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New research spotlights how low-income Black households face greater financial distress and vulnerability as a result of the pandemic economic crisis.
- A paper by a team of Princeton researchers highlights devastating socioeconomic inequalities between racial groups worsened by the pandemic shutdowns.
- By the middle of June, the rates of new debt were similar for Black and Latinx households at more than 80%, while about 70% of white households reported new debt.
- When the pandemic ends, tens of millions of households will still find themselves stuck in a devastating financial hole, and a disproportionate amount of those will be Black and Latinx households.
A snowballing crisis<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="192f3f60949a3a4ba8125e80eac68b82"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/RK2IfGPSqO0?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>We've known that COVID-19 has been <a href="https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html" target="_blank">disproportionately fatal</a> to Black Americans as compared to white, non-Latinx Americans, and that these deaths (as well as hospitalizations) have shone a nasty light on <a href="http://med.stanford.edu/news/all-news/2020/11/deaths-from-covid-19-of-inpatients-by-race-and-ethnicity.html" target="_blank">racial disparities undergirding the U.S. healthcare system</a>. But now a team of researchers from the Princeton School of Public and International Affairs are highlighting devastating socioeconomic inequalities exacerbated by the pandemic. Their report details how low-income Black households experienced higher rates of job loss, greater uncertainty accessing food and medical resources, and higher rates of debt than white or Latinx low-income households.</p>The paper, <a href="https://journals.sagepub.com/doi/10.1177/2378023120970794" target="_blank">published in the journal Socius</a>, is the first of its kind offering systemic, comprehensive, and descriptive estimates of the impacts of COVID-19 crisis on low-income Americans from March 2020 to mid-June. The authors' findings spotlight a snowballing crisis in which a growing number of families with low-income reported financial insecurity, then took on more debt to manage their expenses for resources.
The study<p>The authors aimed to determine the economic impacts of the pandemic on lower income Americans, and spotlight racial disparities within that socioeconomic group. They analyzed factors a family needs to satisfy basic survival needs including job loss, housing instability, and insecurity around food and medical resources.</p><p>"Media coverage has focused on the racially disparate effects of Covid-19 as a disease, but we were interested in the socioeconomic effects of the virus, and whether it tracked a similar pattern," said study co-author Adam Goldstein, assistant professor of sociology and public affairs at Princeton's School of Public and International Affairs in a <a href="https://www.princeton.edu/news/2020/11/30/covid-19-shutdowns-disproportionately-affected-low-income-black-households" target="_blank" rel="noopener noreferrer">Princeton University press release</a>.</p><p>Goldstein noted that it was clear that Black households in America were disproportionately affected amongst low-income households who struggled at the beginning of the pandemic. </p><p>"Even among low-income populations, there is a marked racial disparity in people's vulnerability to this crisis," <a href="https://www.princeton.edu/news/2020/11/30/covid-19-shutdowns-disproportionately-affected-low-income-black-households" target="_blank" rel="noopener noreferrer">said study co-author Diana Enriquez</a>, a doctoral candidate in Princeton's Department of Sociology.</p><p>For the study, the researchers used data that came from two different tracking surveys. The primary data source was a bimonthly survey series of Supplemental Nutritional Assistance Program (SNAP) recipients. The respondents were recruited through the mobile app, FreshEBT, for managing SNAP benefits. Also used was the U.S. Census Bureau's publicly available Household Pulse Survey, which is drawn from representative household samples rather than solely from program recipients. Using these sources, the authors surveyed people who were using the SNAP and Temporary Assistance for Needy Families (TANF) benefits prior to the COVID-19 crisis. Several waves of surveys were sent out between the end of March and mid-June, a window of time when Americans were starting to feel the first economic hits of the shutdowns, but before their economic status had been transformed in a major way. </p><p>Participants were asked about their present and perceived situation related to employment status, housing status, ability to access food and medical resources, and amount of debt. For instance, survey respondents were asked if they currently had stable housing and also if they believed their housing status would be stable after that 30-day period. </p>
Major Findings<p>The authors found that lower-income Americans who were already receiving government assistance had experienced major impacts in all areas except for housing status. <strong>Here were the major findings from each survey wave between the end of April and mid-June:</strong></p><ul><li>Nearly 35 percent of all survey respondents reported losing their jobs by mid-June. </li><li>67 percent said that they missed paying at least one bill at the beginning of the shutdown. </li><li>77 percent of households reported missing a bill or payment on their rent. </li><li>54 percent of individuals said they had skipped meals, were dependent on friends and family for food, or had visited a food pantry due to the shutdown, despite being covered by SNAP. (This figure rose to 64 percent by the end of the month of June.) </li></ul><p>But when the researchers looked at the data in race categories, it was clear that, on average, low-income Black households had taken much greater hits than low-income white households had. The magnitude of racial differences varied across indicators and data sources, but Black respondents fared consistently worse than non-Hispanic whites in both survey data sets, and Latinx respondents fared worse than whites in the Household Pulse Survey.</p><p><strong>Here were the major findings when evaluated on race:</strong> </p><ul><li>At the start of April 2020, 30 percent of Black households reported a job loss. By the end of the month that number rose to 48 percent. </li><li>80 percent of Black households surveyed reported taking on greater debt to cover their bills by the end of April 2020. </li><li>By the middle of June, the rates of new debt were similar for Black and Latinx households at more than 80 percent, while about 70 percent of white households reported new debt. </li></ul>
Implications<p>These survey results have put a magnifying glass on how badly the COVID-19 pandemic has impacted vulnerable households who were already living near the poverty line.</p> <p>"Research shows that these types of debts and unpaid bills — even small ones — can compound over time and trap low-income households in a cycle of financial distress," Goldstein said. And when the survey results are analyzed for differences amongst racial groups, it's clear that those most vulnerable to this snowballing financial devastation are Black and Latnix households. </p> <p>Ultimately, this research shines a light on a disturbing truth emphasized by Goldstein: "Even in a miraculous scenario where the pandemic ends in a few months and low-wage workers are rehired, tens of millions of households will still find themselves stuck in a financial hole without additional infusions of economic relief." </p>
What is human dignity? Here's a primer, told through 200 years of great essays, lectures, and novels.
- Human dignity means that each of our lives have an unimpeachable value simply because we are human, and therefore we are deserving of a baseline level of respect.
- That baseline requires more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose.
- We look at incredible writings from the last 200 years that illustrate the push for human dignity in regards to slavery, equality, communism, free speech and education.
The inherent worth of all human beings<p>Human dignity is the inherent worth of each individual human being. Recognizing human dignity means respecting human beings' special value—value that sets us apart from other animals; value that is intrinsic and cannot be lost.</p> <p>Liberalism—the broad political philosophy that organizes society around liberty, justice, and equality—is rooted in the idea of human dignity. Liberalism assumes each of our lives, plans, and preferences have some unimpeachable value, not because of any objective evaluation or contribution to a greater good, but simply because they belong to a human being. We are human, and therefore deserving of a baseline level of respect. </p> <p>Because so many of us take human dignity for granted—just a fact of our humanness—it's usually only when someone's dignity is ignored or violated that we feel compelled to talk about it. </p> <p>But human dignity means more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose—a freedom that can be hampered by restrictive social institutions or the tyranny of the majority. The liberal ideal of the good society is not just peaceful but also pluralistic: It is a society in which we respect others' right to think and live differently than we do.</p>
From the 19th century to today<p>With <a href="https://books.google.com/ngrams/graph?year_start=1800&year_end=2019&content=human+dignity&corpus=26&smoothing=3&direct_url=t1%3B%2Chuman%20dignity%3B%2Cc0" target="_blank" rel="noopener noreferrer">Google Books Ngram Viewer</a>, we can chart mentions of human dignity from 1800-2019.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDg0ODU0My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY1MTUwMzE4MX0.bu0D_0uQuyNLyJjfRESNhu7twkJ5nxu8pQtfa1w3hZs/img.png?width=980" id="7ef38" class="rm-shortcode" data-rm-shortcode-id="9974c7bef3812fcb36858f325889e3c6" data-rm-shortcode-name="rebelmouse-image" data-width="1225" data-height="451" />
American novelist, writer, playwright, poet, essayist and civil rights activist James Baldwin at his home in Saint-Paul-de-Vence, southern France, on November 6, 1979.
Credit: Ralph Gatti/AFP via Getty Images
The future of dignity<p>Around the world, people are still working toward the full and equal recognition of human dignity. Every year, new speeches and writings help us understand what dignity is—not only what it looks like when dignity is violated but also what it looks like when dignity is honored. In his posthumous essay, Congressman Lewis wrote, "When historians pick up their pens to write the story of the 21st century, let them say that it was your generation who laid down the heavy burdens of hate at last and that peace finally triumphed over violence, aggression and war."</p> <p>The more we talk about human dignity, the better we understand it. And the sooner we can make progress toward a shared vision of peace, freedom, and mutual respect for all. </p>
The COVID-19 pandemic is making health disparities in the United States crystal clear. It is a clarion call for health care systems to double their efforts in vulnerable communities.
- The COVID-19 pandemic has exacerbated America's health disparities, widening the divide between the haves and have nots.
- Studies show disparities in wealth, race, and online access have disproportionately harmed underserved U.S. communities during the pandemic.
- To begin curing this social aliment, health systems like Northwell Health are establishing relationships of trust in these communities so that the post-COVID world looks different than the pre-COVID one.
COVID-19 deepens U.S. health disparities<p>Communities on the pernicious side of America's health disparities have their unique histories, environments, and social structures. They are spread across the United States, but they all have one thing in common.</p><p>"There is one common divide in American communities, and that is poverty," said <a href="https://www.northwell.edu/about/leadership/debbie-salas-lopez" target="_blank">Debbie Salas-Lopez, MD, MPH</a>, senior vice president of community and population health at Northwell Health. "That is the undercurrent that manifests poor health, poor health outcomes, or poor health prognoses for future wellbeing."</p><p>Social determinants have far-reaching effects on health, and poor communities have unfavorable social determinants. To pick one of many examples, <a href="https://www.npr.org/2020/09/27/913612554/a-crisis-within-a-crisis-food-insecurity-and-covid-19" target="_blank" rel="noopener noreferrer">food insecurity</a> reduces access to quality food, leading to poor health and communal endemics of chronic medical conditions. The U.S. Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and Type 2 diabetes, as increasing the risk of developing a severe case of coronavirus.</p><p>The pandemic didn't create poverty or food insecurity, but it exacerbated both, and the results have been catastrophic. A study published this summer in the <em><a href="https://link.springer.com/article/10.1007/s11606-020-05971-3" target="_blank">Journal of General Internal Medicine</a></em> suggested that "social factors such as income inequality may explain why some parts of the USA are hit harder by the COVID-19 pandemic than others."</p><p>That's not to say better-off families in the U.S. weren't harmed. A <a href="https://voxeu.org/article/poverty-inequality-and-covid-19-us" target="_blank" rel="noopener noreferrer">paper from the Centre for Economic Policy Research</a> noted that families in counties with a higher median income experienced adjustment costs associated with the pandemic—for example, lowering income-earning interactions to align with social distancing policies. However, the paper found that the costs of social distancing were much greater for poorer families, who cannot easily alter their living circumstances, which often include more individuals living in one home and a reliance on mass transit to reach work and grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and health care, where maintaining physical distance can be all but impossible.</p><p>The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. "Our interpretation is that poorer people are less able to protect themselves, which leads them to different choices—they face a steeper trade-off between their health and their economic welfare in the context of the threats posed by COVID-19," the authors wrote.</p><p>"There are so many pandemics that this pandemic has exacerbated," Dr. Salas-Lopez noted.</p><p>One example is the health-wealth gap. The mental stressors of maintaining a low socioeconomic status, especially in the face of extreme affluence, can have a physically degrading impact on health. <a href="https://www.scientificamerican.com/index.cfm/_api/render/file/?method=inline&fileID=123ECD96-EF81-46F6-983D2AE9A45FA354" target="_blank" rel="noopener noreferrer">Writing on this gap</a>, Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and impair the prefrontal cortex and other brain functions through anxiety, depression, and cognitive load. </p><p>"Thus, from the macro level of entire body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear," Sapolsky writes. "It is outrageous that if children are born into the wrong family, they will be predisposed toward poor health by the time they start to learn the alphabet."</p>Research on the economic and mental health fallout of COVID-19 is showing two things: That unemployment is hitting <a href="https://www.pewsocialtrends.org/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/" target="_blank" rel="noopener noreferrer">low-income and young Americans</a> most during the pandemic, potentially widening the health-wealth gap further; and that the pandemic not only exacerbates mental health stressors, but is doing so at clinically relevant levels. As <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/" target="_blank" rel="noopener noreferrer">the authors of one review</a> wrote, the pandemic's effects on mental health is itself an international public health priority.
Working to close the health gap<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDc5MDk1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTYyMzQzMn0.KSFpXH7yHYrfVPtfgcxZqAHHYzCnC2bFxwSrJqBbH4I/img.jpg?width=980" id="b40e2" class="rm-shortcode" data-rm-shortcode-id="1b9035370ab7b02a0dc00758e494412b" data-rm-shortcode-name="rebelmouse-image" data-width="2000" data-height="1125" />
Northwell Health coronavirus testing center at Greater Springfield Community Church.
Credit: Northwell Health<p>Novel coronavirus may spread and infect indiscriminately, but pre-existing conditions, environmental stressors, and a lack of access to care and resources increase the risk of infection. These social determinants make the pandemic more dangerous, and erode communities' and families' abilities to heal from health crises that pre-date the pandemic.</p><p>How do we eliminate these divides? Dr. Salas-Lopez says the first step is recognition. "We have to open our eyes to see the suffering around us," she said. "Northwell has not shied away from that."</p><p>"We are steadfast in improving health outcomes for our vulnerable and underrepresented communities that have suffered because of the prevalence of chronic disease, a problem that led to the disproportionately higher death rate among African-Americans and Latinos during the COVID-19 pandemic," said Michael Dowling, Northwell's president and CEO. "We are committed to using every tool at our disposal—as a provider of health care, employer, purchaser and investor—to combat disparities and ensure the <a href="https://www.northwell.edu/education-and-resources/community-engagement/center-for-equity-of-care" target="_blank" rel="noopener noreferrer">equity of care</a> that everyone deserves." </p><p>With the need recognized, Dr. Salas-Lopez calls for health care systems to travel upstream and be proactive in those hard-hit communities. This requires health care systems to play a strong role, but not a unilateral one. They must build <a href="https://www.northwell.edu/news/insights/faith-based-leaders-are-the-key-to-improving-community-health" target="_blank" rel="noopener noreferrer">partnerships with leaders in those communities</a> and utilize those to ensure relationships last beyond the current crisis. </p><p>"We must meet with community leaders and talk to them to get their perspective on what they believe the community needs are and should be for the future. Together, we can co-create a plan to measurably improve [community] health and also to be ready for whatever comes next," she said.</p><p>Northwell has built relationships with local faith-based and community organizations in underserved communities of color. Those partnerships enabled Northwell to test more than 65,000 people across the metro New York region. The health system also offered education on coronavirus and precautions to curb its spread.</p><p>These initiatives began the process of building trust—trust that Northwell has counted on to return to these communities to administer flu vaccines to prepare for what experts fear may be a difficult flu season.</p><p>While Northwell has begun building bridges across the divides of the New York area, much will still need to be done to cure U.S. health care overall. There is hope that the COVID pandemic will awaken us to the deep disparities in the US.</p><p>"COVID has changed our world. We have to seize this opportunity, this pandemic, this crisis to do better," Dr. Salas-Lopez said. "Provide better care. Provide better health. Be better partners. Be better community citizens. And treat each other with respect and dignity.</p><p>"We need to find ways to unify this country because we're all human beings. We're all created equal, and we believe that health is one of those important rights."</p>
A new study shows how poor children are negatively impacted neurologically.
- Children in poor neighborhoods exhibit abnormal activation of motivational circuits in their brains.
- The neurological impact increases the likelihood of criminal behavior and substance abuse later in life.
- Researchers suggest focusing on shaping the environment to set up the child for success.