Impact of the COVID-19 pandemic on employment and inequalities: a systematic review of international evidence and critical appraisal of statistical methods


Abugamza A. Kaskirbayeva D. Charlwood A. Nikolova S. Martin A.
2024SAGE Publications Ltd

Perspectives in Public Health
2024

Aims: To assess the impact of the COVID-19 pandemic on individual labour market outcomes and how these vary over time and between different groups of individuals. Methods: Searches were conducted using Medline, Scopus and EconLit. Grey literature searches used Google Scholar and Econpapers. Study quality was assessed using the risk of bias in non-randomised studies of exposure tool (ROBINS-E), accompanied by a directed acyclic graph (DAG) to identify relevant mediators, moderators and confounders. Results: A total of 85 studies (77 peer-reviewed articles, 8 working papers) were included. The ROBINS-E showed that the overall risk of bias varied between studies from low (n = 14), moderate (n = 56) to serious (n = 15). Studies also varied in terms of outcome measures, study designs and the academic disciplines of researchers. Generally, studies using data collected before and during the pandemic showed large negative effects on employment, working hours and income. Studies that assessed moderators (e.g. by industry, occupation, age, gender, race and country of birth) indicated the pandemic has likely worsened pre-existing disparities in health and work. Generally, women, less educated, non-whites and young workers were affected the most, perhaps due to their jobs involving high levels of personal contact (e.g. hospitality, sales and entertainment) and being less amenable to remote working. The DAG highlighted methodological challenges in drawing robust inferences about COVID-19’s impact on employment, including the lack of an unexposed control group. Conclusions: The COVID-19 health crisis caused unanticipated and unprecedented changes to employment opportunities around the world, with potential long-term health consequences. Further research should investigate the longer-term impact of COVID-19, with greater attention given to low- and middle-income countries. Our study provides guidance on the design and critical appraisal of future studies.

COVID-19 , employment , inequalities , public health , systematic review , work

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Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, United Kingdom
KAZGUU University, Kazakhstan
Leeds University Business School, University of Leeds, United Kingdom
Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Real World Methods and Evidence Generation, IQVIA, United Kingdom
Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Saudi Arabia

Academic Unit of Health Economics
KAZGUU University
Leeds University Business School
Academic Unit of Health Economics
Department of Health Sciences

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