Under Watch: Employer Health Monitoring in a Pandemic

Since March, workers have been struggling to make ends meet. Unemployment insurance claims have hit historic highs and with emergency unemployment insurance funds expiring, workers are growing ever more desperate for a job — any job, even if it pays little and exposes them to the virus.

Many businesses are relying on a wide range of employee health checks and requirements — ranging from temperature checks to required mask usage — to usher customers back into stores. The enforcement of such protective measures tends to be one-sided, favoring the consumer, and can subject these workers to even greater safety risks. A June survey of McDonald’s workers conducted by SEIU found that “nearly half (44 percent) of McDonald’s workers report that they have been verbally or physically threatened or abused by McDonald’s customers refusing to follow safety guidelines, or involved in altercations among customers over safety guidelines.”

Safety measures urgently enacted in the name of stopping the spread of COVID-19 will have significant long-term implications. In particular, employer health monitoring further entrenches the already disturbing trend of employer surveillance, tightening the amount of control employers have over workers — especially those who are on the front lines of this crisis.

Employer health monitoring as a result of the pandemic has the potential to fuel a longstanding trend that transfers information, control and power from workers to employers. While current practices are largely limited to temperature checks and compulsory mask use, it’s not hard to imagine how an employer might soon have access to a worker’s history of vaccination and health records. This level of knowledge opens the door to employers with more information about their workers’ underlying health conditions, which is a slippery slope that further diminishes power from workers like Black and Latinx women, who are already at a disadvantage in the workplace.

Moreover, workplaces are increasingly requiring employees to provide regular evidence of a negative COVID-19 test to return to work, but employers are not providing financial support or insurance coverage to cover the costs. Workers are therefore bearing the financial burden of their own monitoring, especially Black and brown women on the front lines who also bear the burden of a deeply unequal health care system. If we fail to respond in this moment to center worker interests, the COVID-19 crisis has the potential to strip workers of what little power and autonomy they still had before the pandemic.

Employer monitoring of workers is built into the very DNA of the American labor market. Even disasters like the infamous Triangle Shirtwaist Factory fire can be traced back to factory managers’ wanting to witness and control how workers spent their time. In more recent times, we’ve witnessed the widespread acceptance of electronic monitoring. As this practice spreads from companies like UPS and Amazon, and now to the home, it’s arguably creating a new surveillance frontier in the workplace as the pandemic deepens and changes workplace norms.

Companies that sell software that monitor workers’ every action have seen a significant uptick in demand since March — suggesting that the power such monitoring gives to employers vis-a-vis their workers is deeply entrenched for all types of workers, in all types of jobs. Added monitoring of health indicators and conditions in the midst of a pandemic threatens to take employee surveillance to a deeper level of intrusion.

In a system where so many workers rely on employer-sponsored health insurance, employer access to privileged health information significantly risks increased power imbalances between workers and their employers, especially for Black and brown people working on the front lines. Because of institutional and systemic racism, these workers may suffer from more chronic pre-existing conditions driven by of decades of intentional economic disinvestment and unequal health care treatment — underscoring the dual risks of racial discrimination and discrimination on the basis of health status.

Invasive employee health monitoring may also lay the foundation for additional tiers of privilege and discrimination based on immunity from COVID-19 and ableism, deepening the existing caste system within the American labor market. By privileging those who are able to demonstrate health and wellness, employer health monitoring could lead to increases in unemployment, stymie economic mobility and further cement health inequities among a new generation of Black and brown communities who are fighting to overcome this very cycle of oppression from generations past.

Ultimately, the question of the moment is how to keep everyone — workers and consumers — safe and healthy, while also ensuring that workers’ power is not further eroded. That means incorporating worker voices in crafting solutions, while still ensuring appropriate health privacy. De-linking access to health care from a worker’s employment status would mean that employers are less able to functionally hold their workers hostage. But even smaller interventions that center worker power would have significant effects.

For example, the Clean Slate for Worker Power project report released last month puts forth some novel ideas, including safety stewards, workers who are elected by their peers to ensure compliance with health and safety rules. The report also recommends workplace health and safety committees and sectoral negotiation of basic health and safety standards.

Sadly, it seems unlikely that the COVID-19 crisis and the associated risks for workers are going to go away anytime soon. We can’t have a healthy economy if those who keep our economy going feel unsafe and devalued. As policymakers consider the long-term response to this crisis and recovery, they are making decisions at a crucial juncture: one with the potential to dramatically shift power between employers and workers.

Essential workers — who are disproportionately Black and brown — are risking their lives in this moment. Workers are intimately acquainted with the risks associated with being on the front lines. As we envision a path back to work, it must be one built on the foundations of equity, and center the experiences and voices of workers themselves. Without doing so, we risk entrenching existing inequitable power dynamics in the workplace. We have the opportunity to arm workers with stronger labor protections and rights than we have seen in the past, a chance to right past wrongs — let’s make sure we don’t repeat the mistakes of the past.

Dr. Rakeen Mabud is the director of research and strategy at TIME’S UP Foundation and writes extensively on issues relating to inequality, labor, race and gender. Dr. Lauren Powell is the vice president, head of health care industry at TIME’S UP Foundation, and was the youngest Black woman to serve as the director of health equity for the Commonwealth of Virginia. All opinions in this piece represent the views of the authors and not their employer.

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