Health Insurance
More Than 1 in 3 Workplace Injury Victims Not Covered by Employer-Based Health Insurance
Workplace injuries can have costly implications on an employee’s health and ability to return to work. But for those at risk, the consequences may be even costlier. In fact, according to the latest ValuePenguin study, more than 1 in 3 workplace injury victims aren’t covered by employer-based health insurance. To make matters worse, workers in occupations with the most workplace fatalities are paid less on average than typical Americans.
ValuePenguin researchers analyzed employer-based health insurance coverage in the industries with the highest rate of workplace injuries. For a deeper look at how dangerous jobs impact American workers, researchers also looked at median weekly wages across the industries with the highest average annual fatality rates.
- Key findings
- Employees in occupations with higher rates of workplace injuries generally less likely to have employer-based health insurance
- Workers in occupations with most victims of workplace fatalities earned on average 7.9% less
- 64% of 25 occupations with highest average annual fatality rates between 2017 and 2020 earned less than national weekly median
- Which states have the highest percentage of employees in dangerous jobs?
- Prevent costly expenses from workplace injury
- Methodology
Key findings
- Employees in occupations with higher rates of workplace injuries are generally less likely to have employer-based health insurance. In the farming, fishing and forestry industry, 33.4 of every 1,000 workers were injured badly enough to stop working in 2020, yet only 36.7% of workers had employer-based health insurance. On the other hand, in the computer and mathematical industry — the field with the second-lowest rate of workplace injuries, at 0.3 of every 1,000 employees — 88.2% of employees had employer-based coverage.
- More than 440,000 workplace injuries happened to workers not covered by employer-based insurance — representing more than 1 in 3. Overall, 67.7% of employees were covered by employer-based insurance, but workers who had to take time off due to a workplace injury were 7.8% less likely to be covered.
- Workers in occupations with the most workplace fatalities earned on average 7.9% less.. Among the 25 occupations with the most fatalities, workers made an annual average of $51,871. Meanwhile, the average annual salary in the U.S. was $56,310 in 2020 — $4,439 higher.
- 64% of the 25 occupations with the highest average annual fatality rate between 2017 and 2020 earned less than the national weekly median. Of these occupations, aircraft pilots and flight engineers were paid the most, with median weekly earnings of $1,913 in 2021. Comparatively, the weekly median salary for all U.S. workers was $998. However, aircraft pilots and flight engineers also had the highest fatality rate over the four years.
- Half of the 10 states with the most workers in dangerous occupations were in the West. Overall, Wyoming ranked first, with 5.8% in the state working in the top 10 most dangerous occupations. Comparatively, states on the East Coast ranked among the lowest, leading with the District of Columbia (0.6%).
Employees in occupations with higher rates of workplace injuries generally less likely to have employer-based health insurance
Those working in fields with higher workplace injury rates are generally less likely to be covered by employer-based health insurance. On average, 55.3% of workers in the five occupations with the highest injury rates were covered by employer-based health insurance after being injured in 2020. Comparatively, an average of 83.8% of workers in the five occupations with the lowest rate of injuries were covered by employer-based health insurance.
Notably, the farming, fishing and forestry industry saw the highest rate of injuries and the lowest rate of employer-based health insurance. In this industry, 33.4 of every 1,000 workers were injured badly enough to stop working in 2020, yet only 36.7% had employer-based coverage. On the other hand, 88.2% of those in the computer and mathematical industry had employer-based coverage — the highest among the occupations. But workers in this industry also saw the second-lowest rate of workplace injuries at 0.3 of every 1,000 employees.
Percentage of employees with health insurance in the occupations with the highest injury rates
Occupation | Injury rate per 1,000 employees | Percentage with employer-based health insurance | Percentage with any form of health insurance |
|---|---|---|---|
| Farming, fishing and forestry | 33.4 | 36.7% | 70.0% |
| Health care support | 26.0 | 54.9% | 87.7% |
| Health care practitioners and technical | 20.7 | 81.8% | 95.8% |
| Transportation and material moving | 16.9 | 57.4% | 83.3% |
| Building and grounds cleaning and maintenance | 15.8 | 45.4% | 75.5% |
| Installation, maintenance and repair | 14.2 | 69.4% | 86.7% |
| Production | 13.0 | 68.1% | 85.2% |
| Construction and extraction | 11.8 | 47.5% | 69.0% |
| Personal care and service | 6.7 | 48.9% | 83.9% |
| Food preparation and serving-related | 5.9 | 45.1% | 76.6% |
| Management | 5.3 | 74.8% | 92.8% |
| Community and social service | 4.8 | 75.8% | 95.7% |
Source: ValuePenguin analysis of U.S. Bureau of Labor Statistics (BLS) and U.S. Census Bureau data
Still, it can be a tougher overall correlation to make as there are some outliers. Those in health care practitioner and technical roles, for example, saw the third-highest rate of workplace injuries at 20.7 per 1,000 employees. But workers in this industry are much more likely to be insured than in other occupations that rank highest for workplace injuries at 81.8%.
Demand may have something to do with this. Nurse practitioners ranked fourth on a U.S. Bureau of Labor Statistics (BLS) list of fastest-growing occupations. With a projected growth of 52% from 2020 to 2030, employers likely used benefits like health insurance to attract more employees.
Of the fields least likely to offer employer-based insurance, workers in some occupations are more likely not to have any insurance. Only 7 in 10 (70%) employees in farming, fishing and forestry jobs have health insurance, making it the industry with the second-lowest rate of insured employees.
440,000+ workplace injuries happen to workers not covered by employer-based insurance, representing more than 1 in 3
Of those who had to take time off due to a workplace injury, 62.5% were covered by employer-based insurance. Comparatively, 67.7% of Americans are covered by this type of insurance. That means those who experienced a workplace injury were 7.8% less likely to have employer-based insurance.
In total, more than 440,000 workplace injuries happened to workers not covered by workplace insurance — representing more than 1 in 3 workplace injuries in 2020.
Workplace injuries and employer-based health insurance, at a glance | |
|---|---|
| Number of workplace injuries | 1,176,530 |
| Number of workplace injuries not covered by employer-based health insurance | 441,357 |
| Percentage not covered | 37.5% |
Still, not having employer-based insurance doesn’t necessarily mean that a worker isn’t covered by health insurance. Overall, 85.8% of injured employees had health insurance in 2020 — leaving 14.2% without it. That puts the number of workplace injuries not covered by any health insurance at more than 166,000.
Workplace injuries and any health insurance, at a glance | |
|---|---|
| Number of workplace injuries not covered by any health insurance | 166,775 |
| Percentage not covered | 14.2% |
Workers in occupations with most victims of workplace fatalities earned on average 7.9% less
That’s not the only risk dangerous occupations pose. Workers who die on the job are also paid less on average than the typical American.
Based on the occupations with the most workplace fatalities, those who died while working in 2020 made an average of $51,871 annually. Meanwhile, the average annual salary in the U.S. was $56,310 in 2020. That’s a difference of $4,439 — meaning that workers who died on the job earned on average 7.9% less.
For an industry-level breakdown, take a look at the data below:
Average annual wages among occupations with the highest number of fatal injuries in 2020
Occupation | Total fatal injuries | Average annual wages |
|---|---|---|
| Transportation and material moving | 1,282 | $39,680 |
| Construction and extraction | 976 | $53,940 |
| Installation, maintenance and repair | 393 | $52,360 |
| Management | 361 | $126,480 |
| Building and grounds cleaning and maintenance | 307 | $32,760 |
| Farming, fishing and forestry | 264 | $33,310 |
| Protective service | 229 | $52,220 |
| Production | 224 | $41,760 |
| Sales and related | 200 | $45,750 |
| Food preparation and serving-related | 82 | $27,650 |
| Office and administrative support | 69 | $42,390 |
| Personal care and service | 58 | $32,610 |
Source: ValuePenguin analysis of BLS data
Transportation was the most dangerous industry in 2020, resulting in 1,282 fatal workplace injuries, though workers killed on the job in this industry made just $39,680 on average.
That’s not the only way traffic fatalities spiked. Though Americans drove less in 2020, a recent ValuePenguin study on motorcycle fatalities found these deadly crashes were on the rise.
In fact, traffic fatalities generally jumped in most major categories between 2019 and 2020, according to the U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA). This suggests that drivers who remained on the roads engaged in more risky behavior, including speeding and failing to wear seat belts, which may account for the high number of fatalities in the transportation industry.
Comparatively, workers in legal occupations experienced five fatal injuries in 2020, ranking it lowest among the industries with the highest fatality rates. But those who died while working in legal occupations were among the highest-paid. At $112,320 annually, they are second only to management occupations.
64% of 25 occupations with highest average annual fatality rates between 2017 and 2020 earned less than national weekly median
Because 2020 was an understandably unusual year, ValuePenguin researchers also analyzed the four-year rate (2017 to 2020) of workplace fatalities in the most dangerous occupations and each industry’s median weekly wages in 2021. While U.S. workers earned median weekly wages of $998 in this period, researchers found that only nine of the 25 occupations with the highest workplace fatality rates paid wages above that.
Overall, aircraft pilots and flight engineers were paid the most, with median weekly earnings of $1,913. However, the average annual fatality rate for aircraft pilots and flight engineers was 50.91 — ranking it the highest over the four years. Following that, first-line supervisors of mechanics, installers and repairers had the second-highest median wages. Workers in this industry made a median of $1,304 weekly. This industry was also less dangerous than most on this list, with an average fatality rate of 14.31.
Median weekly wages among the 25 occupations with the highest average annual fatality rates between 2017 and 2020
Occupation | Average annual fatality rate (2017-2020) | Median weekly wages (2021) | Median weekly wages higher than across all occupations? |
|---|---|---|---|
| Aircraft pilots and flight engineers | 50.91 | $1,913 | Yes |
| Roofers | 49.43 | $685 | No |
| Refuse and recyclable material collectors | 36.91 | $728 | No |
| Helpers, construction trades | 28.70 | $691 | No |
| Driver/sales workers and truck drivers | 26.35 | $920 | No |
| Farming, fishing and forestry | 23.37 | $623 | No |
| Farmers, ranchers and other agricultural managers | 23.20 | $1,032 | Yes |
| Grounds maintenance workers | 18.33 | $639 | No |
| Miscellaneous agricultural workers | 17.69 | $613 | No |
| Electrical power-line installers and repairers | 17.47 | $1,219 | Yes |
| First-line supervisors of landscaping, lawn service and groundskeeping workers | 17.27 | $900 | No |
| First-line supervisors of construction trades and extraction workers | 17.20 | $1,208 | Yes |
Source: ValuePenguin analysis of BLS data
Which states have the highest percentage of employees in dangerous jobs?
Overall, 3.9% of U.S. employees worked in the 10 most dangerous occupations between 2017 and 2020. When looking at the share of these employees by state, however, Western states generally lead the way. Five of the 10 states were in the West, with Wyoming ranking highest —- 5.8% of the state’s employees worked in the most dangerous jobs.
Other Western states that ranked highest included California (5.6%), Idaho (5.6%), Montana (4.6%) and Oregon (4.6%).
10 states with the highest percentage of workers in the most dangerous jobs
Rank | State | Percentage of workers in most dangerous jobs |
|---|---|---|
| 1 | Wyoming | 5.8% |
| 2 | Arkansas | 5.7% |
| 3 | California | 5.6% |
| 3 | Idaho | 5.6% |
| 5 | Nebraska | 5.4% |
| 6 | Iowa | 5.2% |
| 7 | North Dakota | 5.0% |
| 8 | Mississippi | 4.6% |
| 8 | Montana | 4.6% |
| 8 | Oregon | 4.6% |
Source: ValuePenguin analysis of BLS data
One explanation for the states that rank highest may be because they’re generally more sparsely populated. And for many of these states, their economies are driven by outdoor industries. For example, Wyoming is known as the Cowboy State for its cattle-driven economy, and it has the largest average size of farms and ranches in the U.S. Wyoming is also the top coal-producing state in the U.S., meaning much of its workforce also operates in the mining industry.
Similarly, Arkansas is known for its ample forestry. California, on the other hand, is a major driver of the wine industry, and Idaho leads the nation in potato production and other substantial crops. Among the rest of the 10 states, here’s a breakdown of their most notable contributions to dangerous industries:
- Nebraska: known as the “Golden Triangle,” Nebraska consistently ranks among the highest for cattle, ethanol, and corn production
- Iowa: leading state for ethanol production
- North Dakota: among the leading states for energy production, ranking third for crude oil production and fifth for coal production
- Mississippi: known for its farm-raised catfish, Mississippi is the leading state for aquaculture and among the top states for cotton and soybean production
- Montana: first in the nation in the production of lentils and certified organic wheat and among the top 10 states in the production of other major agricultural products
- Oregon: leading state for berry and hazelnut production and leading state for Christmas tree production
States with lowest percentage of dangerous workers
East Coast states had the lowest percentage of workers in dangerous jobs, representing eight of the bottom 10. Particularly, the District of Columbia was the lowest — just 0.6% of its workers were in a dangerous occupation.
10 states with the lowest percentage of workers in the most dangerous jobs
Rank | State | Percentage of workers |
|---|---|---|
| 51 | District of Columbia | 0.6% |
| 50 | New York | 2.3% |
| 49 | Massachusetts | 2.5% |
| 48 | Rhode Island | 3.0% |
| 47 | Connecticut | 3.1% |
| 44 | Nevada | 3.2% |
| 44 | Maryland | 3.2% |
| 44 | Delaware | 3.2% |
| 42 | Virginia | 3.3% |
| 42 | Alaska | 3.3% |
Source: ValuePenguin analysis of BLS data
It’s difficult to explain why East Coast states generally had fewer workers in dangerous fields. But — generally — those who rank lowest don’t rely so heavily on outdoor industries such as agriculture, mining and forestry.
Additionally, because the East Coast is generally more densely populated, these states generally have more metropolitan areas than the states that rank highest for the most dangerous workers. Consequently, many more metro-area employees work in fields like finance and technology. New York City, for example, is often known as one of the financial capitals of the world, and a large share of its workforce is employed in the finance and insurance sector.
These states’ shares of tourism and tech workers may also play a role. While states like Nevada rely heavily on tourism, Virginia ranks third for the number of science, technology, engineering and math (STEM) workers in any state. It also ranks alongside Maryland and the District of Columbia as the leading areas for biotechnology development in the U.S.
Alaska is the only exception here. While the state is heavily dependent on tourism, it’s also one of the leading producers of crude oil and fishing. Still, it ranks among the lowest for the percentage of employees in such dangerous industries.
Full rankings: States with the highest percentage of workers in the most dangerous jobs
Rank | State | Percentage of workers |
|---|---|---|
| 1 | Wyoming | 5.8% |
| 2 | Arkansas | 5.7% |
| 3 | California | 5.6% |
| 3 | Idaho | 5.6% |
| 5 | Nebraska | 5.4% |
| 6 | Iowa | 5.2% |
| 7 | North Dakota | 5.0% |
| 8 | Mississippi | 4.6% |
| 8 | Montana | 4.6% |
| 8 | Oregon | 4.6% |
| 11 | South Dakota | 4.5% |
| 12 | Hawaii | 4.4% |
Source: ValuePenguin analysis of BLS data
Prevent costly expenses from workplace injury
While some occupations carry a higher risk than others, workplace injuries could happen to anyone — and it can come at a hefty cost. Divya Sangameshwar, a ValuePenguin expert, says the best way to avoid medical expenses from a workplace injury is to invest in health insurance. But for many Americans, that may not be attainable.
“Employer-sponsored health insurance is supposed to offer access to affordable health care to Americans of all social and economic classes, even those with a modest income,” Sangameshwar says. “However, the reality for many Americans is that they really don’t earn enough money to afford health insurance — even heavily subsidized insurance from their employer.”
Many Americans injured on the job — particularly those who aren’t offered employer-sponsored health insurance or can’t afford it — rely on workers’ compensation insurance if injured. But, Sangameshwar says, that often isn’t enough.
“While workers’ compensation insurance is meant to cover lost wages and health care expenses for workers injured on the job, those claims are subject to an approvals process, so it isn’t a guarantee of health care,” Sangameshwar says. “You can be denied workers’ compensation for things like not reporting the accident in a timely manner, or if a doctor thinks your injury isn’t caused by work.”
To avoid shelling out for on-the-job injuries, Sangameshwar advises workers to take the following preventative measures:
- If you have employer-sponsored health insurance, reevaluate your plan. Don’t just go with the ‘recommended’ company option or the plans with the lowest premiums, Sangameshwar says.
- Consider private health insurance as an alternative. “Your employer may not be able to offer you cheaper or better insurance immediately, so if you find a private health insurance plan that works for you, get it,” Sangameshwar says. “You can always register for your employer-sponsored insurance during your company’s open enrollment period if your employer eventually offers a better policy.”
In the event of an injury, Sangameshwar offers the following tips:
- Find out if you qualify for Medicaid. If you suffer from a workplace injury and have no health insurance, Sangameshwar says you should go to your state’s Medicaid office and find out if you qualify. If you do, Medicaid will begin paying your medical bills and may even pay some of your past bills, depending on your state’s Medicaid laws and regulations.
- Alternatively, find out if you qualify for Social Security Disability Insurance. If you have an injury that’ll prevent you from returning to work, you may also be eligible to receive Social Security Disability Insurance (SSDI) benefits. Sangameshwar recommends finding your options by visiting your local Social Security Administration (SSA) office.
Methodology
Researchers used data from the 2020 Survey of Occupational Injuries and Illnesses from the U.S. Bureau of Labor Statistics (BLS) and the March 2021 Current Population Survey from the U.S. Census Bureau to estimate the rate of employer-based health insurance coverage per workplace injury that resulted in time away from work, based on the occupation codes of those affected.
Researchers used the count of fatalities in 2020 by occupation from the Census of Fatal Occupational Injuries and the 2020 Occupational Employment and Wage Statistics (both from the BLS) to estimate the average annualized wage of those killed on the job that year.
Researchers also used the four-year average (from 2017 to 2020) hours-based annual fatality rate calculated by the BLS and compared it to the median weekly wages in 2021 for each occupation. The percentage of workers in each state in one of the 10 deadliest occupations were calculated using 2020 BLS data. Where occupational titles varied slightly between sources, researchers selected those closest.