Exploring U.S. food system workers’ intentions to work while ill during the early COVID-19 pandemic: a national survey

Abstract

ABSTRACTBackgroundWhile “stay at home” orders were in effect during early phases of the COVID-19 pandemic, many U.S. food workers attended in-person work, charged with maintaining operation of the national food supply chain. Anecdotal evidence suggests that many U.S. food system workers encountered barriers to staying home despite symptomatic COVID-19 illness.MethodsWe conducted a national, cross-sectional, online survey between July 31 to October 2, 2020, among 2,535 respondents. We used multivariable regression and free-text analyses to explore factors associated with U.S. food system workers’ intentions to attend work while ill (i.e., presenteeism intentions) during the first four to six months of the COVID-19 pandemic.ResultsOverall, 8.8% of workers surveyed reported intentions to attend work while symptomatic with COVID-19 disease. Almost half of respondents (41.1%) reported low or very low household food security. Workers reporting a high workplace safety climate score were half as likely to report presenteeism intentions (adjusted odds ratio [aOR] 0.52, 95% confidence interval (CI) 0.37, 0.75) relative to those reporting low scores. Workers reporting low (aOR 2.06, 95% CI 1.35, 3.13) or very low (aOR 2.31, 95% CI 1.50, 3.13) levels of household food security had twice the odds of reporting presenteeism intentions relative to those reporting high/marginal food security.ConclusionsOur findings suggest that workplace culture and safety climate could enable employees to feel like they can take leave when sick during a pandemic, which is critical to individual health and prevention of workplace disease transmission. However, the pressure experienced by food workers to work when ill, especially by those experiencing food insecurity, themselves, underscores the need for strategies which address these vulnerabilities and empower food workers to make health-protective decisions.