STREET SMART ECONOMICS | By protecting themselves, workers can better protect the people they serve
We need strong unions, all of us. Tragically, although perhaps not surprisingly, even during the pandemic businesses continue to aggressively resist worker attempts at unionization.
Here is one example of what is at stake: A study of New York state nursing homes published in Health Affairs found that mortality rates from COVID-19 were 30% lower in unionized nursing homes than in facilities without health care worker unions. By gaining better protection for themselves, unionized workers were also able to better protect the health of those they served. And there is good reason to believe that the health benefits from unionization are not limited to New York state nursing homes.
Although the pandemic makes organizing and solidarity actions more difficult, it is essential that we find effective ways to support worker struggles for strong unions.
Work during the pandemic
Many workers, especially those now celebrated as “essential” or “frontline,” don’t feel safe at work, and for good reason. In Oregon, state officials report that “more than 4,000 workers at 227 worksites or their close companions have contracted the virus,” according to The Oregonian newspaper. While surveys find that many employers have implemented new workplace cleaning procedures, they also find that a large percentage have chosen not to provide their workers with needed personal protective equipment (PPE), including masks and gloves. One reason is that relatively few employers require their use. For example, researchers affiliated with UC Berkeley and UC San Francisco found:
“Mask requirements were vanishingly uncommon across workplaces, at between 2% and 7% in convenience stores, coffee shops, fast food, restaurants, grocery stores, retail, department stores, and big-box stores. Just 12% of those in fulfillment centers reported a mask requirement, which was significantly higher than the 5% of warehouse and delivery workers.”
Adding to the danger, many companies are aggressively trying to keep information about worker infections secret from coworkers and the public. As a writer for Bloomberg Law reported:
“U.S. businesses have been on a silencing spree. Hundreds of U.S. employers across a wide range of industries have told workers not to share information about Covid-19 cases or even raise concerns about the virus, or have retaliated against workers for doing those things, according to workplace complaints filed with the NLRB and the Occupational Safety and Health Administration (OSHA).”
These policies may help the corporate bottom line, but they endanger workers and those they serve, and thereby help to spread the pandemic. And, without unions, workers have limited ways to force their employers to create a safe work environment. One is to file a complaint with the U.S. Occupational Safety and Health Administration. Despite fears of retaliation, many workers have done just that.
According to the Brookings Institution, between April 20 and Aug. 20, total COVID-19 related workplace safety complaints rose by more than 350%. The rise has been greater in Oregon. Oregon OSHA has received more than 11,600 complaints from workers over the past five months, almost six times the typical yearly total.
Unfortunately, these complaints have achieved little. Oregon OSHA has issued few fines, and has yet to issue any regulations that specifically address the pandemic and worker safety—no requirements for employers to notify their workers of COVID-19 exposure, no mandates for masking and distance rules, and no minimum standards for ventilation.
Unions can help
Unions are far from perfect, but they are one of the most effective means workers have to protect their interests, and by extension, those they serve. That point was highlighted in the aforementioned nursing home study, which found that mortality rates from COVID-19 are lower in unionized nursing homes. This is significant because approximately 43% of all reported COVID-19 deaths in the United States have occurred in nursing homes.
The authors of the study, Adam Dean, Atheendar Venkataramani and Simeon Kimmel, focused on nursing homes in the state of New York, which has had over 6,500 COVID-19 nursing home deaths, second only to New Jersey. The authors built a model that attempted to explain the variation in confirmed COVID-19 deaths at these nursing homes with an eye to determining if the presence of a health care union made a difference. In some facilities it was only registered nurses who were unionized, in others it was other health care workers, such as certified nursing assistants, dieticians and sanitation workers who were unionized.
Their cross-section regression model also included a range of non-union variables as possible causes for the variation. These variables included: whether or not a facility had an adequate supply of PPE, including masks, eye shields, gowns, gloves and hand sanitizer; the average age of residents; the Resource Utilization Group Nursing Case Mix Index of resident acuity, which classifies patient care needs based on diagnosis, proposed treatment and level of needed assistance with activities of daily living; occupancy rates; staff-hours to resident-days ratios for RN, CNA and licensed practical nurses; percent of residents whose primary support comes from Medicaid or Medicare; overall 5-star rating; whether the nursing home was part of a chain; whether the nursing home was for-profit or nonprofit; and county-level data on confirmed cases of COVID-19 and population.
Their main finding, confirmed by several sensitivity tests, was that, taking all the other variables into account, the presence of a health care labor union was associated with a 30% relative decrease in the COVID-19 mortality rate compared to facilities without a health care labor union.
In examining possible reasons for this result, they ran two other regressions. One found that the presence of a health care labor union was associated with a 13.8% relative increase in access to N95 masks and a 7.3% relative increase in access to eye shields. The other regression found that the presence of a health care labor union was associated with a 42% relative decrease in the COVID-19 infection rate.
The struggle ahead
Unions are one of the most effective ways for workers to ensure access to critical PPE and implementation of safety regulations — things that, as noted above, workers desperately seek and need. But of course, corporations don’t want to pay the higher costs that come with unionization. They prefer the status quo, where working people are forced to pay far greater costs, individually and collectively. And even in the midst of the pandemic, the National Labor Relations Board (NLRB) continues to pass new rules making it ever more difficult for workers to unionize.
Workers are coming to understand that they cannot rely on OSHA or the NLRB to defend their interests. Thus, growing numbers are bravely engaging in direct action, risking their jobs to fight for their rights and the safety of their families, co-workers and those they serve. We need to find ways to support them and improve the broader environment for organizing and unionizing. A recent Gallup Poll offers one hopeful sign: Public support for unions continues to grow.
Martin Hart-Landsberg is a professor emeritus of economics at Lewis & Clark College. Street Smart Economics is a periodic series written for Street Roots by professors emeriti in economics.
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