[Thesis defense] Narges Ghoroubi

On December 19th, 2025, Narges Ghoroubi defended her thesis in epidemiology:

‘COVID-19 inequalities in France: the role of work during the first year of the pandemic’

Her thesis was co-directed by Myriam Khlat and Emilie Counil.

Jury:

• Barbara Charbotel, Professor, Université Lyon 1 (Chair of the jury)
• Joëlle Schwarz, Professor, Université de Lausanne (reviewer and examiner)
• Stéphanie Vandentorren, Research Director, Santé publique France (reviewer and examiner)
• Cyrille Delpierre, Research Director, Université Toulouse III Paul Sabatier (examiner)
• Christophe Paris, Professor and Hospital Practitioner, Université de Rennes (examiner)
• Myriam Khlat, Emeritus Research Director, Ined (co-supervisor)
• Émilie Counil, Researcher, Ined (co-supervisor)

Abstract:

The COVID-19 pandemic revealed deep social inequalities in exposure to infectious risks and reaffirmed the central role of occupation as a key social determinant of health. This thesis analyses socio-occupational disparities in potential work-related exposure to SARS-CoV-2 and how these exposures contributed to social inequalities in COVID-19 in France in 2020.

First, we identify the occupational groups with the greatest potential for work-related exposure by using the 2019 Working Conditions Survey and the 2017 SUMER survey conducted before the pandemic. Under routine working conditions, workers deemed “essential” emerge as particularly vulnerable: they face frequent exposure to infectious risks, greater face-to-face contact with the public, and are over-represented in disadvantaged social groups.

Second, drawing on the first two waves of the national EpiCoV cohort, we examine the contribution of work-related exposure to infection disparities across occupational classes. Karlson-Holm-Breen mediation analysis shows that occupational exposures increase infection risk in every class relative to the upper occupational class, although the configuration of disparities varies with the regional intensity of viral circulation.

Third, again using the two initial EpiCoV waves, we investigate the impact of key-worker status on infection inequalities by sex and migration background. A non-linear decomposition analysis reveals disparities along both dimensions and a double burden for women, intensified by migration status: women are over-represented in certain essential jobs, especially in health care, and occupying these positions, particularly within the lower occupational classes, exposes them to a higher risk of infection.

These findings underscore the critical role of the occupation in amplifying social inequalities during the COVID-19 pandemic.