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Life in AC: After COVID-19

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By Roseanne Mirabella, Seton Hall University; Heather Carpenter, Notre Dame of Maryland; Norman Dolch, University of North Texas; Helen Wise, Louisiana State University at Shreveport; Timothy Hoffman, Seton Hall University

Roseanne Mirabella, Seton Hall University; Heather Carpenter, Notre Dame of Maryland; Norman Dolch, University of North Texas; Helen Wise, Louisiana State University at Shreveport; Timothy Hoffman, Seton Hall University

​​

​​Top left: Norman Dolch, University of North Texas; Top right: Roseanne Mirabella, Seton Hall University; Center: ​Heather Carpenter, Notre Dame of Maryland; Bottom left: Helen Wise, Louisiana State University at Shreveport; Bottom right: Timothy Hoffman, Seton Hall University


New York Times columnist Thomas Friedman referred to it as our 'new historical divide,' life in BC, before coronavirus and life in AC, after coronavirus (2020). Three months into the pandemic we know now the virus has significantly impacted those individuals and families already living at the margins of society. NPR reports that people with intellectual disabilities, particularly those living in group homes, were four times more likely to contract COVID-19 and at least twice as likely to die from it, a higher death rate than that found among people of color (Shapiro, 2020).

It is estimated that 42% of all deaths from COVID-19 have taken place in nursing homes or long-term care facilities, many of which operate as nonprofit organizations (Roy, 2020). Nursing home staff have also become ill from the virus and many have died.

Black and brown people of all ages have been especially hard hit by the virus, both in terms of health and economic outcomes. The disparities in the impact of COVID-19 reflect the structural inequities faced by minorities including 'racism, neighborhood segregation, income, housing, and education inequality, and poor access to medical care' (Anyane, et. al., 2020). It is also a reflection of the employment status of people of color who were much more likely to be considered essential workers than their white counterparts. Black Americans and Latinos were more likely to lose their jobs or have their hours cut during the pandemic. While the national unemployment rate rose to 14.7% in April 2020, unemployment among Black and Latinos was much higher at 16.7 and 18.9 percent, respectively (Cho & Winters, 2020). Many Latina women employed as household workers were 'cast aside' as employers asked that their cleaning be cancelled.  Being on lockdown made many families concerned about having a non-family member in their home to clean or watch the children. However, these dismissals often came with no compensation, severance, or unemployment insurance. “I'll go crazy with despair," said one Latina woman, after several clients called one after the other to cancel their housekeeping. The impact of job losses was compounded by the fact that many Latinos are non-citizens or live in non-citizen families making them ineligible for relief programs such as unemployment or safety net programs, or fearful of applying  for such programs out of concern for noncitizen family members.

Over half (54.2 percent) of Hispanic adults in families with noncitizens and two-fifths (40.6 percent) of those in which all family members are citizens reported at least one of the following material hardships in the 30 days before they completed the survey: household food insecurity, a family member forgoing medical care because of its cost, problems paying utility bills, or problems paying the rent or mortgage (Gonzalez, et. al., 2020). Due to their noncitizen status and lack of health insurance, Latinos are more likely to depend on emergency rooms for primary care rather than on outpatient care, which becomes far more complicated during a pandemic. For example, one study found that undocumented immigrants were more like to depend on emergency dialysis for treatment of kidney disease instead of outpatient treatment.  During the pandemic, they were far more likely to avoid going to the hospital for dialysis treatment in fear of getting infected with the virus, or upon arrival at the hospital for dialysis treatment their symptoms were often mistaken for virus symptoms, i.e., shortness of breath, nausea and fatigue (Rizzolo, Novick & Cervantes, 2020).  

The COVID-19 pandemic appears to have had a disproportionate impact on women both in and out of the home.  One study exploring the impact of remote work on employment revealed that that male workers were more likely to be employed in occupations where telecommuting is possible than female workers, 28% compared with 22% (Alon, et. al., 2020, 9). An analysis conducted by the New York Times found that positions held by women were much more likely to be designated as essential, than those held by men, with one in three jobs dominated by women deemed as essential during the pandemic. Employed as home care aids, supermarket cashiers, nurses and respiratory therapists women headed out to work more often than men who were either in positions that could be performed remotely or were in the types of work on hold during the pandemic, such as construction or carpentry.  They also reported that women of color were more likely to be in positions considered essential than anyone else (Robertson & Gebeloff, 2020).

Prior to the pandemic, studies continued to show unequal responsibility between men and women in the home for childcare, chores, and household maintenance (Cerrato & Cifre, 2018; Gerst, 2017; Kauppinen & Gordon, 2019). With the emergence of COVID-19, this reality was much more exacerbated for women with the need to balance working remotely or outside the home with primary responsibility for unpaid work in the home including childcare and remote schooling (Kantamneni, 2020).  As previous childcare arrangements disappeared during the pandemic, with grandparents no longer able to provide support due to their need to remain in lockdown and other formal childcare arrangements curtailed as day care centers were shuttered, parents, especially moms, were now responsible for the full-time care of their children, in addition to external paid work requirements (Alon, et. al., 2020). In addition, parents are now responsible for co-producing the education of their children as schools were closed and learning went remote. A statewide assessment of the transition to remote schooling conducted by MIT found clear evidence of a digital divide with some families unable to access online options for learning. Often there is no technology access for families living in poverty other than a smart phone and if there is a computer there is one shared by all.  The authors recommend that states “continue to place issues of equity at the center of remote learning plans, with increased guidance for special populations" (Reich, et. al., 2020, iv). The inability to successfully provide support to their children due to lack of appropriate technology, added additional stressors for parents, particularly moms.

Though it is not yet known to what extent COVID-19 will affect the LGBTQI+ community, Human Rights Campaign Foundation published a brief on the ways in which this community may be disproportionately impacted.  The LGBTQI+ community is more likely to live in poverty, prior to the pandemic nearly one in ten were unemployed, and will be at greater risk of contracting the virus due to their economic situation. The community has inadequate access to medical care, for example, in response to a behavioral risk factor survey, nearly one in five members of the LGBTQI+ community reported that they have not seen a doctor as they could not afford it. Furthermore, the LGBTQI+ community is employed in industries that have been highly impacted by the pandemic, including restaurants and food services, hospitals, retail, and all levels of education. Finally, older and younger members of the LGBTQI+ community may face 'unique challenges' during this moment.  The brief reports that older LGBTQI+ individuals are twice as likely to live alone as the general population and four times more likely not to have any children, leaving them without family support. LGBTQI+ youth are more likely to experience homelessness, foster care or unstable home environments, which may become exacerbated during the pandemic as they have to spend more time in home environments that are not supportive (2020).

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Reclaiming the Public Space: Lessons learned from COVID-19

Considering changes thrust upon us by the pandemic, Tom Friedman has asked us how we will change as a society in AC (Friedman, 2020). Will it be business as usual in a neoliberal environment where the market is seen as the solution to all problems? Or will this be the moment when we shift from the market to a 'care-centered economic system' (Gillespie, et. al., 2020) informed by a variety of voices rejecting individuality in favor of community?

The real question is not when but what: What kind of economy will emerge from the crisis? Will it be one that continues to create inequalities that poison our politics and undermine any sense of national community? Or will it be one that honors the dignity of work, rewards contributions to the real economy, gives workers a meaningful voice and shares the risks of ill health and hard times? (Sandel, 2020).

Again, the federal government has a critical role to play here.  Inequality has increased during the crisis.  Some people had access to health care and others did not.  Though some will see a dip in their 401 (k) plans, most of those with these plans will still have jobs.  The uber wealthy may lose money in their stock portfolios, but they are uber wealthy and will survive.  We will see poverty in our nation and around the world like we have never seen it before unless we act collectively.  It remains to be seen whether we have the will and the leadership to do this.  Only national governments have the resources to address future needs of and vital services for our communities as we continue to navigate through the pandemic.

We argue that a government that works for all can emerge from the pandemic through government intervention in and support of communities, much like FDR's New Deal programs in response to the Great Depression. There must be government support for communities impacted by the digital divide including equitable educational expenditures regardless of school district or neighborhood. To provide ongoing support for people who have lost their jobs, the government should establish an infrastructure investment program that will create a significant number of jobs while tackling the serious infrastructure issues in all corners of our nation resulting from deferred maintenance (Sumberg, 2020). As some young people, unwilling to continue their education remotely, decide to take a gap year, the federal government can employ Generation Z's as testers and contact tracers who will be in great demand until a vaccine is developed. Government can provide the resources such as tests and data capabilities, while state and local governments together with nonprofit organizations can mobilize the army of young people that will be required to meet this need.

An important lesson we have learned over the past few months is the need to embrace health care as a human right that protects all people, not just those without access to care. Although we acknowledge that COVID-19 is not the 'great equalizer' many have touted it to be, it has forced us to acknowledge how small the world has become. Just as wearing masks and social distancing will protect us from coronavirus infection, providing everyone with access to health care will protect us from illness as well. The Families First and CARES Act mostly eliminated fees for COVID testing and balance billing for health care services related to the virus. The act effectively provided universal health care for everyone during with COVID related illnesses.  Perhaps this has opened the door for our nation to finally acknowledge that health care is a human right. Finally, we must join other nations in providing affordable child care for all families, providing women with the opportunity work with the assured that their children are cared for in a safe, affordable environment.​

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COVID-19 and Structural Racism

Within weeks of each other, the United States saw two very different mass protests across the country. Anti-lockdown protestors took to the streets, brandishing their weapons, demanding the reopening of the economy. And as this book goes to press, protests arose in every major city in the nation in response to the murder of George Floyd by the Minneapolis Police. The response of the police and the federal government to the protests could not have been more different.  Those attending the anti-lockdown protests came armed with guns and stood face to face with law enforcement officials who were reserved and stood quietly.  In contrast, those protesting the murder of an American by the police were met by police and national guard in riot gear, pushing, shoving, and injuring protestors.  These protests became violent in some places, perhaps in response to being met with such force by the police. And actions by police such as the use of tear gas and pepper spray may result in more spread of the virus as it causes people to cough, tear from the eyes, and become unable to breathe. One group of Americans were protesting for their economic rights, the other for their human rights.

The pandemic has clearly revealed that we live in two very different Americas.  One that has constitutional rights and privileges based of the color of their skin, the other that has historically and continually been denied these rights because of colorism. Structural racism has its roots in economic systems dating back to the 15th century.  Africans were forcefully taken from their homeland to support the economic needs of white Europeans, eventually brought to the Americas to support wealthy landowners. After the Civil War in the United States, these racial structures continued with the implementation of Jim Crow laws and the passage of countless federal and state laws that disadvantaged and disenfranchised Black Americans.  Despite the gains of the Civil Rights Movement of the 1960s, structural racism continues today through 'The New Jim Crow' so powerfully labeled and described by Michelle Alexander (2020). Structural racism has permeated every part of our society from education to health care to employment to criminal justice. The knee of Police Officer Derek Chauvin on the neck of George Floyd as he gasped for air, is a metaphor for the knee on the necks of all African Americans in our nation as so eloquently expressed by Rev. Al Sharpton in his eulogy for George Floyd:

[L]ast Thursday, and when I stood at that spot [where George Floyd was killed], reason it got to me is George Floyd's story has been the story of black folks because ever since 401 years ago, the reason we could never be who we wanted and dreamed to being is you kept your knee on our neck. We were smarter than the underfunded schools you put us in, but you had your knee on our neck. We could run corporations and not hustle in the street, but you had your knee on our neck. We had creative skills, we could do whatever anybody else could do, but we couldn't get your knee off our neck. What happened to Floyd happens every day in this country, in education, in health services, and in every area of American life, it's time for us to stand up in George's name and say get your knee off our necks (2020).

Unlike people of color, those of us who are white do not have a knee on our necks in education, health care, employment or in the criminal justice system. Defeating structural racism requires difficult and necessary conversations about the relationship between wealth and power, including coming to terms with how structures have been developed and maintained to the advantage of white Americans and to the disadvantage of Black Americans.  If we are to come out of this pandemic and the current racial crisis with our democracy intact, we must finally address the role that racism has played in wealth development in this country.  Our nation's tradition of liberal democracy is intricately tied to maintenance of current power relationships.  Those looking to address our national issues regarding race have posited a participatory democracy that would work for all.  Addressing structural racism will be a massive undertaking with real solutions required not just a few tweaks around the edges. Among the ideas proposed to shift the moral narrative around structural racism have been reparations for descendants of enslaved people, creation of a community-oriented, nonviolent public safety approach, and diversion of the extraordinary amount of money now spent on policing to youth programs, community health centers, and other social service programs targeted to communities of color.  These are the types of ideas that need to be explored if we are to shift the moral narrative and create a participatory democracy for all Americans regardless of the color of one's skin.

Roseanne Mirabella, Seton Hall University 

Heather Carpenter, Notre Dame of Maryland 

Norman Dolch, University of North Texas 

Helen Wise, Louisiana State University at Shreveport 

Timothy Hoffman, Seton Hall University​

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References:

​​Alexander, M. (2020). The new Jim Crow: Mass incarceration in the age of colorblindness. The New Press.

Alon, T. M., Doepke, M., Olmstead-Rumsey, J., & Tertilt, M. (2020). The impact of COVID-19 on gender equality (No. w26947). National Bureau of Economic Research. 

Anyane, Yeboa, A., Sato, T., & Sakuraba, A. (2020). Racial Disparities in COVID-19 Deaths Reveal Harsh Truths About Structural Inequality in America, Journal of Internal Medicine, https://doi.org/10.1111/joim.13117.

Barnes, P. (2020). COVID-19 Has Benched A Critical Volunteer Workforce – Seniors. FORBES, https://www.forbes.com/sites/patriciagbarnes/2020/04/03/covid-19-has-benched-a-critical-volunteer-workforceseniors-volunteers/#559f7c19449f.

Béland, L. P., Brodeur, A., & Wright, T. (2020). The short-term economic consequences of Covid-19: exposure to disease, remote work and government response. IZA Discussion Paper No. 13159, April 27.

Bhatia, R. (2020). Predictions of Covid-19 Related Unemployment on Suicide and Excess Mortality in the United States. medRxiv.

Bibbins-Domingo, K. (2020). This time must be different: disparities during the COVID-19 pandemic. Annals of Internal Medicine, April 28. https://doi.org/10.7326/M20-2247.

Center for Medicare Advocacy. (2012). Non-Profit vs. For-Profit Nursing Homes: Is there a Difference in Care? March 15.

Cerrato, J., & Cifre, E. (2018). Gender inequality in household chores and work-family conflict. Frontiers in psychology, 9, 1330.

Cho, S. J., & Winters, J. V. (2020). The Distributional Impacts of Early Employment Losses from COVID-19. Available at SSRN 3602755.

Friedman, Thomas. (2020). Our New Historical Divide: B.C. and A.C. — the World Before Corona and the World After, The New York Times, March 17.

Garrett, A. B., & Gangopadhyaya, A. (2020). How the COVID-19 Recession Could Affect Health Insurance Coverage, May 4. Available at SSRN: https://ssrn.com/abstract=3598558 or http://dx.doi.org/10.2139/ssrn.3598558.

Gerst, K. (2017). Ambivalent sexism and traditional patterns of housework: Why women still perform most of the work at home (Doctoral dissertation).

Gillespie, E. M., Mirabella, R. M., & Eikenberry, A. M. (2020) # Metoo/# Aidtoo and Creating an Intersectional Feminist NPO/NGO Sector. Nonprofit Policy Forum. De Gruyter.

Gonzalez, D., Karpman, M., Kenney, G. M., & Zuckerman, S. (2020). Hispanic Adults in Families with Noncitizens Disproportionately Feel the Economic Fallout from COVID-19. Washington, DC: Urban Institute.

Grills, N. (2020). COVID-19 and Containment: A Dual Burden for India. Christian Journal for Global Health, 7(1), 24-26.

Hessekiel, D. (2020). How Nonprofit Are Pivoting to Virtual Fundraising in the Face of COVID-19, Forbes, April 23, https://www.forbes.com/sites/davidhessekiel/2020/04/23/how-nonprofits-are-pivoting-to-virtual-fundraising-in-the-face-of-covid-19/#157001396bec.

Human Rights Campaign Foundation. (2020). The Lives and Livelihoods of Many in the LGBTQI+ Community are at Risk Amidst COVID-19. https://assets2.hrc.org/files/assets/resources/COVID19-IssueBrief-032020-FINAL.pdf?_ga=2.11208372.1207112948.1591651559-599515141.1591651559

Kantamneni, N. (2020). The impact of the COVID-19 pandemic on marginalized populations in the United States: A research agenda, Journal of Vocational Behavior, 119.

Kauppinen, F., & Gordon, T. (Eds.). (2019). Unresolved dilemmas: women, work and the family in the United States, Europe and the former Soviet Union. Routledge.

Parks, D. (2020). Coronavirus-Related Giving Tops $10 Billion Worldwide, Chronicle of Philanthropy, May 7.

Patrick, R. (2017). For whose benefit?: The everyday realities of welfare reform. Policy Press.

Reich, J., Buttimer, C. J., Fang, A., Hillaire, G., Hirsch, K., Larke, L. R., ... & Slama, R. (2020). Remote learning guidance from state education agencies during the covid-19 pandemic: A first look, MIT Teaching Systems Lab, April 1.

Reich, R., & Wimer, C. (2012). Charitable giving and the Great Recession. Palo Alto, California: The Russell Sage Foundation and the Stanford Center on Poverty and Inequality.

Rizzolo, K., Novick, T. K., & Cervantes, L. (2020). Dialysis Care for Undocumented Immigrants with Kidney Failure in the COVID-19 Era: Public Health Implications and Policy Recommendations. American Journal of Kidney Diseases.

Robertson, C. & Gebeloff, R. (2020).  How millions of women became the most essential workers. New York Times, April 18, https://www.nytimes.com/2020/04/18/us/coronavirus-women-essential-workers.html.

Rowan, H. B. (2019). Charity Care Spending by Hospitals Plunges. Kaiser Health News, August 13, https://khn.org/news/charity-care-spending-by-hospitals-plunges. 

Roy, A. (2020). The Most Important Coronavirus Statistic: 42% Of U.S. Deaths Are From 0.6% Of the Population. May 26.

Royston, S. (2017). Broken benefits: What's gone wrong with welfare reform. Policy Press.

Sandel, M. (2020). Are we all in this together? The New York Times, April 13, https://www.nytimes.com/2020/04/13/opinion/sunday/covid-workers-healthcare-fairness.html.

Shapiro, J. (2020). COVID-19 Infections and Deaths Are Higher Among Those With Intellectual Disabilities. NPR, https://www.npr.org/2020/06/09/872401607/covid-19-infections-and-deaths-are-higher-among-those-with-intellectual-disabili.

Sharpton, Rev. A. (2020) Eulogy of Georgy Floyd in Minneapolis, MN, June 4. https://www.rev.com/blog/transcripts/reverend-al-sharpton-eulogy-transcript-at-george-floyd-memorial-service

Sumberg, B. (2020). COVID-19 Relief: The Time is Now for a Federal Infrastructure Bill. JDSUPRA, May 31, https://www.jdsupra.com/legalnews/covid-19-relief-the-time-is-now-for-a-20871.

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A government that works for all can emerge from the pandemic through government intervention in, and support of, communities
12/8/2020
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Biden Challenge, Biden Institute, Biden Forum, Middle Class, Biden School, University of Delaware