How COVID-19 is exposing inequality in America

The gap between the rich and the poor in the U.S. has been widening over the last few decades, and it’s becoming increasingly apparent thanks to the financial difficulties from the pandemic. Around 4 in 10 Americans would have difficulty covering a $400 emergency without going into debt, according to the Federal Reserve. That means an unexpected health care bill, a loss of a job or hours at work, or another financial hiccup could put people in this demographic into a debt spiral.

When it comes to aging-health problems, the U.S. ranks 53rd out of 195 countries, according to a 2017 study from The Lancet. The high levels of diseases related to aging combined with the fact that the risk of COVID-19 is higher for older adults with severe underlying medical conditions further exposes how seniors are disproportionately impacted by the pandemic.

Not only will rural communities see fewer federal relief dollars than other localities, but they also have less access to health care than their metro counterparts—a dangerous situation, given that some rural areas have yet to hit their peak infection rates, according to Olugbenga Ajilore of the Center for American Progress. Most rural counties lack intensive care units at their hospitals, while others have no hospital at all, according to Kaiser Health News.

[Pictured: Poplar Bluff Regional Medical Center, Poplar Bluff, Missouri.]

COVID-19 has also exposed inequality at the geographic level. The federal CARES Act allocates states with $150 billion and localities with $30 billion to help with relief efforts. The $150 billion won’t be enough to cover state budgets, though, and since rural towns won’t see money from the $30 billion locality fund, they may be left behind in the recovery, reports Olugbenga Ajilore of the Center for American Progress.

[Pictured: Athens, Georgia.]

When the pandemic hit the U.S., the government created new financial benefits (such as a $1,200 stimulus check) to help struggling Americans. However, those measures didn't help everyone equally. Around 15 million immigrants and 15 million adult children (including students) still claimed by their parents as tax dependents were excluded from the CARES Act, according to the Center on Budget and Policy Priorities.

Job seekers may be facing a grim future for their careers compared with people who continued working. According to the Bureau of Labor Statistics, many of the industries with the most expected job growth are also among those that pay the least.

[Pictured: Smithfield Foods, Sioux Falls, South Dakota.]

Your wealth (or lack thereof) can make a big difference in your ability to protect yourself from COVID-19. Wealthy people can fly out of town on a private plane to ride out the pandemic in secluded locations, while many other people may be forced to stay in crowded cities and risk exposure to the virus while taking public transportation to work, reports Max Abelson of Bloomberg.

[Pictured: Ocean Drive, Newport, Rhode Island.]

While 93% of workers who earn the highest wages get paid sick time, the same can only be said for less than half of the bottom quarter of wage-earners, according to Elise Gould of the Economic Policy Institute. That may leave low-paid workers at greater risk of spreading the coronavirus (or getting infected by it) if they have symptoms and can’t afford to take time away from the job.

While some cities and states require that companies provide paid sick time to employees, workers’ access to that benefit can vary quite a bit—a problem that the coronavirus has spotlighted. Workers who hold down multiple jobs often can’t accrue sick time that they can actually use, notes Alana Semuels of Time.

Fourteen states, most of which are located in the Plains or the South, have turned down the Affordable Care Act Medicaid expansion. That's created more inequalities in the health care system and potentially leaves millions of the poorest, least healthy Americans more vulnerable to not getting the treatment they need if they get COVID-19, according to Aaron van Dorn, Rebecca E. Cooney, and Miriam L. Sabin of The Lancet.

Health insurance in the U.S. is typically provided through an employer, and those without an education might not be able to secure a job with health benefits. Around a third of people in the U.S. who have not earned a high school degree lack health insurance—a situation that affects only about 5% of college graduates, according to Jonathan JB Mijs of The Conversation. That could make them resistant to seeking care if they have COVID-19 symptoms or leave them with a huge medical bill if they get treatment.

Your exposure to the coronavirus can be impacted by your education and what type of job you have. While more than half of college graduates can work remotely (and thus avoid exposing themselves to the virus in the office and on public transportation), just 12% of workers who have a high school degree can work from home. What’s more, only 4% of workers without a high school diploma have the option to telecommute, according to the Bureau of Labor Statistics via Jonathan JB Mijs of The Conversation.

While women are less likely to die from COVID-19 than men are, they are disproportionately bearing the brunt of other negative effects of the pandemic. They comprise the majority of the world’s older adult population, they’re more likely not to live with anyone else, and they tend to have less access to mobile phones or the internet, leaving them at risk of isolation, according to the United Nations.

Household income levels are making it harder for some students to keep up with online schoolwork while their classrooms are closed. Around 14% of U.S. households with students have no internet access, according to the National Telecommunications and Information Administration via the Observer. These offline households tend to have much lower incomes than families who are connected to the internet.

With more students relying on the internet to keep up with school during the pandemic, the digital divide (and those who are left behind due to a lack of internet access) is becoming more apparent. Only about 8 in 10 African American and Hispanic children have internet access at home, compared with nearly 9 in 10 Asian American and white children. Furthermore, there is a four-percentage-point divide in home internet access between urban and rural households, according to the National Telecommunications and Information Administration.

Health insurance is a vital service that can play a role in whether or not people can afford treatment for COVID-19 or another serious issue. While people of color are more likely to be affected by COVID-19, they’re also less likely than their white counterparts to have health insurance, according to Samantha Artiga, Rachel Garfield, and Kendal Orgera of Kaiser Family Foundation.

COVID-19 is impacting racial groups in different ways, with people of color faring the worst. Data from The COVID Tracking Project shows that while people of color make up a smaller percentage of state populations, they account for a disproportionately high rate of COVID-19 cases and deaths in many states.

Health disparities among races have become more visible in coronavirus hot spots. In New York City, for example, Black people face double the risk of dying from COVID-19 than white people, according to data released in mid-April by the city’s Health Department, via ABC News.

While telecommuting has been one strategy people and companies have used to avoid exposure to the coronavirus, it’s not an option for all workers. Just 16.2% of Hispanic or Latinx Americans and 19.7% of Black or African Americans can work from home, compared with nearly 30% of white people, according to 2017–2018 data from the Bureau of Labor Statistics.

Essential workers have been forced to put their own health at risk by going into their workplace throughout the pandemic. Jobs deemed essential like grocery clerks, bus drivers, health care workers, and custodians tend to be held by minorities rather than white people, according to Aaron van Dorn, Rebecca E. Cooney, and Miriam L. Sabin of The Lancet.

People with underlying health conditions are at higher risk of coming down with a severe case of COVID-19. Native Americans in particular have disproportionately high levels of conditions like diabetes and heart disease, which puts them at higher risk of having a complicated case of COVID-19, according to Aaron van Dorn, Rebecca E. Cooney, and Miriam L. Sabin of The Lancet.

[Pictured: Casamero Lake, New Mexico.]

People who live in crowded cities may have a more difficult time practicing social distancing and avoiding coronavirus exposure than those in rural or suburban areas. When it comes to city-dwelling, people of color face a greater likelihood of living in a densely populated location and in residences with multiple generations of people under the same roof, according to Dr. Jerome Adams, the U.S. surgeon general, via NPR.

[Pictured: New York City.]

Health disparities can be severe among immigrant communities compared with their white counterparts. Undocumented Latinx workers employed in industries like meat production, poultry, and farming often don’t have health insurance, according to Aaron van Dorn, Rebecca E. Cooney, and Miriam L. Sabin of The Lancet.

Stimulus checks meant to offer sweeping help to families across the U.S. left some people behind. At least 1.2 million American citizens won’t get the $1,200 stimulus check or the additional $500 per child because they are married to non-Americans, according to the Migration Policy Institute via ABC News. The Mexican American Legal Defense and Educational Fund puts the figure of people who won’t get checks even higher at 2 million.

The 2.2 million people incarcerated in the U.S. may be living in facilities that are "in no way equipped" to manage the coronavirus, according to Talha Burki of The Lancet. Older adults, who are at higher risk of COVID-19, comprise a larger share of the U.S. prison population than those between the ages of 18–24, according to The Marshall Project. People living in prisons around the world may also be subjected to crowding and inadequate health care resources.

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The industry a person is employed in can affect their risk of exposure to the coronavirus. America’s 3.4 million food production workers, who often lack health insurance and citizenship, may have a more difficult time accessing COVID-19 tests and getting health care treatment, according to Samantha Artiga and Matthew Rae of the Kaiser Family Foundation.

Health care workers are rightfully being lauded as heroes during the pandemic, but they're not all treated that way when it comes to pay and benefits. There are nearly 7 million people who work low-paid health jobs, including health care support workers, direct care workers, and health care service workers, where the 2019 median wage was $13.48 an hour, according to Molly Kinder of the Brookings Institution. What’s more, almost 50% of home health care workers and nurses don’t have any paid sick leave, according to author and former economic advisor Gene Sperling, via Forbes.

Homeless people may be at greater risk of COVID-19 due to crowded living quarters at shelters and a lack of access to testing, according to Amy Maxmen of Nature. Previous research has already found that people who lack housing tend to have worse health outcomes, and the pandemic may be worsening that situation, according to Dr. Lipi Roy of Forbes.

Crowded cities make it harder to practice social distancing, thus putting urban dwellers at greater risk of exposure to the coronavirus. Many of the wealthiest city slickers, however, have been able to lower their risk by fleeing to their second homes in suburban and rural towns. Some have even purchased their own ventilators and medical supplies, according to Vicky Ward of CNN.

Immigrants and asylum-seekers who have been detained by the U.S. Immigration and Customs Enforcement agency may be at higher risk of catching the coronavirus than others. One of every 31 people detained by ICE has tested positive for the virus, according to data from mid-May, via the Brookings Institution.

[Pictured: GEO Aurora ICE Detention Center, Aurora, Colorado.]

The financial ramifications of the pandemic have hit small businesses harder than large corporations. They tend to have far less political influence and fewer cash reserves that can help them weather the shutdowns, according to Heather Boushey and Somin Park of the Washington Center for Equitable Growth.

[Pictured: Shuttered retail space, Beverly Hills, California.]

Farmers are facing a double whammy during the pandemic. Not only are everyday shoppers tightening their budgets, but restaurants and institutions have cut back on food orders while they’re shut down. As a result, farmers haven’t been able to charge nearly as much for food, according to Monica Jimenez of Tufts Now. They’ve also needed to destroy millions of pounds of food that has gone unsold, according to David Yaffe-Bellany and Michael Corkery of The New York Times.

[Pictured: Rotting Russet Burbank potatoes, Warden, Washington State.]

Adults with disabilities may face a greater risk of COVID-19 complications due to underlying conditions. They’re three times as likely as Americans without disabilities to have cancer, heart disease, stroke, or diabetes, according to the CDC.

While experts recommend keeping distant from elderly relatives and other at-risk people during the pandemic, that’s not always an option for the 64 million people in the U.S. who live in a multigenerational household, according to Cara Anthony of Kaiser Health News. Grandparents may be confined in tight quarters with their younger relatives, who may not have any other place to stay.

Undocumented immigrants have increased risk of the coronavirus due to the types of jobs they tend to have and the low wages they tend to be paid, but the problem compounds when the risk of deportation is added to the mix. Many are increasingly avoiding medical care and other public services out of a fear of deportation, according to Usha Lee McFarling of STAT.

With historically underfunded health services, Native Americans face greater challenges than other groups during the pandemic. Nearly 1 in 5 Native Americans and Alaska Natives have avoided seeing a doctor because of the cost, while 36% of people in those groups have waited to get medical care for other reasons as well, according to Samantha Artiga, Rachel Garfield, and Kendal Orgera of the Kaiser Family Foundation.

While many businesses have faced challenges during the pandemic, some—like restaurants, hospitality companies, retail stores, and other service industries—have been hit particularly hard. The low-wage workers in these industries have proved far more vulnerable to layoffs than those in more lucrative positions in other industries, according to Anna North of Vox.

Prior to the pandemic, people of color had already reported more financial concerns, such as whether they could pay their rent and make minimum credit card payments, than white people. Those challenges have only worsened during the pandemic, with people of color more likely to work in sectors hit hard by layoffs, according to Samantha Artiga, Rachel Garfield, and Kendal Orgera of the Kaiser Family Foundation.

The ongoing underfunding of public health care clinics, which had started prior to the pandemic, is exacerbating risks associated with the coronavirus for low-income people, notes Simon F. Haeder of MarketWatch. The most vulnerable people in the country may be left without a go-to place for medical care, according to Anna North of Vox.

Women may face greater exposure to the coronavirus than men simply due to their jobs. Women make up 64.4% of the workforce in all frontline industries like grocery stores, public transportation, building cleaning services, and health care, Hye Jin Rho, Hayley Brown, and Shawn Fremstad of the Center for Economic and Policy Research report.

Frontline workers who have continued to put their health at risk on the job throughout the pandemic have an added challenge to contend with: low pay. Around 25% of all front-line workers come from low-income families, according to Anna North of Vox.

Empty supermarket shelves might leave many shoppers disappointed, but for people who rely on government assistance for food, a lack of options could leave them at risk of going hungry.

Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have found their grocery stores emptied of all food eligible under the strict guidelines of the federal program, reports Julia Reinstein of BuzzFeed.

With schools closed, the 30 million kids who participate in the National School Lunch Program and the 14.7 million students who get the first meal of the day through the School Breakfast program may not get the food on which they’ve come to rely, according to Abigail Hess of CNBC Make It. A study from Feeding America, released in late April, forecasts that 18 million children may face food insecurity because of the public health crisis.

[Pictured: Second Harvest Food Bank of Central Florida, Orlando.]

While health care workers were already at an increased risk of exposure to the coronavirus due to the nature of their jobs, they faced an even greater danger when their hospitals ran out of equipment. The Department of Health and Human Services predicted in March that health care workers and patients would need 3.5 billion N-95 masks—far more than the 12 million the country had stockpiled, reports Abby Vesoulis of Time. Some health care providers have been forced to reuse masks.

With some states reopening, workers who had been receiving hazard pay are seeing that benefit phased out, notes Eric D. Lawrence of the Detroit Free Press. Given that millions of people are unemployed, these workers have virtually no leverage to demand more compensation, which forces them to stay in underpaid positions, according to Alina Selyukh of NPR.

Around 31% of the country’s 13.4 million renters could not afford to pay rent in April, based on data from the National Multifamily Housing Council via NPR. Renters are more likely to lack the money to cover basic needs than homeowners, according to Corianne Payton Scally and Dulce Gonzalez of the Urban Institute, and the pandemic may be widening that disparity.

People who live in public housing may be facing a greater risk of COVID-19, according to Mica O’Brien and Susan J. Popkin of the Urban Institute. Many of these residents rely on service providers, like home health aides, who could increase their exposure. Senior residents may also face increasing isolation, which can lead to mental health problems.

Without another adult to share responsibilities at home, single parents face disproportional struggles balancing childcare with work, now that schools are closed, according to Mieke Beth Thomeer and Jenjira Yahirun of The Hill. Those problems get even worse when you add the challenges of accessing government benefits, like unemployment insurance, which may require many phone calls.

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