Dive Brief:
- In New York state nursing homes, the presence of a healthcare union was associated with a 30% relative decrease in COVID-19 deaths and a 42% relative decrease in infections compared to nursing homes without a union, a Health Affairs study published late last week found.
- Unions were associated with greater access to personal protective equipment, too. Those at unionized nursing homes had greater access to N95 masks and eye shields, according to the report.
- The authors concluded that healthcare worker unionization "may play an important role in ensuring access to appropriate PPE and implementing infection control policies that protect vulnerable nursing home residents."
Dive Insight:
The COVID-19 pandemic has hit nursing homes brutally due to their vulnerable populations and close living quarters. More than 40% of reported COVID-19 deaths in the U.S. occurred in nursing homes, according to the Health Affairs report.
Adam Dean, co-author and assistant professor of political science at George Washington University, said early research focused on facilities' quality ratings and local levels of COVID-19 spread to explain why certain nursing homes fared far worse than others across early hotspot states.
He and other Health Affairs researchers looked at New York specifically, and were able to link another factor to mortality rates at similar facilities in the same region — union status.
Looking at mortality, their sample included 355 nursing homes across the state. About half, or 246 facilities, had healthcare worker unions. The majority of those unionized employees are represented by Service Employees International Union. Others are members of the New York State Nurses Association and Teamsters.
Their findings suggest those labor unions performed some functions that reduced COVID-19 deaths among their patient population. Beyond holding protests and vigils and gathering data on unsafe working conditions to raise awareness, they took legal action demanding employers offer more protections, Dean said.
He was wary though to apply the findings to other settings, such as hospitals, without further research.
As he and the other authors wrote, "more research is needed to understand the numerous mechanisms through which unions may influence COVID-19 mortality rates, such as staff training, reducing use of part-time workers, implementing infection protocols, and giving workers a collective voice in the workplace."
Unionized facilities in the study were more likely to be for-profit and less likely to be associated with a chain. They also had lower staffing ratios and were located in metro areas with higher levels of COVID-19 spread, according to the report.
Healthcare labor unions have been active throughout the pandemic, holding protests and other events, often over PPE and staffing concerns. Some with expired contracts have gone on strike, including nurses and service workers on strike this week at University of Illinois Hospital in Chicago.