COVID 19 Lessons Learned, Part 2: The Impact of Inequality

The pandemic rages on.  COVID 19 infections, hospitalizations, deaths, and loss of income have touched every corner of America, but the hammer of this disease has fallen more heavily on some than others.  Due to lack of foresight, such an outcome was inevitable. We should be acting now to address that lack of imagination for the most vulnerable.  We should also look to the future.  When the next pandemic comes, failure to prevent today’s inequities will be inexcusable. 

Demographically, the elderly have suffered the most, the result of compromised immune systems, age and underlying conditions.  Nearly forty percent of all deaths can be traced to nursing homes, which have a case fatality rate (deaths divided by cases) over five times the national average.  These congregated facilities were ill-prepared to use isolation and distancing measures.   

Compared to whites, the case, hospitalization, and death rates for blacks are 2.6, 4.7, and 2.1 times higher respectively.  For Native American and Latinos, the case and hospitalization rates are similarly high; the death rates are 1.4 and 1.1 times higher respectively.  Likely reasons include higher rates of poverty and underlying conditions, less access to affordable health care, poor living conditions and jobs for which COVID protections were weakly implemented.  

There are also glaring inequities in lost income.  In a series of polls by NPR, Harvard and the Robert Wood Johnson Foundation, researchers found “At least half of households in the four largest U.S. cities—New York City (53%), Los Angeles (56%), Chicago (50%), and Houston (63%)—report serious financial problems including depleted savings and trouble paying bills or affording medical care.”  This certainly includes financial problems in lower income white households, and the study reported that at least 40 percent of Latino, Black, and Native American households used up all or most of their household savings.

While the unemployment rate is down to 6.9 percent overall, it’s lower (6.0 percent) for whites but much higher for blacks, Hispanics, and Asians (10.8, 8.8 and 7.6 percent respectively). Those with low incomes often rent their homes, leaving them particularly vulnerable to lost income. While an eviction moratorium was extended by the CDC through December 31, unpaid rents still pile up, as does the threat of losing water, electric, and phone service due to overdue bills.

Some jobs will not come back as businesses close permanently; others will be replaced through automation.  A recent study by the Federal Reserve Bank of Philadelphia found industries that were already automating produced 4.2 more lost jobs per hundred (5.1 for minorities) due to COVID than those less susceptible to automation. Other jobs remain but are still COVID-dangerous.  Crowding in the meatpacking and poultry processing industry caused an estimated 16,233 infections in 236 plants, with 87 percent being racial and ethnic minorities.  Indeed, many jobs we depend on most (e.g. farm workers, meat packers, transportation workers, health aides, first responders, janitorial staff) require employees to show up though they may lack sufficient PPE and cannot practice adequate social distancing.

The loss of jobs has been greater for women compared to men, concentrated as so many are in teaching, food service, hospitality and caring professions.  Women-owned small businesses have also suffered disproportionately.  Many women are leaving the workforce because day-care and school closures have eliminated these essential support systems.

For those who have lost jobs, unemployment insurance has been scattershot, depending on 53 separate systems that are under-funded in a pandemic, confusing to access and have often been woefully slow.  How to qualify for benefits, what one receives and for how long are some of the problems when no national system exists, problems magnified when jobs are cut by businesses that cannot do otherwise without government help.

People with intellectual or physical disabilities constitute another group for whom COVID-relief measures have proved particularly difficult.  Many (not just the elderly) also live in congregated facilities and have underlying conditions.  For students with disabilities, assuring adequate virtual education is challenging.

Inequities in education go beyond those with disabilities.  The movement to virtual learning disadvantages all those, especially in rural areas, who lack broadband access or up-to-date technology.  It makes learning at home difficult when parents are either absent to supervise children’s learning or struggle with managing children and a remote job.  For children living in poverty, no classroom education can mean no free meals.  Without universal day care, the youngest and poorest children receive no early childhood education.  For those without computers - or who lose electricity due to unpaid bills, virtual learning is a mirage.  For the unemployed who depend on student loans for higher education, the choice they face is between school they cannot afford and loans they cannot repay.  Too many, especially the poor, in a generation of students face gaps in learning that will impact their adult lives.

You can judge the moral quality of a nation by how it treats its most vulnerable.   COVID19 has cast our moral failings in stark relief.  We must prevent such disparities in future pandemics – and we must address them in this one.

Photo Credit: (simulated COVID patient) Mufid Majnun - unsplash.com