9.22: Health Inequities in the Pandemic

Inequities in the Pandemic aren't all about Covid

2020 was a devastating year for many reasons, and not only due to Covid-19 itself -- and while the strictest shut-downs ended fairly quickly, many schools didn't open until 2021 or even 2022 -- and in many ways, our economy and our health system are still adjusting to the aftermath of the worst phase of the pandemic. Covid continues in an endemic way now in 2023 and moving into 2024, still taking lives of older adults and many people with chronic conditions.

2020 also saw an uprising of hope and rage in response to the deaths of George Floyd, Breona Taylor, and many others -- we are still grappling with the need for greater racial equity in policing, in the economy, in our society as a whole.

And we are seeing a political backlash against both the covid-related public health measures and the movement for racial justice, as well as a strong anti-LGBTQ backlash, that have added to the distrust, inequities, and violence in this country.

Here are some of the struggles that influenced health inequities in 2020 -- which do you still see continuing now? In what ways? With what effects?

• Social isolation
• Job loss and income loss
• Housing insecurity
• Small businesses affected
• School shut downs
• Lack of access to primary care clinics
• Mental health strains
• Opioid epidemic increasing
• Racialized threats and hate crimes
• Racialized police violence
• The hope and rage in last summer's major mobilizations against racism
• The slow rate of change by institutions to address that racism

What more might you add to this list?

And -- because RESILIENCE is important to lift up, too -- what habits, relationships, behaviors did you adopt during the pandemic that have been HELPFUL to you, your family, or your community? What social movements were strengthened in the last few years, and how might that help to reduce health inequities in the long run?

Immigrant and Refugee Communities

In terms of global health, this is a global pandemic. Many immigrants and refugees living in the US have family members back in their countries of origin affected by the disease. You can imagine the worry and distress this can cause.

The pandemic also has had dire effects on refugees around the world. As borders shut down to stop the spread of disease, many people seeking to flee persecution or other intolerable situations were no longer able to enter another country for safety. In addition, refugees in crowded refugee camps or camps for displaced persons (internal refugees) have been at terrible risk of disease -- Covid-19 and other communicable diseases, too.

Differential impacts

There are many ways that the COVID-19 pandemic may affect different communities differently.

Here are just a few to consider:

• For Native American and Alaskan Native tribes that are small in number, there are concerns that this disease is causing a new genocide. Many elders have died -- elders who were the native speakers of languages and the holders of tradition and history.
• People of color are more likely than whites to have a "front-line" job that requires them to still go to work -- as bus drivers, line cooks, hospital staff, and more. More whites have the type of job that can be completed from home. That has meant that people of color are more likely to be exposed to Covid-19 and to become ill, get hospitalized, and even die from the disease.
• At the same time, people of color have also experienced high rates of unemployment -- as entire industries have largely shut down (tourism and entertainment, for example). They are less likely to have enough savings to weather the crisis.
• For the many non-English-speaking populations, the chance that they may face hospitalization without any access to language interpreters is increased during a time of such stress in our healthcare systems.
• Social distancing and isolation aren't easy for anyone. But for cultures that emphasize interdependence and mutual support, it is even harder.
• Discrimination and hate crimes against Chinese Americans and other Asians have risen since the pandemic began, and police violence against African Americans and Latinx communities has come to the fore.
• What types of impacts are you most worried about?