Inequality in the middle of a crisis: an analysis of health workers during the COVID-19 pandemic from the profession, race, and gender perspectives

Magri, Giordano; Fernandez, Michelle; Lotta, Gabriela

doi:10.1590/1413-812320222711.01992022

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ARTICLE • Ciênc. saúde coletiva 27 (11) • Nov 2022 • https://doi.org/10.1590/1413-812320222711.01992022EN linkcopy

Inequality in the middle of a crisis: an analysis of health workers during the COVID-19 pandemic from the profession, race, and gender perspectives

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Studies show that people in vulnerable conditions and some social groups such as women and black people have suffered more intensely from the COVID-19 pandemic impacts. This expression of inequality also manifests itself among healthcare workers, with greater exposure of some specific groups. This paper analyzes the effect of COVID-19 on health care workers and the working conditions in the Brazilian public health system, analyzed from professional, gender, and race perspectives. Data were collected from an online survey of 1,829 health workers conducted in March 2021. Indeed, we identified inequalities in health workers’ experiences during the health crisis generated by COVID-19, which are marked by the profession of each worker and are traversed by their gender and race traits.

Key words:
Health worker; Inequality; Gender; Race; COVID-19

Themes	Questions	Variable type	Possible answer
Organizational conditions	Do you feel prepared to address the coronavirus crisis?	Closed-ended and binary	Yes/No
	What else contributes to you feeling that way [concerning preparation]?	Open-ended	Open-ended
	Have you received the necessary equipment to protect yourself?	Closed-ended and multiple-choice	- I did not receive - I received a few times - I received continuously
	Have you received training to address the COVID-19 crisis?	Closed-ended and binary	Yes/No
	Did you receive testing material at your workplace?	Closed-ended and multiple-choice	- I did not receive - I received a few times - I received continuously
	Does your direct supervisor support you?	Closed-ended and binary	Yes/No
Emotions and mental health	Are you afraid of the Coronavirus?	Closed-ended and binary	Yes/No
	Do you believe your mental health has been affected by the pandemic?	Closed-ended and binary	Yes/No
	Did you receive any support to take care of your mental health?	Closed-ended and binary	Yes/No
	Who do you turn to when you have mental health problems?	Closed-ended and multiple-choice	- Family - Mental health professionals (psychologists, psychiatrists) - Religious guide (pastor, priest, African religion priest, or other) - Friends - Coworkers - Boss/Supervisor - Nobody - Other
	What personal emotions did you/do you feel during the pandemic?	Closed-ended and multiple-choice	- Fear - Distance/coldness - Indifference - Sadness - Hopelessness - Loneliness - Empathy - Rage - Stress/anxiety - Recognition - Hope - Fatigue - Other
Exposure to violent situations	Were you morally harassed during the pandemic?	Closed-ended and multiple-choice	- No - Yes, it is the same as before the pandemic - Yes, it increased with the pandemic - Yes, it started with the pandemic
Exposure to violent situations	Who abused you?	Closed-ended and multiple-choice	- Boss - Colleagues - Rulers - Service users - Family members of users - People on the streets - Others

Total respondents	ACS/ACE	Physicians	Nursing workers	Other
	N (%)	N (%)	N (%)	N (%)
	945 (51.7)	198 (10.8)	315 (17.2)	371 (20.3)
Gender
Female	709 (75,0)	140 (70,7)	290 (92,1)	291 (78,4)
Male	235 (24,9)	58 (29,3)	25 (7,9)	76 (20,5)
Did not answer	1 (0,1)	0 (0)	0 (0)	4 (1,1)
Skin color/race
White	265 (28)	156 (78,8)	185 (58,7)	230 (62)
Brown	557 (58,9)	32 (16,2)	102 (32,4)	105 (28,3)
Black	109 (11,5)	1 (0,5)	22 (7)	19 (5,1)
Yellow	10 (1,1)	8 (4)	3 (1)	12 (3,2)
Indigenous	3 (0,3)	0 (0)	3 (1)	1 (0,3)
Did not declare	1 (0,1)	1 (0,5)	0 (0)	4 (1,1)
Region
Midwest	50 (5,3)	12 (6,1)	25 (7,9)	22 (5,9)
Northeast	643 (68)	23 (11,6)	51 (16,2)	75 (20,2)
North	62 (6,6)	2 (1)	15 (4,8)	11 (3)
Southeast	103 (10,9)	146 (73,7)	151 (47,9)	173 (46,6)
South	87 (9,2)	15 (7,6)	73 (23,2)	90 (24,3)
Service
Primary Care	945 (100)	44 (22,2)	106 (33,7)	123 (33,2)
Specialized Care	0 (0)	48 (24,2)	37 (11,7)	68 (18,3)
Hospital Care	0 (0)	86 (43,4)	141 (44,8)	76 (20,5)
Management	0 (0)	2 (1)	3 (1)	10 (2,7)
Others	0 (0)	18 (9,1)	28 (8,9)	94 (25,3)
Age
19-29 years	51 (5.4)	21 (10.6)	32 (10.2)	46 (12.4)
30-39 years	278 (29.4)	49 (24.7)	124 (39.4)	118 (31.8)
40-49 years	402 (42.5)	43 (21.7)	96 (30.5)	115 (31)
50-59 years	195 (20.6)	53 (26.8)	51 (16.2)	69 (18.6)
60-69 years	18 (1.9)	27 (13.6)	11 (3.5)	23 (6.2)
70-79 years	1 (0.1)	5 (2.5)	1 (0.3)	0 (0)

	Black women	White women	Black men	White men	ACS/ACE	Nursing workers	Physician	Others
Does not feel prepared	78.2%	66.4%	65.0%	56.1%	79.0%	59.4%	56.6%	63.1%
Received PPE on an ongoing basis	42.6%	57.9%	38.1%	57.9%	34.1%	69.5%	64.1%	63.3%
Received training	20.9%	31.6%	22.0%	43.9%	14.5%	44.8%	46.0%	35.6%
Received testing on an ongoing basis	11.5%	18.3%	13.9%	22.6%	9.3%	24.7%	26.7%	16.4%
Received support from superiors	45.9%	47.2%	52.0%	53.7%	44.8%	50.8%	50.5%	51.8%
Claims to be afraid of COVID-19	89.6%	87.8%	83.9%	84.2%	90.1%	82.9%	78.8%	90.0%
Mental health was affected	81.7%	85.4%	64.6%	70.1%	75.1%	85.1%	85.4%	86.3%
Harassment increased during the pandemic	18.0%	19.0%	17.0%	18.0%	16.3%	24.4%	17.2%	20.2%

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