COVID-19 has been particularly dangerous for the elderly, men, ethnic minorities and people with low educational attainment or existing illnesses. We also know that occupations such as frontline health workers and bus drivers have higher rates of infection. However, less is known about occupational differences in COVID-19 mortality. A new study by Sunnee Billingsley, Maria Brandén, Siddartha Aradhya, Sven Drefahl, Gunnar Andersson and Eleonora Mussino (Stockholm University Demography Unit, Department of Sociology, Stockholm University) examines inequalities in COVID-19 mortality according to working-age individuals’ occupations as well as the indirect effect of occupation on COVID-19 mortality of older individuals with whom they live.
Using data from the first year of the pandemic in Sweden, they conduct the first large-scale population-level study on this topic. The time period covered in the study includes three waves of the pandemic with only low vaccination rates towards the end of the observation period. Vaccinations may play a more decisive role in mortality patterns in the future.
The authors show that people who work as taxi or bus drivers, cleaners or in services were overrepresented among those who have died from COVID-19. But, when taking other measures into account including income, education and country of birth, COVID-19 mortality was not linked to occupation for working-aged adults.
One possible explanation for the fact that occupational exposure and contact with others was not related to COVID-19 mortality could be due to protective measures being used by the people with the riskiest jobs. Another possible explanation might be related to Sweden having fewer restrictions than the majority of other countries. Since there was no lockdown, people generally continued to work, visit restaurants and take public transportation without masks, which could have lessened the role of certain workplaces as a main transmission site.
Concerning indirect effects, elderly people, living with individuals in occupations where working from home is uncommon or who worked in delivery or postal services, had a higher risk of dying from COVID-19. Even if the elderly may have limited their engagement with others to protect themselves during the pandemic, they were put at risk by workers in their homes and this risk persisted even when their socioeconomic factors were taken into account.
The finding that socioeconomic status better explained the risk of dying from COVID-19 than the work situation points to health inequalities playing a major role. Likewise, the lack of a relationship between COVID-19 mortality for workers and their occupations is something that future research should dig deeper into. According to the authors, it is important to know the sources of vulnerability for COVID-19 mortality. Better protection and information can be disseminated to the people most at risk, where we know there is a high concentration of people with socioeconomic risk factors and older people who live with others whose jobs seem to pose a higher risk.