IN THE WRONG PLACE?: GEOGRAPHIC VARIATION IN U.S. OCCUPATIONAL INJURY / ILLNESS RATES

BACKGROUND: Around the world and across U.S. counties, workers and businesses operate in a diverse landscape of demographics, economy, culture, policy and industry. This dissertation presents four papers exploring geographic variation in U.S. occupational injury/illness rates. METHODS: The literature on geographic variation in occupational injury/illness is reviewed and categorized. Three papers examine geographic variation in the OSHA Data Initiative (ODI), 1997-2001, a database of high injury/illness industries. The first presents surveillance tools including mapping, spatial statistics, and ranking. The second uses multilevel regression to examine social determinants of county-level variation in lost workday injury/illness rates (LWDII). Finally, a case study of the meat processing industry uses mapping and regression to explore risk factors associated with both establishment location and high-LWDII establishments. RESULTS: 1) There is a small, uncoordinated literature using geographic methods to examine occupational injury/illness. 2) There is geographic variation in occupational injury/illness rates. The sample mean LWDII was 7.22 per 100 workers (county range: 0, 25.2). The five highest rate states were Vermont (9.77), West Virginia (9.76), Michigan (9.67), Maine (9.54) and Kentucky (8.99). Rates were low throughout the South. 3) Geographic variation was associated with social risk factors. In regressions, high rates were positively associated with county poverty, percent Caucasian, unionization, strong safety net, and industry hazard. Meat establishment locations were associated with county percent African American, non-college educated, longterm job gain, and urbanicity, plus iii state-level anti-union policy, medium union membership, and slightly reduced OSHA inspections. By contrast, high-LWDII meat establishments were associated with county percent Caucasian, low income, high school education, and longterm job loss. 4) There is suggestive evidence of substantial, biased underreporting in the ODI. CONCLUSIONS: Explanations for the findings are discussed. Recommendations focus on addressing underreporting, generating more county-level occupational injury/illness data, promoting county-level surveillance, increasing geographic research in occupational injury/illness, piloting programs for geographic targeting, and changing business and worker incentives and capacity for prevention

Employment and Food During Coronavirus

Key Findings 1. 45% of respondents with jobs experienced some type of job disruption or loss. 19.7% had a reduction in hours or income, 9.3% had been furloughed, and 15.5% had lost their job since the coronavirus outbreak. 2. 38.5% of respondents experiencing job loss or disruption since the outbreak were classified as food insecure. 3. Respondents experiencing job disruption or loss were significantly more likely to be already implementing food purchasing or eating changes and concerned about food access compared to those who did not experience a change in employment. 4. Respondents with job disruption or loss were significantly more likely to need higher amounts of money per week to help meet their basic needs if they could no longer afford food ($100 with a reduction in hours/income,$107 furloughed, $158 with job loss, compared to$82 with no job impact)

Food Access and Security During Coronavirus: A Vermont Study

Key Findings 1. Respondents reported a 33% increase in food insecurity since the coronavirus outbreak began in Vermont (from 18% to 24%). 2. 45% of respondents with jobs experienced a job disruption or loss. 3. Respondents said the most helpful actions for meeting their food needs would be increased trust in the safety of going to stores and more food in stores. 4. Respondents worried most about food becoming unaffordable and running out of food if they were unable to go out. 5. Vermonters are using a variety of strategies to adapt: a majority of respondents are at least somewhat likely to buy foods that don\u27t go bad quickly (90%); buy different, cheaper foods (69%); and stretch the food they have by eating less (52%)

The Impact of Coronavirus on Vermonters Experiencing Food Insecurity

Key Findings 1. Respondents experiencing food insecurity were more likely to be people of color, female, live in households with children, and live in larger households. 2. 84.2% of respondents who experienced food insecurity at some point in the year before the coronavirus pandemic remained food insecure during the early days of the outbreak. 3. The majority of respondents experiencing food insecurity are not utilizing food assistance programs. 4. ⅔ of respondents experiencing food insecurity are already buying different, cheaper foods or eating less to make their food last. 5. ⅔ of respondents experiencing food insecurity with a job had job disruption or loss since the coronavirus outbreak. 6. Vermonters are helping each other – there was a reported doubling in the percentage of people receiving their food via delivery from other people

COVID-19 and Food Insecurity Impacts: A Follow Up Vermont Study

This brief report details the results from a follow-up survey of 1,236 Vermonters in June 2020, after an initial survey in March/April 2020 focused on the impact of COVID-19 on food access and security. The key results include: 1) Nearly 1 in 4 respondents (23%) were classified as food insecure in June, a reported 22% decrease since March, but higher than before COVID-19. 2) People of color, those without a college degree, those with a job loss, households with children, women, and younger people had greater odds of experiencing food insecurity. 3) The majority of respondent households had experienced some job loss or disruption in the last 30 days, and were still experiencing job changes at the time of the survey. 4) People receiving unemployment were significantly more likely to be using multiple food assistance programs compared to others. 5) Respondents significantly increased use of food assistance programs since March. 6) Vermonters today have greater concerns about food becoming more expensive and possible loss of food assistance programs compared to June. 7) Vermonters today are facing fewer perceived challenges in food access and have fewer worries about food availability compared to March

Food and Job Insecurity in Vermont During COVID-19 Infographic

This infographic details the summary results from a second Vermont survey on food and job insecurity in Vermont during COVID-19 in March and June 2020. Key results include: 1) Nearly 1 in 4 Vermonters experience food insecurity in June 2020; 2) People of color, those without a college degree, with job disruption, with children, and women were more likely to be food insecure; 3) More than 50% of Vermonters experienced job loss or disruption, and 20% received unemployment in June 2020; 4) Use of food assistance programs rose significantly between March 2020 and June 2020

Early COVID-19 Impacts on Food Retail and Restaurants: Consumer Perspectives from Vermont

The novel coronavirus (COVID-19) pandemic has affected people worldwide, disrupting food access and security. To understand how food systems and security are impacted during this pandemic, an online survey was launched in Vermont from March 29th - April 12th, 2020 (less than a week after the Governor’s Stay Home/Stay Safe order). A total of 3,219 Vermonters responded, and nearly half provided written remarks in response to open-ended questions about worries or general comments. This brief summarizes survey findings and respondent comments about food retail and restaurants. We use quantitative data to understand the frequency of beliefs and behaviors, and qualitative data to understand respondents’ experiences and perspectives in their own words. Of note, the findings reflect early responses to and concerns with food-related risk; as more information was provided by experts, these fears may have been allayed. This will be investigated in future iterations of the survey. Key findings include: Key Findings Security of the Food Supply The novel coronavirus (COVID-19) pandemic has affected people worldwide, disrupting food access and security. To understand how food systems and security are impacted during this pandemic, an online survey was launched in Vermont from March 29th - April 12th, 2020 (less than a week after the Governor’s Stay Home/Stay Safe order). A total of 3,219 Vermonters responded, and nearly half provided written remarks in response to open-ended questions about worries or general comments. This brief summarizes survey findings and respondent comments about food retail and restaurants. We use quantitative data to understand the frequency of beliefs and behaviors, and qualitative data 1. Respondents worried about the risk of contracting COVID-19 through the food system and emphasized the importance of protecting worker health. 2. 87% of respondents usually or always reduced grocery trips in the early weeks of the pandemic in order to avoid exposure. 3. There was high demand for stores to support social distancing and reduce opportunities for disease transmission, as well as provide guidance around safe food acquisition. 4. Poor access to food delivery was a challenge, especially among those in rural areas and using public benefits to buy food. 5. Respondents were interested in supporting local restaurants, but were concerned about safety. 6. 88% of respondents felt that more trust in stores would be helpful and 65% reported that more trust in food delivery would be helpful