Far from an “equalizer,” the virus is affecting already marginalized Americans the most.
A month after being declared a pandemic by the World Health Organization, the coronavirus has caused deaths in every state in America. It has taken the lives of celebrities like John Prine as well as local grocery store workers, transit operators, and other service employees. Tom Hanks has shared his thoughts on quarantine, and so have teens on TikTok. Millions of Americans of all walks of life have been ordered to stay at home, with no clear end in sight.
For this reason, some have described the coronavirus as an “equalizer.” “Everyone is subject to this virus,” New York Gov. Andrew Cuomo said in March. “I don’t care how smart, how rich, how powerful you think you are.”
But with every day that goes by, it becomes more clear that the virus isn’t an equalizer at all. Instead, it is exacerbating the inequalities in American society, taking a disproportionate toll on low-income Americans, people of color, and others who were already marginalized before the crisis hit.
It starts with who’s able to shelter in place — while many white-collar workers can work from home, a disproportionate share of the front-line workers still going to their jobs in many industries are women and people of color. And among those staying at home, inequality is still a huge issue, with some able to order delivery and others forced to visit overstretched food banks to meet their needs.
Meanwhile, early data suggest that black Americans are becoming ill and dying of coronavirus at much higher rates than white people, potentially as a result of existing health disparities that have their roots in structural racism and economic inequality.In Michigan, for example, black residents made up around 40 percent of coronavirus deaths as of April 9, even though only about 14 percent of the population is black, as Khushbu Shah reports at Vox. The prevalence among black Americans of heart disease and other “chronic conditions that are related to socioeconomic status” is “making the effect of the Covid crisis much worse,” Julia Lynch, a political science professor at the University of Pennsylvania who studies health inequality, told Vox.
The pandemic has also brought with it an economic crisis — and that too has been far from an equalizer. Low-wage workers are especially vulnerable to layoffs during this time, as Vox’s Emily Stewart and Christina Animashaun report, with restaurant and retail workers especially at risk. That has left many workers who used to have jobs with the country’s major restaurant chains scrambling to keep a roof over their heads, Anthony Advincula, public affairs officer and national policy coordinator at Restaurant Opportunities Centers United, which works on behalf of low-wage restaurant workers, told Vox. But “if you look for the executives of these restaurant chains, they’re probably in their vacation houses,” Advincula said.
Overall, the lesson of the pandemic so far is that while the virus itself can infect anyone, those hit hardest by the national and worldwide crisis around it are those who were already hurting — experiencing racism, housing instability, job insecurity, and other ills that disproportionately affect marginalized communities around the country. And many fear that unless policymakers do more to address the disparate impacts of the virus, the result will be a country that’s more unequal than it was before, even long after the pandemic is over.
The virus is hitting Americans of color the hardest
Despite repeated claims of being an “equalizer,” the coronavirus has always had a disproportionate impact on people who are already vulnerable — and often ignored. People over 65 and those who are immunocompromised are at higher risk of serious illness if infected, according to the Centers for Disease Control and Prevention. That fact led some younger, healthy people to dismiss the virus initially as something that “only” harmed the old and sick.
Such an attitude “relegates people who have a chronic illness, people who have disabilities, and older adults” to a category of people who somehow don’t matter to society, sending the message that “we don’t have to care about this group as much,” Stacy Torres, an assistant professor of sociology at the University of California San Francisco, told Vox in March.
With much of the nation under stay-at-home orders, there’s a greater understanding that people of all ages and without underlying conditions can become seriously ill from the virus. But that doesn’t mean it’s impacting all groups of people equally.
Instead, preliminary data from states and cities around the country suggests that black Americans are disproportionately likely to get sick and die from Covid-19. Michigan, where the majority-black city of Detroit is emerging as an epicenter, is just one example. In Chicago, black people made up 50 percent of cases and 68 percent of deaths as of April 7, Fabiola Cineas reports at Vox, even though just 30 percent of the city’s population is black. And according to preliminary data released by New York City on April 8, the coronavirus death rate for black New Yorkers is twice that of white residents.
There are a number of possible reasons for the disparity, but a big part of the reason black Americans are being affected so much more than white people in many places is “the underlying health problems that they are already experiencing,” Lynch said. Those include hypertension and diabetes, which can worsen the effects of the coronavirus — and which affect black Americans at disproportionately high rates.
And black Americans are more likely to have underlying conditions because of widespread racism and inequality, experts say. Many differences in health outcomes in America are “produced by access to things like adequate time to prepare healthy foods at home” and “adequate money to not be working three shifts and have really high stress levels,” Lynch said — access that white people are just more likely to have. As Cineas notes, 22 percent of black Americans lived in poverty in 2018, compared with 9 percent of white Americans.
Beyond poverty, a number of factors contribute to poor health among black people, from racism in medical settings to the physical health effects of discrimination. Redlining and other forms of housing discrimination have made black Americans more likely to live in neighborhoods affected by environmental contamination, which federal and state officials have been slow to respond to, in turn raising rates of chronic illness. In Flint, Michigan, for example, where much of the majority-black population has been affected by lead-contaminated drinking water, the pandemic is “a crisis on top of a crisis with a side of crisis,” Mayor Sheldon Neeley told Shah. Essentially, inequality in all facets of American society appears to have set up black Americans to bear the brunt of this crisis.
That inequality also extends to whether people can get (and pay for) adequate care during this time. Funding for public health clinics that serve low-income Americans has been drying up, Lynch said, leaving people who rely on such clinics without an obvious place to go for care, or even for information about whether they might be infected. And while the Trump administration now says it will pay for the treatment of Covid patients without insurance, some people have already incurred thousands of dollars in bills.
Danni Askini, for example, was being treated for lymphoma when she contracted the virus, according to Time. The bill for her Covid testing and treatment was $34,927.43. “I personally don’t know anybody who has that kind of money,” she told the magazine.
Not everyone can afford to shelter in place
Underlying conditions are likely only part of the reason Covid is hitting some Americans harder than others. In a time when people are being advised to stay home to minimize their risk of exposure, many literally can’t afford to do so.
To begin with, there are people whose jobs can’t be done remotely, like grocery store cashiers, delivery workers, and bus drivers. These workers have already seen a devastating impact from the virus, with 41 New York City transit workers having died and about 1,500 testing positive as of April 8, according to the New York Times. Grocery store chains are also beginning to report the deaths of workers, according to the Washington Post, with deaths of a Trader Joe’s employee in Scarsdale, New York, and two employees at a Walmart in Evergreen Park, Illinois, among the first to be publicly reported.
Workers in these front-line industries are also disproportionately female, according to a recent report by the Center for Economic and Policy Research. In many occupations within these industries, such as bus driving, warehouse work, and building cleaning, people of color are overrepresented. And about a quarter of all front-line workers live in low-income families.
While some health care workers, like doctors, can make a high income, inequality shows up within the health care workforce as well. Women and people of color are “much more likely to be in those really front-line staff positions where they’re less well-protected,” Lynch said, such as catering or janitorial services in hospitals. Especially given current shortages of protective equipment, these workers may be less likely than doctors to have the masks and gloves that can help keep them safer. In one Service Employees International Union poll of 250 hospital workers, mostly housekeepers and nurse’s assistants, 75 percent said they were told they did not need protective equipment or had to ask a nurse for it, according to Reuters.
Just as Americans’ jobs affect their risk during this time, so does their living situation. While people with means have been able to leave coronavirus hot spots like New York City for their vacation homes (sometimes sparking conflict with local residents), most Americans lack the mobility to leave areas that are hard-hit by the pandemic. Race and class also determine how much people can isolate themselves — housing discrimination and other inequalities contribute to the fact that black Americans are more likely to live in multigenerational homes and share resources like cars, as Cineas reports, making social distancing more difficult and increasing their exposure to the virus.
For incarcerated Americans and those who are homeless, the risks are especially acute. Cook County Jail in Chicago, for example, is the site of one of the nation’s largest coronavirus clusters, and at least 1,324 confirmed cases had been linked to prisons and jails across the country as of April 8, according to the New York Times. Meanwhile, as Vox’s Catherine Kim reports, homeless Americans are disproportionately at risk due to a lack of shelter space — especially as shelters try to adapt to distancing recommendations and deal with a lack of volunteers during the crisis.
Even for people who do have a home to go to, getting necessities can be difficult and risky in this moment — and like everything else, it’s more difficult and risky for those with less money. In a time when the White House has advised Americans not to go to the grocery store at all, some are able to order delivery from services like Instacart or Peapod. Demand for these services is skyrocketing — Instacart, for example, has seen a 300 percent increase in order volume in the past week, compared with the same period last year, Eater reports.
But “it’s the middle- and upper-class families who have the income to not only purchase items through these delivery systems but also the ability to pay for the delivery and the additional fees,” Daphne Hernandez, an associate professor at Cizik School of Nursing at The University of Texas Health Science Center at Houston who studies food insecurity, told Vox. Fees vary by service and order, with Instacart, for example, charging between $3.99 and $9.99 to deliver an order under $35, not including tip. Grocery items may be more expensive on some delivery platforms than in stores as well.
The services also require internet access, something not all low-income families have. So while wealthier people are able to order groceries on their phones (if they can get a time slot), lower-income families may have to go a store — and if they are still working, they may have to go at night, when shelves are more likely to be empty, Hernandez said. That means that lower-income people are both putting themselves at greater risk to get groceries right now and likely feeling the brunt of food shortages. Meanwhile, people who rely on food assistance programs are facing difficulty buying staples, because the brands designated as eligible for these programs have already been bought by other shoppers, BuzzFeed reports.
Add to that the fact that many resources that usually help food-insecure people are struggling right now. Many children used to rely on schools for free or reduced-price breakfast and lunch, Hernandez points out — around the country, about 30 million kids qualify for these programs — and although schools set up food distribution centers when the crisis hit, some have shut down as a result of stay-at-home orders or a rise in infections. And food banks around the country are struggling to meet a spike in demand as a result of the pandemic.
Overall, “we’re going to see food insecurity rates spike,” which could lead to increases in health problems like obesity and diabetes among low-income Americans, Hernandez said. That, in turn, would set them up to be even more at risk in future public health crises.
The economic crisis will impact low-income Americans and people of color the most
In addition to its devastating impact on Americans’ health, the virus has ushered in an unprecedented economic crisis — the most serious since the Great Depression of the 1930s, according to the International Monetary Fund. In the US alone, more than 16 million new jobless claims were filed in just three weeks in March and early April.
The effects are being felt across the economy, from restaurants to tourism to media, but as with everything else about the crisis, the economic effects are being felt most keenly by those who are already most vulnerable. In March, experts estimated that those most vulnerable to layoffs during this time were those who could least afford to lose a paycheck, like low-wage workers in the restaurant and retail industries, as Vox’s Stewart and Animashaun report.
And across industries, those least able to weather a period of unemployment will be “lower-wage, lower-income households, which also tend to be disproportionately black and Latino households,” Valerie Wilson, the director of the Economic Policy Institute’s Program on Race, Ethnicity, and the Economy, told Vox. Lower-income people are less likely to have savings to fall back on in such a time — and because of the racial wealth gap in America, black and Latino families are less likely than white Americans to have money put away. While the median wealth for white Americans was $171,000 in 2019, it was just $17,600 for black Americans, as Trymaine Lee reported at the New York Times Magazine.
The economic impact of the virus isn’t just about layoffs. It’s also about people who get sick, Wilson noted: “What will that mean in terms of their ability to work and support and care for their families?”
And since black Americans appear more likely to get seriously ill and die from the virus, their families are more likely to feel the economic impact of that as well.
The federal government has made moves to help, bolstering unemployment insurance, promising stimulus payments for many, and mandating paid sick leave for some. But those efforts leave out a lot of the most vulnerable Americans. For example, companies with more than 500 employees are exempt from providing paid sick leave to workers. While some large companies, like Walmart and Target, have said they will offer sick leave anyway, others, like Dine Brands, the parent company of the restaurant chains Applebee’s and IHOP, have not.
In an especially tone-deaf move, Applebee’s recently offered laid-off employees a 50 percent discount on Applebee’s orders, ROC United’s Advincula told Vox. (Applebee’s told Vox in a statement that 96 percent of its restaurants are franchise-owned, but that “for the 69 company-owned Applebee’s restaurants, we have a paid sick leave policy for our team members in accordance with applicable laws.”)
Moreover, applying for unemployment has become very difficult for many, with state unemployment offices overrun. And undocumented workers — who make up more than 10 percent of the restaurant workforce, according to Advincula — can’t get unemployment or stimulus payments.
Overall, there are a lot of gaps in the federal government’s efforts to stem the economic impact of the virus, Advincula said, and “a lot of restaurant workers have fallen into those cracks.”
The pandemic will dramatically worsen American inequality — unless the country takes action
Ultimately, the coronavirus pandemic stands to worsen the already enormous problem of inequality in America. But it doesn’t have to be that way. A variety of solutions would help protect the most vulnerable during this time, and set up the country for a more equal recovery.
“Obviously and most basically, people need to be able to go to the hospital and get care if they need it,” Lynch said. “We need to have universal access to health care that is affordable and of a high quality.”
Beyond that, robust paid sick leave in America would both allow people to care for themselves and family members when they are sick and help prevent the spread of disease. And the country needs to get to work on “generally reducing socioeconomic equality and deprivation,” because those are driving the prevalence of cardiovascular disease, diabetes, and other underlying conditions among people of color and low-income Americans.
“People who are living lives close to the economic margins are always going to experience more of these kinds of conditions, and so reducing the poverty and inequality that generate ill health is going to make people more resilient in the face of these kinds of new illnesses,” Lynch said.
One way to promote health is to combat food insecurity. To do that right now, the US needs an expansion of SNAP and other food assistance programs for a minimum of six months, Hernandez said. After the Great Recession began in 2007, food insecurity rose about 30 percent the following year, she said. “We’re going to see something like that again unless we have programs in place that will sustain people after all of this is over.”
And, she added, food assistance programs need to be coupled with assistance paying for utilities and other necessities. “If people are having trouble accessing food,” she explained, “they’re also having problems paying for their bills.”
ROC United is asking the federal government to eliminate loopholes that allow large companies (as well as those with fewer than 50 employees) to deny paid sick leave. The group also calls for a loosening of unemployment restrictions, payments to unemployed workers who are undocumented, and a nationwide moratorium on evictions and utility shutoffs during this time. It’s also asking the Occupational Safety and Health Administration to issue standards for safe working conditions in light of Covid-19.
“Another pandemic is going to happen, so if we’re not ready again, this would hurt the economy and the country again,” Advincula said.
The Trump administration, however, has shown little appetite for many of these reforms. For example, the Department of Labor earlier this month issued guidelines giving small businesses broad latitude to deny their employees paid sick leave, according to the New York Times.
Still, members of Congress have been pressing the administration to pay attention to the ways the virus could be magnifying inequality. In March, Sen. Elizabeth Warren and Rep. Ayanna Pressley of Massachusetts sent a letter to the Department of Health and Human Services calling on it to address racial disparities in the nation’s coronavirus response, including collecting and releasing nationwide data on cases broken out by race and ethnicity. “Without demographic data,” they wrote, “policy makers and researchers will have no way to identify and address ongoing disparities and health inequities that risk accelerating the impact of the novel coronavirus and the respiratory disease it causes.”
State officials are taking action too; Michigan Gov. Gretchen Whitmer, for instance, created a task force on April 10 to address racial disparities in the virus’s impact on Michiganders. “We know that generations of racial disparities and inequality has a detrimental impact on the lives of people across the state,” Lt. Gov. Garlin Gilchrist II, who will chair the task force, said in a statement. “The coronavirus pandemic has shown this inequity to be particularly true.”
As the disease continues to spread and the economic impact increases, more and more people around the country will be in need of help — whether it’s caring for loved ones, healing from their own illnesses, or paying their bills. The impact of the pandemic, now and in the future, will likely remain concentrated among those who were already at a disadvantage before it hit — unless the country acts now to remedy the inequities that made them vulnerable in the first place.
Update: This story has been updated to include a statement from Applebee’s.
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