A new Health Affairs article, released ahead-of-print this week reveals the association between union status and nursing home resident COVID-19 deaths and worker infection rate from June 2020 through March 2021.

Since the COVID-19 pandemic began, nursing home residents have accounted for one of every six deaths in the United States. Nursing home workers have also been at risk, with more than one million workers testing positive since April 2020.

Previous research has shown that labor unions play an important role in improving workplace safety for nursing home workers and their residents.

In their research, Adam Dean and coauthors determine that nursing home labor unions were associated with 10.8 percent lower resident COVID-19 mortality rates and 6.8 percent lower worker COVID-19 infection rates.

"Our results suggest that industrywide unionization would have been associated with approximately 8,000 fewer resident deaths," the authors write.

The authors' findings contribute to recent studies that find that labor unions were associated with better infection control policies and COVID-19 outcomes for essential workers in education and retail.

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This week in Health Affairs Forefront, authors cover topics including postmortem diagnostic overshadowing, the administration of COVID-19 vaccines, and fixing the family glitch in the ACA.

Over the past two years, the Food and Drug Administration (FDA) has approved or issued emergency use authorizations (EUAs) for several interventions intended to prevent or treat COVID-19.

Health care professionals, as well as state and local governments, have often expressed interest in using these COVID-19 interventions outside the parameters specifically approved or authorized by the FDA.

Govind Persad and coauthors discuss how ambiguity in provisions, federal agreements, and guidance has left questions about the legality of approved COVID-19 products.

Elsewhere in Forefront, Scott Landes and Margaret Turk write about postmortem diagnostic overshadowing—the inaccurate reporting of intellectual and developmental disabilities on death certificates.

The authors argue that improving the accuracy of death certificate data could benefit public health and reduce disparity by addressing deaths due to preventable premature mortality.

Adding to the conversation around health reform, Katie Keith writes about new studies from the Kaiser Health Foundation and Third Way that examine the impact of fixing the family glitch.

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About Health Affairs

Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.

Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.

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