Abstract
BACKGROUND: The impact of Coronavirus disease-2019 (COVID-19) extends beyond health, potentially affecting long-term income and employment dynamics. In Israel, disparities exist between Jewish and Arab populations across many dimensions, including socioeconomic. The study's primary aim was to compare changes in employment and income among COVID-19-infected and non-infected participants among Jews and Arabs, the two main population groups comprising the population of Israel. METHODS: We conducted a cross-sectional study between March 2021 and June 2022 among adults employed prior to the pandemic, whose SARS-CoV-2 polymerase chain reaction test was processed in three hospitals in Israel's Northern District. Using a validated online survey, we collected information about socio-demographics, SARS-CoV-2 infection, vaccination, employment (full-time, part-time, unemployed, retired), and income status by income bracket. Multivariate binary logistic regression models were used to estimate the associations between SARS-CoV-2 infection and (1) changes in employment status and (2) income decreases among Jewish and Arab participants. RESULTS: Of the 7741 respondents, 1468 met our inclusion criteria (fully answered employment questions, employed pre-pandemic). Of these, 19% were Arabs, and 36% (n = 523) reported SARS-CoV-2 infection. High-income earners were less likely to experience employment and income changes than low-income earners (OR = 0.4 for both, p < 0.01). After adjusting for age, gender, vaccination, income level, and other socio-economic factors, Arab participants who reported SARS-CoV-2 infection were more likely to report employment change and income loss (OR = 7.0 and 4.2 respectively, p < 0.01). No association between infection and changes in employment or income was found among Jewish participants. CONCLUSIONS: After adjusting for potential socio-economic confounders, SARS-CoV-2 Infection was a significant determinant of employment changes and income loss among Arabs, but not Jews, in Israel. This finding suggests the pandemic has exacerbated pre-existing inequalities and highlights the need for economic recovery policies specifically targeting vulnerable groups.