Journal of migration and health · 2025
Essential worker status, gender, and migration background disparities in COVID-19: An intersectional approach.
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Ghoroubi Narges, Khlat Myriam, Counil Emilie, EpiCoV Study group
Аннотация
OBJECTIVES: COVID-19 disproportionately hit women, immigrants, ethno-racial minorities, and essential workers. This study examines disparities in SARS-CoV-2 seropositivity by gender and migration background in France (late 2020) and assesses how much essential worker status explains them.
METHODS: We grouped 30,018 workers from the EpiCoV cohort into four categories defined by gender and migration background. Worker status included seven categories: non-essential workers; high- and low-class healthcare workers (HCWs), social and educational workers (SEWs), and other essential workers (OEWs). We assessed SARS-CoV-2 seroprevalence across gender and migration-background groups. Non-linear decomposition analysis quantified the extent to which significant seropositivity differences were driven by unequal representation in essential occupations and varying infection risk within similar essential occupations.
RESULTS: SARS-CoV-2 seropositivity was lowest among men without a migration background, higher among women without a migration background, and highest among individuals with a migration background. Compared to men without a migration background, seropositivity was 1.6 percentage points higher among women without a migration background (43.7% attributed to overrepresentation among HCWs and 5.8% to greater risk within low-class HCWs), and 6.9 percentage points higher among women with a migration background (31.5% driven by their overrepresentation among HCWs and low-class SEWs, and 19.4% by stronger risks across low-class essential jobs). The 5.3-point seropositivity gap between women with and without a migration background was 33.4% attributable to stronger infection risks among low-class SEWs and low-class OEWs.
CONCLUSIONS: Women bore a double burden exacerbated by their migration background: overrepresentation in certain essential jobs and elevated COVID-19 risk within these occupations.
METHODS: We grouped 30,018 workers from the EpiCoV cohort into four categories defined by gender and migration background. Worker status included seven categories: non-essential workers; high- and low-class healthcare workers (HCWs), social and educational workers (SEWs), and other essential workers (OEWs). We assessed SARS-CoV-2 seroprevalence across gender and migration-background groups. Non-linear decomposition analysis quantified the extent to which significant seropositivity differences were driven by unequal representation in essential occupations and varying infection risk within similar essential occupations.
RESULTS: SARS-CoV-2 seropositivity was lowest among men without a migration background, higher among women without a migration background, and highest among individuals with a migration background. Compared to men without a migration background, seropositivity was 1.6 percentage points higher among women without a migration background (43.7% attributed to overrepresentation among HCWs and 5.8% to greater risk within low-class HCWs), and 6.9 percentage points higher among women with a migration background (31.5% driven by their overrepresentation among HCWs and low-class SEWs, and 19.4% by stronger risks across low-class essential jobs). The 5.3-point seropositivity gap between women with and without a migration background was 33.4% attributable to stronger infection risks among low-class SEWs and low-class OEWs.
CONCLUSIONS: Women bore a double burden exacerbated by their migration background: overrepresentation in certain essential jobs and elevated COVID-19 risk within these occupations.