The Washington PostDemocracy Dies in Darkness

Unions say they help stop covid-19 from spreading. They may be right.

Unionized nursing homes were far safer for workers and residents, our research finds, with lower rates of covid-19 cases and deaths.

An Amazon Labor Union (ALU) organizer greets workers outside Amazon’s LDJ5 sortation center, as employees begin voting to unionize a second warehouse in the Staten Island borough of New York City on April 25. (Brendan McDermid/Reuters)
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In March, an independent union won a stunning victory at an Amazon warehouse in Staten Island — a victory that grew from workers’ concerns that Amazon wasn’t doing enough to protect them from the coronavirus’s spread.

Two years ago, Amazon fired Chris Smalls for organizing a strike for more precautions after one of his co-workers tested positive for the coronavirus. Now Smalls is founder and president of the Amazon Labor Union, which appears aimed at unionizing Amazon warehouses across the country. (Amazon founder Jeff Bezos owns The Washington Post.)

Similarly prompted by coronavirus concerns, Starbucks workers have been winning union elections every month. Workplace safety demands appear to be driving a surging unionization wave.

Labor unions appear to reduce coronavirus transmission

Workers may be right to see labor unions as their best bet for improving workplace safety. Last year, we reported here at TMC about our study in the journal Health Affairs that found that having a strong teachers union increased the likelihood that a school would adopt mask mandates — a policy linked to lower incidence of covid-19 cases in schools. In a new study published this week in the same journal with Simeon Kimmel and Atheendar Venkataramani, we found that unions made a life-or-death difference for thousands of nursing home residents and workers.

The pandemic has hit nursing homes particularly hard. In nursing homes throughout the Northeast, four out of every 10 workers have been infected with the coronavirus. But in many U.S. nursing homes — especially in the South — worker infection rates have been twice as high. Why did some nursing homes have higher worker infection rates than others?

To find out, we gathered data on the union status of more than 13,000 nursing homes across the continental United States from the Service Employees International Union, the country’s main nursing home union. We also gathered data on other factors that may influence nursing home covid-19 outcomes, such as county-level coronavirus case rates; whether nursing homes were for-profits or part of a chain; and nursing home occupancy rates and staffing ratios. We then used a statistical technique called “regression analysis” to see which of these factors best explained coronavirus worker infection rates across nursing homes.

Unionized nursing homes were far safer places for workers, we found, with coronavirus worker infection rates 6.8 percent lower than in non-unionized nursing homes. And these union benefits spread to nursing home residents, who were 10.8 percent less likely to die of covid-19.

Since only 17 percent of U.S. nursing homes are unionized, these benefits were limited to a small portion of workers and nursing home residents. In many states with right-to-work laws, which weaken unions by restricting their ability to collect dues, the nursing home sector is nearly entirely nonunion. These nonunion facilities may be more likely to produce poor outcomes for workers and residents.

Our results suggest that if the entire U.S. nursing home industry had been unionized, it could have prevented 25,000 workers from being infected and saved 8,000 nursing home residents from dying during the 10 months from June 2020 and March 2021.

The pandemic hurt gender equality. A lot.

This new study extends the results from a paper that one of us, Adam Dean, wrote with Venkataramani and Kimmel when the pandemic first hit nursing homes in New York in the spring of 2020. By May 2020, this group found that unionized facilities were more likely to give workers N95 masks and that residents were 30 percent less likely to die of covid-19.

Nursing homes were not outliers. Throughout essential industries, unions provided more paid sick leave and more personal protective equipment (PPE), helping workers protect themselves and those around them.

Unionized workers feel more confident about speaking out about potential hazards without fear of management retaliation. Polls show strong support for unions in the United States: 64 percent of Americans approve of unions; in 2017, roughly half of all workers said that they would like to join one. But only 10 percent of workers are currently union members, in part because while U.S. labor law technically prohibits employers from retaliating against unionization drives, in practice it is hardly a deterrent.

How much do vaccinated Americans dislike the unvaccinated? We measured.

The right to unionize

Last year, the U.S. House passed a bill called the Protecting the Right to Organize Act, which now awaits a vote in the Senate. The bill, which would be the first major update to labor law in seven decades, would restore workers’ right to organize without management interference by reducing the obstacles that employers can throw in their way. Much of what major companies such as Amazon routinely do to deter unionization campaigns, for example, would be illegal if the PRO Act were law.

Chris Smalls and his Amazon co-workers, however, showed that unions need not wait for policymakers or even established unions to make change. His grass-roots multiracial movement, which relied primarily on the warehouse’s own workers, was more successful than the country’s main retail worker’s union effort to unionize an Amazon warehouse in Alabama.

Similarly, a certified nursing assistant in Chicago we spoke with led a bitter strike in November 2020 that included hundreds of caregivers at 11 nursing homes. When the pickets eventually came down, they’d won a raise, hazard pay, and more paid sick leave — which not only benefited the workers but also reduced the spread of the virus to residents and the community.

As the strike leader and nursing assistant from Chicago told us, the safer workers are, the safer are the people they look after. This will be true long after this pandemic recedes and when the next one arrives.

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Adam Dean (@adamdean34) is a professor of political science at George Washington University whose research focuses on international trade and labor politics. He is the author of a forthcoming book on free trade and labor repression, “Opening Up By Cracking Down” (Cambridge University Press, fall 2022).

Jamie McCallum (@jamiekmccallum) is a professor of sociology at Middlebury College whose research focuses on labor movements, unions and workplace power relations. His book, “Essential: How the Pandemic Transformed the Long Fight for Worker Justice,” will be released in the fall by Basic Books.