Health Impacts of the (In)visibility of UW Custodial Workers

Project Size: Large, >$1,000
Estimated Amount to be requested from the CSF: $3,000

Letter of Intent:

The COVID-19 pandemic has led to nearly 14,000 confirmed cases and over 600 deaths in King County.[1] Furthermore, people of color are dying from COVID-19 at disproportionate rates in comparison to the white population.[2] Washington State Governor Inslee issued the “Stay Home, Stay Healthy” order to reduce the spread of SARS-CoV-2. However, this mandate does not apply to custodians who are considered essential workers. To protect the health of the University of Washington Seattle Campus community, 259 custodial workers continue to work, cleaning and disinfecting various campus areas. The majority of custodial workers are immigrants, refugees, and people of color. Many are over 60 years of age and vulnerable to SARS-CoV-2 exposure. The purposes of this project are to bring visibility to the people who take care of the UW Seattle Campus and facilitate dialogue among the UW community that focuses on the health impacts to UW custodial workers. Through continued dialogue there is an overarching goal to advance health equity. Specifically, the project aims to: 1. Identify custodians’ perceptions of their workplace and home or neighborhood as sources of health opportunities or barriers. 2. Identify attainable workplace improvements that protect and support the health of custodians, especially during the COVID-19 pandemic. Informational flyers translated in Amharic, Tigrinya, Korean, and Tagalog will be distributed in all seven areas of UW Seattle Campus. Languages were selected based on Evalynn’s experience growing up around UW custodians, and more recently, her weekly breakfast deliveries throughout campus. 15 custodial workers will be recruited (approximately two workers per area) who identify as: immigrant, refugee, Black, Indigenous, or person of color. Each participant will be compensated with a $100 Visa gift card. Lunches will be provided during sessions. There will be four sessions with adequate social distancing measures and health standards in place. The UW Harry Bridges Center for Labor Studies has offered logistical support that include reserving meeting spaces on campus for the sessions. Session 1: A 1-hour orientation to the project and how to take photos with smartphones or project-provided cameras. Participants from one or two areas will form discussion groups (three to four people per group) for the project duration. The guided questions for the photographs are: 1. What does your work look like for you? a. How does your work impact your health? 2. What does your home or neighborhood look like for you? a. How does your home or neighborhood impact your health? 3. How can the UW community best support your work and health? Questions will be translated to their preferred language for reference and additional clarity. Sessions 2 and 3: 1-hour discussions where participants will provide descriptions of photographs (first in their native language and then English). The descriptions are guided by the SHOWED process (what do you See here?, what is Happening?, how does it relate to Our lives?, Why does this situation exist?, how can we Empower/Educate to address it, and what can we Do about it?).[3] Discussions may be audiotaped if participants agree. Session 4: Evalynn with one additional UW student, staff or faculty will analyze information collected from all sessions, present findings to the participants and gather feedback, and ask for ideas on the design of the public art installation. An art installation will be located at a public space on campus. Participants are encouraged, though not required, to attend the opening. Photographs with descriptions selected by each participant will be displayed. The participant may decide to include their name or a pseudonym with their pieces. Recommendations and action steps for how the UW community can support custodians will be part of the installation. A website will also be available for wider accessibility.


A growing literature points to the importance of structural racism in an unequal labor market and in persistent racial health inequities.[4,5] Not only are lower employment positions like custodial work linked to greater stress, but work-related stress combined with other life stressors that disproportionately impact Black, Indigenous, and people of color result in poor health.[5] Furthermore, custodial workers face a wide range of health and safety issues in the workplace that include exposure to cleaning chemicals and demands of physical labor. Community-based participatory research (CBPR) is a collaborative approach that focuses on inequities through active involvement of community members in all aspects of the process in order to either directly benefit participants or use the results to inform action for change. This project will follow the key principles of Israel et al.’s (1995) community-based approach in examining health and quality of life inequities.[6] Visual image is one way to enable people to think critically about their community. Photovoice is a method often used in CBPR to reach, inform, and organize community members, enabling them to prioritize their concerns and discuss problems and solutions.[7] It invites people to become advocates for their own and their community’s well being, acting as potential catalysts for change.


The evaluation questions for the project are: 1. How many custodians completed this project? 2. What prevalent themes did custodians identify pertaining to how their work impacts their health? 3. What prevalent themes did custodians identify pertaining to how their home or neighborhood impacts their health? 4. What prevalent themes did custodians identify pertaining to how the UW community can best support their work and health? 5. What are the changes or actions from the UW community in response to this project?


1. $1500; 15 - $100 Visa gift card incentives 2. $100; Printing costs for recruitment/informational flyers, orientation packets 3. $400; Translation services 4. $300; Costs for developing photographs 5. $700; Frames and supplies for mounting photographs


I am the daughter of UW custodians. UW Building Services leadership and many UW custodians have known me since I was a child. I have also been leading an appreciation effort for UW custodial workers since March by delivering and serving breakfast to each area of campus per week. I am well known in the UW custodial community and have built rapport with them through the many years and especially this year. References 1. King County. COVID-19 Data Dashboards. Available at: 2. King County. Race and Ethnicity Data Dashboard. Available at: 3. Wang C. Youth Participation in Photovoice as a Strategy for Community Change. Journal of Community Practice. 2006;14(1-2):147-161. 4. Gee GC, Ford CL. Structural Racism and Health Inequities. Du Bois Review. 2011;8(1):115–132. 5. McCluney CL, Schmitz LL, Hicken MT, Sonnega A. Structural Racism in the Workplace: Does Perception Matter for Health Inequalities? Soc Sci Med. 2018;199:106-114. 6. Israel BA, Schulz AJ, Parker EA, Becker AB. Review of Community-Based Research: Assessing Partnership Approaches to Improve Public Health. Annu. Rev. Public Health. 1998;19: 173-202. 7. Wang C, Burris MA. Photovoice: Concept, Methodology, and Use for Participatory Needs Assessment. Health Education & Behavior. 1997;24(3):369-387.

Primary Contact First & Last Name: Evalynn Romano