Issue 25: COVID-19 is the ‘Great Unequalizer’

The health effects of the coronavirus and the burden of providing care to its victims is falling disproportionately on the vulnerable. Our policy choice must reflect their needs

Policy for Pandemics is produced and edited by Andrew Potter and co-edited by Charlotte Reboul and Paisley Sim (bios here). Today’s briefing is by Ruhee Ismail-Teja (RIT), a graduate student at the Max Bell School of Public Policy. She is currently riding out the pandemic at her home in Calgary, Alberta.

It’s easy to characterize this pandemic as a ‘great equalizer’ because no one is immune. But this is an oversimplification. As is becoming clear, Covid-19 disproportionately affects the poor and the vulnerable, and many of the policy decisions being taken today must prioritize people facing major barriers to their health and economic stability.

Health

Low-income people consistently have below-average health outcomes; they are twice as likely to suffer from chronic conditions and on average, have poorer mental health. They are less likely to receive quality health care due to inadequate access to preventative care, affordability, and logistical barriers.

Covid-19 has only worsened their health outcomes. Low-income people are more likely to live in small spaces with more people under one roof, making physical distancing a challenge, if not impossible. Low-income Canadians are overrepresented in frontline services - such as grocery store workers, cleaning staff, and delivery personnel - increasing potential exposure to the virus. Canada’s emergency response policies don’t yet cover everyone and people who fall through the cracks may be forced to continue to work, putting themselves at increased risk.

New research emerging from the United States shows that the number of coronavirus related deaths amongst visible minorities is disproportionately high. In Chicago, despite making up only 30 percent of the population, black residents account for over 70 percent of deaths due to coronavirus. In New York, neighbourhoods with high black and latino populations have the highest rates of infection, dying at rates 5 to 6 percent higher than the population they make up. The statistics are staggering – but experts on chronic conditions like diabetes, heart disease, and asthma aren’t surprised. They point to social conditions rather than genetics. African Americans are 75% more likely to live in places with high air pollution and have weaker lungs as a result. 

Inadequate housing increases health risks. Homeless shelters are prone to outbreaks because physical distancing is more challenging in small confined spaces. Domestic violence has skyrocketed, and women fleeing abusive partners are retreating to increasingly crowded shelters. We have seen an alarming number of deaths in elderly care homes, which are filled with immunocompromised people living in close quarters and receiving limited care because staff are sick themselves or unable to work. Refugees and asylum seekers often live in shelters, some of which have seen recent outbreaks of the coronavirus.

Women are overrepresented in risky  frontline jobs. Women account for 75% of respiratory therapists, 80% of medical lab workers, and 90% of nurses and personal support workers in Canada. As the number of cases rises in Canada, and if personal protective equipment shortages continue, frontline workers and women will disproportionately be put at risk. 

These same communities will be hardest-hit by the economic recession that follows. 

Economics

It’s expected Canada will see the weakest year of economic growth since the financial crisis – maybe worse. While this will impact all Canadians, not everyone will bear the brunt of the downturn evenly. 

The Conference Board of Canada predicts that transportation, accommodation, retail, restaurants, oil and gas, and manufacturing will see the highest number of layoffs, as many working in these industries cannot work remotely. Retail, accommodation, and restaurant sectors employ a disproportionate number of women, racialized minorities, immigrants, and young people – the same communities that face greater health concerns right now. They are among the lowest paid and least likely to have an economic cushion. Job loss is expected to affect 40% of workers earning $14 or less per hour and 33% of workers earning $14-$16 per hour – compared to just 1% earning over $40 per hour.

The history of wealth accumulation drives financial inequalities, with white Canadians more likely hold and profit from investments than visible minorities. In the U.S., on average, black households have 7 cents of wealth for every dollar compared to white households, - visible minorities have fewer savings and are less prepared to weather the economic storm. This manifests in several ways, creating multifaceted issues and increasing the complexity of adequate solutions. For instance, 20% of visible minority families live in unsuitable or unaffordable homes – nearly twice the rate of non-visible minorities.

Around 13% of women in Canada are expected to lose their jobs due to coronavirus-related issues, compared to just 9% of men. With women already earning just 87 cents on the dollar compared to men, they are likely to be harder hit. Women also work in more part-time and non-salaried jobs; many have had their hours reduced but not eliminated, and are therefore less likely to be eligible for the Canadian Emergency Response Benefit.

What is the government doing?

The Canadian government has introduced supports for vulnerable people, including:

  • $350 million to impacted charities to ensure they can continue serving vulnerable communities

Other policies are being explored to minimize the number of people who slip through the cracks. One option that has been put forward is a temporary universal basic income, which would extend the CERB to all Canadians, clawing back the benefit in the coming tax year if 2020 income did not significantly differ from 2019 income. No single policy is going to be a silver bullet. The issues faced by vulnerable communities are multifaceted and intertwined, and require conscious and thorough evaluation and redress. 

As the government continues to introduce measures to support Canadians, policymakers should have the disproportionate effects of Covid-19 on vulnerable communities front of mind and specifically design policies with a human-rights based approach that provides strong support to those hardest hit. (RIT)

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