Anonymized transcripts and coding tables on the employment-health dilemma in the corona crisis

The corona crisis exacerbated social inequalities and hit precarious workers, who, as part of the ‘industrial reserve army’, often cover short-term or seasonal labor demands, particularly hard. While the corona crisis reduced many employment opportunities for precarious workers (e.g., in tourism), healthcare facilities, among others, needed additional labor power. However, the latter work activities were often associated with both increased infection risks and additional burdens due to corresponding protective requirements (e.g., working in protective clothing).
Due to few highly demanded employment alternatives, support staff in healthcare facilities faced the dilemma of having to choose between (continuing) employment and protecting their health (Kößler et al., 2023). We expected a particularly strong manifestation of this employment-health dilemma (E-H dilemma) among non-medical workers in healthcare facilities (e.g., cleaners), as the corona crisis simultaneously confronted them with an economic threat (few alternative employment options) and a health threat (a heightened infection risk).
Therefore, the project aimed to analyze under which circumstances the combination of an economic and a health threat led to an employment-health dilemma (Study 1). The aim was also to understand how employees coped with economic threats, health threats, and the employment-health dilemma (Study 2).
To explore the E-H dilemma, we conducted 42 qualitative interviews with 45 non-medical workers in healthcare facilities. The interviews were based on a semi-structured interview guideline that we developed in a participatory manner with works councils and workers of comparable facilities. Interviews were then transcribed and anonymized. During data cleansing, we removed 6 interviews for methodological reasons (e.g., due to poor audio quality or sampling interviewees outside healthcare facilities) and 9 other interviews for content-related reasons (i.e., interviewees did not report an economic and/or health threat). Then we analyzed the remaining 27 interviews using qualitative content analysis by Mayring (2015). For this purpose, two independent coders inductively formed categories based on interview excerpts that dealt with economic threats, health threats, the EH dilemma (Study 1), and potential coping strategies (Study 2).
The analysis of Study 1 showed that the antecedents of economic and health threats can be categorized at a societal, organizational, and personal level. For example, the loss of part-time jobs (societal level), internal organizational restructuring processes (organizational level), and formal training (individual level) contributed to the perception of an economic threat. The perception of a health threat was conditioned, among other things, by the availability of information (societal level), defective protective equipment (organizational level), and contact with people with pre-existing conditions (individual level). Some interviewees who felt the economic threat forced them to keep their employment despite a health threat reported an E-H dilemma.
The analysis of Study 2 highlighted that workers used various coping strategies that can be mapped on two axes: On the one hand, these strategies may be either problem-oriented (e.g., naming problems) or emotion-oriented (e.g., cognitively avoiding problems). On the other hand, the mode of coping strategies was either cognitive (e.g., planning work) or behavioral (e.g., reducing stress during leisure activities).

Kößler, F. J., Wesche, J. S., & Hoppe, A. (2023). In a no‐win situation: The employment–health dilemma. Applied Psychology, 72(1), 64–84. https://doi.org/10.1111/apps.12393