Protecting vulnerable communities during a pandemic

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Local to federal governments are figuring out best practices to control the spread of coronavirus while minimizing the negative effects of sweeping health strategies.

While communities are working to stay safe, they are still trying to understand how to balance personal liberty, especially for poor and marginalized communities, which may be the hardest hit, according to a post by Health Affairs.

According to a report by TIME Magazine, many low-income jobs can’t be done remotely, and the majority of low-income jobs don’t offer paid sick days. According to a 2019 Federal Reserve study, 40% of Americans could not come up with $400 to cover an emergency.

As schools get shut down, many low-income children can not rely on free and reduced school meals for daily nutrition as well as low-income parents who can’t afford child care when their kids are suddenly home all day. About 22 million free and reduced-price lunches and 12.5 million breakfasts are served in school each day. More than 34 million households rely on the Supplemental Nutrition Assistance Program (SNAP), and 6.4 million rely on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). As many schools go to virtual learning, millions of households across the country that lack access to high-speed internet may be out of luck.

Social distancing and sheltering in place have emerged as a key strategies for flattening the curve of the epidemic and mitigating impacts on already-stressed health care systems. This could be difficult for particularly vulnerable populations including people with disabilities, workers who do not have the option of staying home, homeless or those without secure affordable housing.

According to the most recent data from the Census Bureau, 38.1 million people, or 11.8 percent of the U.S. population, were living in poverty in 2018. Individuals and families in poverty have less control over their environment and few to no alternatives to substandard housing.

Many low-income individuals and families face significant challenges that prevent them from protecting themselves and others from COVID-19. Many lack disposable income and flexible work schedules. Being forced to choose between paying for food, health care, utilities, or other necessities as well as keeping up with rent can be a challenge.

At the same time, being largely confined to their homes could pose its own health risks for many low-income individuals and families. Low-income people are more likely to live in homes with poor air quality, mold, asbestos, lead, pest infestations, and inadequate space to separate the sick from the well. 40% of homes in US metropolitan areas have one or more health and safety hazards and rental properties have a higher rate of health-harming conditions than owner-occupied units

Two million people in the United States live in severely inadequate homes that lack hot water or electricity as well as have structural defects.

Fortunately, there are actions state and local governments can take immediately to support the ability of low-income and marginalized communities to safely shelter in place.

Beyond affordable testing and treatment for COVID-19, supporting more routine, but equally life-threatening, physical, mental, and behavioral health needs is a priority. This should also extend to people in custody.

Policies should address health, financial, and social impacts on vulnerable communities.

Thirty-four million workers have no paid sick leave. Working people without sick leave are 1.5 times more likely to go to work with a contagious disease and three times more likely to go without medical care compared to those with paid sick days.

To address healthy behaviors like social distancing, also look at the immediate legal, social, and financial protections that support those behaviors.

More than 560,000 individuals were homeless in the U.S. on a given night in 2019. People without consistent housing often lack access to soap and water, live in communal-style shelter, as well as have a high rate of untreated infectious and chronic disease and disabilities. At the same time, half of the adult homeless population is over age fifty, increasing the risk of health complications. For many people who are homeless, COVID-19 could be life-threatening and difficult to contain. 

Finally, policy responses should address root problems in addition to immediate needs.

According to the World Health Organization, access to clean water for cooking, hydration, and hygiene is crucial to preventing the spread of the novel coronavirus. Similarly, electric, gas, and steam utilities are essential to one’s ability to heat a home, cook, preserve perishable foods and medication, and use medical equipment— all necessary to shelter in place, especially for extended periods of time.

State and local leaders have an opportunity to protect workers, freeze evictions and utility shut-offs, and prioritize programs that secure safe as well as healthy housing conditions and nutritional supports.

Ultimately, the COVID-19 pandemic underscores the importance of ensuring that all members of society have the ability to benefit from and comply with public health measures.

Resources in Michigan:

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