9.1%) (Luckhaupt et al., 2017).

In addition, research has demonstrated the associations of economic security with suicide, parent’s ability to satisfy children’s needs, and access to adequate housing:

• Unemployment is associated with greater incidence of suicide; the risk is greatest in the first five years and persists for up to 16 years after unemployment (Milner et al. 2013).
• There is strong evidence linking low income to children’s development, academic achievement, and health and evidence that financial security can improve parents’ ability to satisfy children’s basic needs (e.g., food, shelter, medical care) and provide developmentally appropriate child care.
• Economic security is associated with homelessness that can both worsen health and the ability to seek treatment.

During this pandemic, the economic security of millions of workers and their families continues to be severely affected through the temporary or permanent loss of jobs and the related loss of income and access to benefits. Millions of workers have filed for unemployment insurance benefits, and there may be many more unemployed or underemployed workers who haven’t filed. Many of the newly unemployed may not be seeking work due to the lack of job openings or because they hope to return to their previous jobs. Some workers may not file for unemployment benefits because they find the process daunting, slow, or uncertain. In addition, some of those who are currently working may eventually end up losing their jobs because they work for businesses affected by the pandemic. With fewer customers and reduced revenue, businesses may have to close or reduce their number of workers despite the economy reopening. In addition to losing their jobs, newly unemployed workers who had employer-sponsored health coverage will have to continue their coverage by paying the full premium unless they become eligible for other coverage (e.g., through Medicaid). After unemployment benefits end, coverage options become more limited.

Problems with economic security during the COVID-19 pandemic are already evident through data collected through the COVID Impact Survey. The survey is conducted by the National Opinion Research Center at the University of Chicago for the Data Foundation and asks how households experience the pandemic using physical health, economic security, food security, and employment metrics. Data collected in April and May 2020 demonstrate that:

• Despite the economic stimulus effort, respondents in 17% of households in April and 16% in May reported they would not be able to pay for an unexpected $400 expense.
• Respondents in approximately 27% of households worried about having enough food over the past month, and 22% of households reported not being able to afford to buy more food when it runs out. Six percent of respondents also received support from food pantries across the country.
• Both “worry about” and “experience with” food insecurity were higher for respondents without a high school diploma (53% worry, 47% experience), with household incomes less than $30,000 (47%, 41%), and in households with children (36%, 32%) compared to respondents with more education, higher incomes, and no children.

Of those who continue to work during the pandemic, many are unable to work remotely. This distinction has health, social, and economic implications. Those working remotely are less exposed to infection, better able to preserve their economic security, and already earning more than those who are unable to work remotely. During April and May 2020, 57% of those in households earning more than $125,000 per year reported working remotely, only 19% of those in households earning less than $60,000 per year reported having this ability.

Both parents who are unable to work and parents who are able to work are disproportionally affected by daycare and school closures during the pandemic, which in turn increase the need for childcare. Physical distancing restrictions further limit options for childcare that could be provided by extended family and friends. Because women tend to have more childcare duties than men, the pandemic will have a disproportionate negative effect on women and their employment opportunities; these effects are likely to outlast the pandemic (Alon et al., 2020).

Some businesses were able to either stay open or re-open faster than others during the pandemic by redesigning work processes according to infection control recommendations, including social distancing. This allowed some workers to keep their jobs or return to work quickly, preserving their economic security. Some businesses that were unable to remain open have found innovative ways to partially alleviate economic insecurity among their workers during the pandemic. For example, U.S. companies from different industries such as hotels and pharmacies have been coming together to share workers, a practice that is more common in Europe. Expedited hiring of furloughed employees by other companies through these agreements helps businesses to quickly address short-term needs and provides income to workers who would otherwise be unemployed. While it is hard to predict if work sharing will persist beyond the current crisis, this type of non-standard work arrangement remains a focus area of HWD.

Multiple pandemic-related changes affecting worker economic security are taking place simultaneously, rapidly, and on a global scale. This makes it hard to fully assess the long-term effects of these changes for workers, their families and communities, and their employers. While economic security is a determinant of worker well-being regardless of overall economic conditions, the current pandemic provides an opportunity to design strategies both at the policy and the organizational levels that improve both the level and distribution of economic security for all workers, including through adequate income and benefits.

Do you know of any work design practices that have improved economic security during the current pandemic? If so, please share them in the comment section below.

This is a part of the series of blogs sponsored by NIOSH’s Healthy Work Design and Well-Being Program on issues impacted by the COVID-19 pandemic. Other blogs include:

COVID-19 Stress Among Your Workers?  Healthy Work Design and Well-Being Solutions Are Critical

Improve Sleep: Tips to Improve Your Sleep When Times Are Tough

The Role of Organizational Support and Healthy Work Design

Rene Pana-Cryan, PhD, is the Director of the NIOSH Economic Research and Support Office and Co-Manager for the Healthy Work Design and Well-Being Cross-Sector program.

Tapas Ray, PhD, is an Economist in the NIOSH Economic Research and Support Office and Co-Assistant Coordinator of the Healthy Work Design and Well-Being Cross-Sector program.

Tim Bushnell, PhD, MPA, is an Economist in the NIOSH Economic Research and Support Office and Co-Coordinator of the Healthy Work Design and Well-Being Cross-Sector program.

Brian Quay, MS, is an Economist in the NIOSH Economic Research and Support Office and a member of the Steering Committee of the Healthy Work Design and Well-Being Cross-Sector program.

References

Alon TM, Doepke M, Jane Olmstead-Rumsey J, Michèle Tertilt M. April 2020. The impact of cOVID-19 on gender equality. National Bureau of Economic Research Working Paper 26947 (http://www.nber.org/papers/w26947).

Asfaw A, Chang C. 2019. The association between job insecurity and engagement of employees at work. J Workplace Behav Health 34:96-110. https://doi.org/10.1080/15555240.2019.1600409

Asfaw A, Colopy M. 2017. Association between parental access to paid sick leave and children’s access to and use of healthcare services. Am J Ind Med 60(3):276-284.

Asfaw A, Pana-Cryan R, Rosa R. 2012. Paid sick leave and nonfatal occupational injuries. Am J Public Health 102:e59-64.

Asfaw A; Rosa RR; Pana-Cryan R. 2019. QuickStats: percentage of currently employed adults who have paid sick leave, by Industry – National Health Interview Survey, 2009 and 2018. MMWR 68(34):753

Asfaw A, Rosa R, Pana-Cryan R. 2017. Potential economic benefits of paid sick leave in reducing absenteeism related to the spread of influenza-like illness. J Occup Environ Med 59:822-829.

Hacker JS. 2018. Chapter 8, Economic security. In Stiglitz, J, J Fitoussi and M Durand (eds.), For Good Measure: Advancing Research on Well-being Metrics Beyond GDP, OECD Publishing, Paris, https://doi.org/10.1787/9789264307278-en.

International Labour Organization. 2004. Definitions: What we mean when we say “economic security”: https://www.ilo.org/public/english/protection/ses/download/docs/definition.pdf.

Leigh JP; De Vogli R. 2016. Low wages as occupational health hazards. J Occup Environ Med 58(5):444-447.

Luckhaupt SE, Asfaw A, Tamers SL, Su C-p. 2017. QuickStats: percentage of currently employed adults with no health insurance, by type of work arrangement, National Health Interview Survey, 2010 and 2015. MMWR 66(32):864.

Milner A, Page A, LaMontagne AD. 2013. Long-Term Unemployment and Suicide: A Systematic Review and Meta-Analysis. PLoS One 8(1): e51333. doi: 10.1371/journal.pone.0051333

Ray TK, Sauter S. 2012. Economy and work stress: are they related and how? Perspectives on Work, Labor and Employment Relations Association. 2012;15.