We tested for gender disparities in financial strain with a variable for respondent sex (female). However, various actors rapidly utilized the effects of the health crisis for political purposes. Attention has been focused on the health sector, as it was the first impacted by the pandemic. “And senate Republicans were okay with a billion and it fine-tuned its way to $8 billion.” But the deep history of injustice by the US government towards these people means that the US response will be looked on with suspicion. Factors exacerbating psychological distress include Hispanic ethnicity and a previous mental illness diagnosis. Covid-19: Control measures must be equitable and inclusive, Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 States, March 1–30, 2020, California releases racial data on coronavirus patients, Coronavirus batters younger Latinos and blacks in California, Infections and Inequalities: The Modern Plagues, Social Class and Mental Illness: Community Study, Health inequalities among British civil servants: The whitehall II study, Life after Hurricane Katrina: The resilience in survivors of Katrina (RISK) Project, Heat Wave: A Social Autopsy of Disaster in Chicago, Five years later: Recovery from post traumatic stress and psychological distress among low-income mothers affected by Hurricane Katrina, Effects of the Great Recession: Health and well-being, Sociodemographic inequality in exposure to COVID-19-induced economic hardship in the United Kingdom, Inequality in the impact of the coronavirus shock: Evidence from real time surveys, Socio-economic impacts of COVID-19 on household consumption and poverty, Snapshot of the COVID crisis impact on working families, Hispanic adults in families with noncitizens disproportionately feel the economic fallout from COVID-19, Understanding the unequal post-Great Recession wealth recovery for American families, Racial segregation and the American foreclosure crisis, Middletown: A Study in Contemporary American Culture, House of Debt: How They (and You) Caused the Great Recession, and How We Can Prevent It from Happening Again, Notes on labor markets after the great recession: Unemployment and policy for Indiana, The importance of selection bias in internet surveys, Pew Internet & American Life Project Surveys, Using the Internet to survey small towns and communities: Limitations and possibilities in the early 21st century, America’s health rankings analysis of America’s health rankings food insecurity measure. © 2020 Elsevier Ltd. All rights reserved. Temporarily closing the economy sent shock waves through communities, raising the possibility that social inequities, preexisting and current, have weakened economic resiliency and reinforced disadvantage, especially among groups most devastated by the Great Recession. Disasters are exogenous shocks to social systems that reveal enduring failings and inequities (8). Science and Culture: Expedition artists paint a picture of science exploration, Journal Club: Successful tree-planting schemes may require villager involvement. Alternative measures that are more fine-grained were explored at the county and ZIP code level, including Rural-Urban Continuum Codes, Rural-Urban Commuting Areas, and population density, but none significantly predicted economic outcomes. 6 million Native Americans living on tribal reservations. Moreover, unemployment in Indiana reached its peak during data collection (around 14%). However, we do have rare precrisis data on a representative sample of adults, combined with information about how those same individuals fared early in the COVID-19 pandemic (8). As unemployment reached near-Great Depression era levels during the early stages of the pandemic, questions remain about the potential of the COVID-19 pandemic to exacerbate historically high levels of socioeconomic inequality in the United States (13). Copyright © 2021 National Academy of Sciences. Since Indiana is predominantly white, the P2P oversampled racial and ethnic minorities to provide more robust information about people from minority groups. These latest results also suggest the cancer itself and its impact on the body may play a role in exacerbating Covid-19 infections, the researchers said. Specifically, we used ordinal logistic regression models for categorical outcomes (housing insecurity, food insecurity, financial insecurity, get help—services, get help—finances, and get help—food) and logistic regression for binomial outcomes (fired/unemployed). These latest results also suggest the cancer itself and its impact on the body may play a role in exacerbating Covid-19 infections, the researchers said. The COVID-19 pandemic raises renewed concerns about inequality. Living in a rural (i.e., nonmetropolitan) county was largely unrelated to economic precarity, with the exception that rural residents were significantly less likely to report general financial worry than those in more metropolitan counties. In the United States, race, gender, age, and education have affected vulnerability to COVID-19 infection. The IHS also does not cover care from external providers. For example, COVID-19 has resulted in higher levels of housing insecurity and financial stress for students across the country, including the disproportionate number of trans and gender nonconforming students who rely on campus housing in … A higher percentage of Latinx individuals experienced economic precarity than did Whites for all economic indicators, but most differences were not statistically significant. The economic impact of Covid-19. Similar to national trends, although simple indicators (e.g., private sector job growth) suggest that Indiana had recovered by 2014, the structure of the state’s economy shifted during the Recession, reducing opportunities for middle-wage jobs and widening gaps between workers with different educational credentials (26). In suggesting that such events stand outside the human capacity for prevention and intervention, this social construction minimizes the pressure for institutional social change (39). Observations with smaller weight had less impact on the final parameter estimates than observations with larger weights. Housing insecurity, food insecurity, and general financial insecurity were measured in wave 2 by asking respondents the extent to which they agreed that COVID-19 has made them worry that they “may not have a place to live,” that they “may not have enough money to buy food,” and “about their finances, in general” (0 = strongly disagree, 1 = disagree, 2 = agree, and 3 = strongly agree). They’re not only recording but also interpreting complex, changing phenomena as they raise awareness with members of the public. Dots represent parameter estimates, and lines represent 95% CI. “It would be impossible to live through COVID and not be impacted by in some way by stress or grief,” said Bruder, manager of education at the GHS. The COVID-19 pandemic is sometimes described as an anomalous “perfect storm” (38). In univariate statistical analyses, these weights were multiplied by each observed value prior to aggregation. Pointedly, research across a wide range of natural and man-made disasters, including hurricanes, floods, and economic downturns, repeatedly demonstrate the greater health burden that falls on those in disadvantaged social and geographic locations when large-scale calamities occur (8⇓⇓⇓–12). Cluster-robust SEs by shared county allow for intragroup correlation in our parameter estimates while still assuming no correlation in SEs across counties (53). While the exact racial, gender, ethnic, or otherwise socially categorized groups may change by place or over time, those who are “categorically unequal” will disproportionately bear the burden of natural and unnatural disasters (40). Similar factors are significantly related to fear of the virus and self-assessed likelihood of contracting it. We used a series of multivariate regression models to estimate how our different sociodemographic factors work in tandem to lead to financial disparities resulting from the COVID-19 pandemic. In Milwaukee, WI, three quarters of all COVID-19 related deaths are African American, and in St Louis, MO, all but three people who have died as a result of COVID-19 were African American. The 2008 Great Recession widened socioeconomic inequities among young adults, people of color, and those without a college degree. We do so using the state representative Person to Person Health Interview Study (P2P) (27), which employs a probability sampling frame and interviewer administration. As with these disasters, additional surges are likely to escalate short-term hardships, revealing the axes of social devastation that translate into durable inequality. An additional outcome measures self-reported job loss or inability to find a job due to COVID-19. Johns Hopkins Biocontainment Unit Medical Director Dr. Brian Garibaldi joins Yahoo Finance Live to discuss. To address clustering at the county level, we used cluster-robust SEs. Author contributions: B.L.P. In the short term, the government should maintain supplemental unemployment benefits, provide additional economic impact payments, expand educational opportunities and government training programs for the unemployed, and pass temporary federal eviction and tax relief laws. About 55% indicated the pandemic made them worry about their finances in general. Further, the burdens are not equally distributed, with reports of unemployment and income shocks due to the pandemic being highest in Latinx communities, and particularly among the undocumented (18, 19). The 2008 Great Recession widened socioeconomic inequities among young adults, people of color, and those without a college degree. It is conservatively estimated that about 45 million jobs in the EU-27 labour market (23% of total EU-27 employment) are faced with a very high risk of Covid-19 disruption … This agreement provides for a commitment 1) to use the data only for research purposes, 2) not to attempt to identify any participant, 3) to appropriately secure the data, and 4) to destroying or returning the data after analyses are completed. Moderna says its COVID-19 vaccine will still protect recipients from virus variants. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. All respondents who agreed to future contact were recruited from the P2P sample between March 28 and May 31, 2020, to assess social, psychological, and economic outcomes of the pandemic (n = 1,026; response rate = 69%). Parameter estimates for all multivariate models provided in Fig. “We knew the White House wanted to give us nothing”, Allis said. Studies show that cancer patients have a higher risk of Covid-19 complications, due in part to factors such as older age, higher smoking rates, comorbidities, frequent health care exposures, and the effects of cancer therapies. The P2P was in the field from October 2018 to March 2020, with 90% of observations collected between January 2019 and February 2020. As forecast in 2020, Africa is coming up short in the Covid-19 environment, fiscally and in terms of social policy provisions. 2 report log odds, where values above zero indicate factors associated with increased pandemic-related economic precarity and those below zero indicate factors negatively associated (gray bars denote nonsignificance; full tables are available in SI Appendix, Tables S2–S5). The higher risks of infection and mortality recorded for specific population groups can be traced to a legacy of cumulative inequities in the social determinants of health (SDH). Eligible participants were contacted through postal mail and email to invite participation. And, with climate change leading to cumulating disasters, the Matthew Effect, where the rich get richer and the poor get poorer, will compound widening socioeconomic disparities (35). COVID-19 is exacerbating a mental health crisis in Genesee County, according Lisa Bruder of the Genesee Health System (GHS) in a presentation to the January meeting of Flint Neighborhoods United (FNU). Finally, we controlled for respondents’ financial strain prior to the COVID-19 pandemic, with two dichotomous variables from the previous wave of the P2P survey: respondents’ unemployment status (0 = employed, 1 = unemployed) and whether respondents had stated that they had ever not had enough money to pay for food or shelter during the past 6 mo (0 = never, 1 = rarely, sometimes, or often). A summary of stakeholder insights into factors affecting the impact of coronavirus (COVID-19) on black, Asian and minority ethnic (BAME) communities. They expose groups that are vulnerable due to prejudice, discrimination, and neglect. Image, Recommend Lancet journals to your librarian. The COVID-19 pandemic and containment responses have exposed existing social, economic, gender, ethnic and health inequities and are rapidly exacerbating these. Compared to those with at least a bachelor’s degree, individuals with less than a high school education reported significantly higher rates of economic precarity across every outcome, whereas individuals with a high school diploma and some college tended to have economic precarity that falls between those with less than a high school education and those with a bachelor’s degree. We do so with data from a representative sample of residents in Indiana, a state that is home to “Middletown” (i.e., Muncie, IN), made famous by the Lynds’ classic field studies of culture in America’s small cities (24). The disproportionate effects of COVID-19 on deprived population groups are well documented.1 Not only are case and fatality rates for COVID-19 higher than among people living in less deprived areas, policies that are aimed at preventing spread, such as social restrictions and lockdown, have a greater effect on vulnerable populations.2 Crises lay bare the social fault lines of society. Another aspect of the COVID downturn is its risk of exacerbating already worrisome levels of inequality. Instead, they are likely to have boomerang effects on inequality and on health, accumulating in greater material deprivation and poorer life chances (43⇓–45). The COVID-19 pandemic has disrupted or halted critical mental health services in 93% of countries worldwide while the demand for mental health is increasing, according to a new WHO survey. The demographic characteristics of the weighted P2P sample are similar to Indiana as a whole. All P2P respondents who consented to future contact were eligible for the COVID-19 rapid response follow-up (wave 2). Additionally, 11% reported being worried about having a place to live, and 27% worried about their ability to buy food due to the pandemic. Published by PNAS. © 2020 Reuters/Kevin Lamarque. Cluster-robust SEs are one of the most common methods for accounting for shared geography among members of a sample. All estimates are adjusted with poststratification weights to account for minor differences between the P2P’s sample and that of Indiana, and are adjusted for clustering at the county level. analyzed data; and B.L.P. In one unidentified American city, a survey of hourly service workers found two-thirds experienced income losses following stay-at-home orders, nearly half had been laid off, and many were unable to receive assistance regarding unemployment insurance, childcare, distance learning for their children, or basic necessities (17). Rates of unemployment in the year prior to COVID-19 (4%) matched national averages during 2019, and about 24% reported being food or housing insecure, suggesting substantial economic vulnerability even before the pandemic. Residents without a college degree are twice as likely to report food insecurity (compared to some college), while those not completing high school (compared to bachelor’s degree) are 4 times as likely to do so. However, less well understood are the cross-cutting short- and long-term impacts of such events on the economic wellbeing and life chances of individuals across sociodemographic groups. Using longitudinal data (n = 994) from the Person to Person Health Interview Study, fielded in 2019–2020 and again during Indiana’s initial stay-at-home order, we provide a representative, probability-based assessment of adverse economic outcomes of the pandemic. Adjusted parameter estimates for disparities in COVID-19 precarity, P2P (n = 994). Overall, we expect unemployment to be at its peak during the snapshot provided by these data, although economic and material insecurity may have been offset by savings, Economic Impact Payments, and supplemental unemployment payments that likely had short-term protective effects. Findings are consistent with patterns of inequality observed following other disasters, including Hurricane Katrina, the Chicago Heatwave, the Buffalo Creek Flood, and the Great Recession. Pandemic precarity: COVID-19 is exposing and exacerbating inequalities in the American heartland. This suggests that the pandemic has disproportionately threatened the economic security of those already vulnerable and disadvantaged. Yet, consequences likely extend far beyond morbidity and mortality. We estimated educational disparities in financial strain with four dichotomous measures of respondents’ educational attainment: bachelors or higher, some college, high school, and less than high school. Individuals with less than a bachelor’s degree reported significantly higher odds of enduring all indicators of economic precarity. “There is … Breaking News, Latest Updates Highlights of January 10 . The COVID-19 pandemic has revealed wide disparities in infection and recovery rates by race, ethnicity, socioeconomic status, and place of residence (1⇓⇓–4). Copyright © 2021 the Author(s). ↵†Regarding the pandemic, the COVID-19 test positive rate (1,431/100,000) in Indiana was similar to the median for the country as a whole (Utah at 1,696/100,000) during the time of data collection (55). Edited by Douglas S. Massey, Princeton University, Princeton, NJ, and approved December 28, 2020 (received for review October 2, 2020). Although the final dataset will be stripped of identifiers prior to release for sharing, there remains the possibility of deductive disclosure of participants. States with governors that Trump sees as political allies (such as Florida), have received the full measure of requested personal protective equipment from the federal stockpile, while states with governors whom Trump identifies as political enemies (such as New York's Cuomo, Oregon's Jay Inslee, and Michigan's Gretchen Whitmer, all Democrats) have received only a fraction of their requests. Overall, Black respondents had significantly (P < 0.05; sample-weighted Student’s t test) higher rates of economic precarity for all but one outcome (housing insecurity). designed research; B.A. The little we do know is alarming. Although the numbers of reported cases seem to be levelling off in New York City and other urban areas, perhaps evidence that social-distancing measures are beginning to have an effect, emerging morbidity and mortality data have already clearly demonstrated what many have feared: a pandemic in which the brunt of the effects fall on already vulnerable US populations, and in which the deeply rooted social, racial, and economic health disparities in the country have been laid bare. Multivariate models used to estimate effects include the predictors described above and use the same analysis sample (n = 994). Many of our outcomes may be correlated with county-level information. Data collection began on March 28 and was completed on May 31, 2020, during the height of the first wave of the pandemic in Indiana. However, the trend has not been universal: in Ohio, Republican Governor Mike DeWine was swift in issuing orders to shut non-essential businesses and in responding to the crisis. In the long term, public social expenditures and initiatives that reduce the wealth gap and strengthen the social safety net will, in turn, improve economic preparedness for disasters. It’s not a coincidence that Black people are more likely to get coronavirus: It’s the result of policy choices leading to poor health and economic outcomes. Data were collected face-to-face by professional interviewers employed by the Indiana University (IU) Center for Survey Research, and respondents were paid up to $125 for participation. Most notably, Indiana has a substantially lower proportion of Latinx residents than the United States as a whole (56). They were then recruited and consented into the study by phone. If unique disasters have similar effects, then specifically tailored recommendations for health and health care inequities in the face of crises are likely to be of little use in protecting vulnerable individuals in the next disaster, whatever its nature. However, despite changes in patterns of viral transmission in urban and rural areas, patterns of inequality are likely to have remained relatively stable, even if the magnitude of economic impact improved over the course of the pandemic. However, the IHS's ability to respond to the crisis might be limited: according to according to Kevin Allis, Chief Executive Officer of the National Congress of American Indians, the largest Native American advocacy organisation, the IHS has only 1257 hospital beds and 36 intensive care units, and many people covered by the IHS are hours away from the nearest IHS facility. Colored dots indicate statistically significant parameter estimates; gray dots indicate nonsignificant parameter estimates. To determine differences in financial strain by race following the COVID-19 pandemic, we measured four dichotomous race variables: White, Black, Latino, and other. This article is a PNAS Direct Submission. Sample means are estimated with survey weights. Financial insecurity prior to the pandemic using measures of employment status and food or housing insecurity reported in the baseline is controlled. We address pandemic precarity, or risk for material and financial insecurity, in Indiana, where manufacturing loss is high, metro areas ranked among the hardest hit by the Great Recession nationally, and health indicators stand in the bottom quintile. The CARES Act also included US$8 billion to supplement the health and economies of Native Americans and Alaska Natives. Together, the results support contentions of a Matthew Effect, where pandemic precarity disproportionately affects historically disadvantaged groups, widening inequality. Image credit: Mathieu Caffin on behalf of Bailey Ferguson/Schmidt Ocean Institute. Investing in reducing wealth inequality will improve economic mobility, mental and physical health, and quality of life. And, as Charles Tilly (41) described, unless the social organization of tacitly or forcefully agreed upon social relations change, the inequities that accompany those statuses will be “durable.”. Florida Governor Ron DeSantis, a Republican Trump ally, was slow to implement social-distancing measures and close non-essential businesses, and Georgia Governor Brian Kemp ordered beaches closed by local authorities to be reopened on April 3. where g denotes the gth cluster in the sample (54). Comparing data before COVID-19 reached the state and during the initial stay-at-home orders, we find socioeconomic shocks disproportionately affecting vulnerable groups, controlling for prepandemic status. and B.A.P. If we parameterize a typical ordinary least squares (OLS) regression asyi=βxi+ui. Evidence out of Europe suggests that job losses and economic hardship have disproportionately affected the less educated and those in the lower income strata (14, 15). What these findings from Indiana reveal, with important but minor nuances, is the same story observed during and following Hurricane Katrina (8, 10), the Chicago Heatwave (9), the Buffalo Creek Flood (11), and, most recently, the Great Recession (12, 22, 23, 35). S4). The study's researchers also noted that the pandemic itself has been exacerbating these conditions in many people, potentially threatening their future immunity to COVID. However, there is a glimmer of hope—some of the factors that could dampen a person's immune response can be … And, in fact, the COVID-19 variants from the United Kingdom and South Africa (officially B.1.1.7 and B.1.351, respectively) are featured in several models and play an exacerbating factor. In short, Indiana—the heartland of America—is an ideal place to examine the societal fault lines of pandemic precarity, and the reproduction and widening of social inequalities. 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