Briefing for July 19-23, 2021 on COVID-19 and Low-Income Communities

Briefing for July 19-23, 2021 on COVID-19 and Low-Income Communities

We are struck that one of the few certainties about the coronavirus outbreak is that low-income communities and workers in low-income, service sector occupations will be disproportionately impacted — likely in devastating fashion.

One step in combatting this will be to share information about what is happening and what can be done. That’s why we are offering a daily news service summarizing relevant stories, which you can read below.

If you would like to receive a daily briefing, feel free to email to subscribe.

Briefing for July 23, 2021

The pandemic drove women out of the workforce. Will they come back? From Politico: “Nearly 1.8 million women have dropped out of the labor force amid the pandemic and are now grappling with whether and how to return to work in a vastly different landscape — one where some jobs have disappeared, others are vulnerable to automation, and nearly all involve some level of health risk. Returning to work after so many months at home also means, for many mothers, finding a new form of child care and giving up the additional time spent with families and kids that the pandemic provided. Taking into account how the labor force was growing pre-pandemic, 2.3 million fewer women are working now than would have been without the disruption. Overall, 57.5 percent of women aged 20 and older were participating in the U.S. labor force in June — down from 59.2 percent in February 2020 and a level that, even after months of improvement, is still the lowest in more than 30 years. Economists caution that women’s workforce participation in the U.S. has been stagnant for decades, more or less plateauing around 2000 — a phenomenon experts say shows that even before the pandemic, working women needed more societal supports than were available. But the pandemic still dealt a resounding blow. The question now, which holds major implications for the economy, is how many of those women will come back. There’s cause for concern. So far, low-income women and women of color are lagging far behind other groups in how fast they are returning to work and recovering financially. Mothers across the income spectrum have been forced to take on additional child care responsibilities as schools and day cares have closed. And some higher-income women are moving to lower cost of living areas — allowing two-parent families to justify going down to one income — or opting to pause or downshift their careers.” 

States keep snatching back tax refunds during the pandemic: The Center for Public Integrity and Huffington Post report that in the wake of the COVID-19 pandemic, “many states and local governments temporarily suspended debt collection to ease the financial burden on struggling businesses and families. But one little-known practice has continued mostly unabated: deducting money from tax refunds to collect delinquent debts. In virtually all states that levy a personal income tax, this practice, known as the “garnishments,” has been deployed on thousands of tax refunds — along with lottery winnings and stimulus checks, among others — during the pandemic-driven recession. ast year, seven of the most populous states in the country — California, Georgia, Illinois, Michigan, North Carolina, Ohio and Pennsylvania — collected more than $728 million combined from state tax refunds, according to garnishment data obtained by the Center for Public Integrity. Michigan, which collected $136.5 million in 2020, had the highest garnishment rate of $13,546 per 1,000 residents — followed by Ohio, which collected $10,161 per 1,000 residents. In three states — Michigan, North Carolina and Ohio — more state tax refunds were garnished last year than in 2019, a Public Integrity analysis shows. And the garnishments appear to have been hitting the poor and people of color the hardest, trapping them deeper in the cycle of debt. 

Thousands of children deal with pandemic grief: CBS News reports that least 113,000 American children are struggling with “pandemic grief” after losing a parent, or caregiver, to the coronavirus, according to Lancet and the Journal of the American Medical Association. A quarter of them are younger than age 10, while 20% are Black. Minorities are disproportionately affected. “Researchers see an increase in depression and PTSD in children who lose a parent. It can leave them traumatized, confused and angry. Asia is getting therapy from Lauren Strini, who teaches children how to express their emotions in healthy ways at Baptist Centers for Good Grief. “Grief is just one of the thoughts or feelings that we have,” Strini said. “I think it’s important for grieving people — for grieving children, especially — to know that anger is okay.” 

Wildfires drive people in unvaccinated areas inside, raising outbreak fears: NPR reports from Missoula, Mont., that the smoke and unrelenting heat pummeling the state “have driven people to seek refuge at libraries, movie theaters, museums and other indoor venues. In areas with low COVID-19 vaccination rates where people have largely abandoned masks and physical distancing, health officials are concerned the result will be covid outbreaks. Adding to that worry is the rise of the highly transmissible delta variant of the coronavirus, and research suggests that COVID cases and deaths increase during periods of intense wildfire smoke. Missoula County has the highest vaccination rate in Montana, at 60%, but Whitney Kors was still mindful of the risks as she took her family to the library to get out of the smoke. “My daughter and I are still masked because she’s not vaccinated,” Kors said. She said that until her daughter, who’s under 12 years old, becomes eligible for her shot, her family will continue to distance from others when they’re out. However, health officials worry that not everyone seeking out smoke-free activities indoors this summer will take the same precautions if they are unvaccinated.” 

Broadband anchor institutions can drive telehealth adoption in rural America: In a commentary for the Daily Yonder, Craig Settles sees the two institutions – libraries and schools – that have been crucial to increasing broadband access in rural America can play the same role in expanding telehealth. “For 20 years, libraries, schools, local government buildings, healthcare facilities, and other anchor institutions have been critical elements of community broadband network design, partly because these institutions can help finance (through fees) many network buildout costs. But institutions’ key value is driving people (subscribers and users) to the network. Today, these institutions still drive telehealth access and adoption. Telehealth may or may not be the silver bullet for public health. But it is a powerful tool to attack the healthcare gap between those who can access affordable, quality healthcare, and those who cannot, especially, rural populations, seniors, immigrants, the unemployed, and the working poor.”

Briefing for July 22, 2021

Nearly 120,000 children have lost a primary caregiver during the pandemic: From ABC News: “Since the onset of the pandemic, children in the U.S. have faced multiple challenges and hardships. Tragically, recent data reveals that a staggering number of children have been faced with the most heartbreaking reality: the loss of a caregiver to COVID-19. An estimated 119,000 children across the country have lost a primary caregiver due to COVID-19 associated death, and more than 140,000 children experienced the death of a primary or secondary caregiver, defined as co-residing grandparents or kin, according to data in an internal Centers for Disease Control and Prevention document obtained exclusively by ABC News. ‘This is yet another horrible byproduct of the pandemic, and we as a global community must commit to supporting these children and families. The effects of this pandemic will be felt for decades,’ Dr. Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University Medical Center, told ABC News. The data is provisional, and the CDC confirmed to ABC News that it plans to release official data next month.” 

Low-wage workers now have options, which could mean a raise: The New York Times reports: “McDonald’s is raising wages at its company-owned restaurants. It is also helping its franchisees hang on to workers with funding for backup child care, elder care, and tuition assistance. Pay is up at Chipotle, too, and Papa John’s and many of its franchisees are offering hiring and referral bonuses. The reason? ‘In January, 8% of restaurant operators rated recruitment and retention of work force as their top challenge,’ Hudson Riehle, senior vice president for research at the National Restaurant Association, said in an email. ‘By May, that number had risen to 72%.’ Restaurant workers — burger flippers and bussers, cooks and waiters — have emerged from the pandemic recession to find themselves in a position they could not have imagined a couple of years ago: They have options. They can afford to wait for a better deal. In the first five months of the year, restaurants put out 61% more ‘workers wanted’ posts for waiters and waitresses than they had in the same months of 2018 and 2019, before the coronavirus pandemic shut down bars and restaurants around the country, according to data from Burning Glass, a job market analytics firm. That’s not all: The jobs that waiters and waitresses typically transition to — as bartenders, hosts and hostesses, chefs and food preparation workers — are booming, too. Something similar is happening all along the least-paid end of the labor market. Many employers have blamed expanded unemployment benefits for their troubles in filling gaping job vacancies. But the sharp rebound in hiring — clustered in urban service industries — is creating bottlenecks in sets of occupations that are improving prospects across much of the nation’s low-wage labor force.” 

Making sure every child has a bed: Luke Mikelson describes himself and his team at Sleep in Heavenly Peace as “just a bunch of hicks from Idaho.” The remarkable growth of his nonprofit tells a very different story, of a group of committed volunteers who were startled to find children without beds to sleep on in their community and created an organization that has grown to have nearly 270 chapters across the country and in four foreign nations. Mikelson, named a CNN Hero in 2018, spoke with Spotlight on Poverty and Opportunity recently about SHP’s difficult experience during the pandemic, the surge in interest its seen in recent months, and the lessons the organization’s rapid growth might offer for other nonprofits. 

Life expectancy decline is particularly sharp for Black and Hispanic Americans: From the New York Times: “New federal data draws one of the starkest illustrations to date of how the coronavirus pandemic has disproportionately affected Hispanic and Black Americans, showing that they suffered a far steeper drop in life expectancy in 2020 than white Americans. Overall, life expectancy in the United States fell by a year and a half, a federal report said on Wednesday, a decline largely attributed to the pandemic that has killed more than 600,000 Americans. It was the steepest decline in the United States since World War II. From 2019 to 2020, Hispanic people experienced the greatest drop in life expectancy — three years — and Black Americans saw a decrease of 2.9 years. White people experienced the smallest decline, of 1.2 years. The coronavirus ‘uncovered the deep racial and ethnic inequities in access to health, and I don’t think that we’ve ever overcome them,’ said Dr. Mary T. Bassett, a former New York City health commissioner and professor of health and human rights at Harvard University, who characterized the findings as devastating but unsurprising. ‘To think that we’ll just bounce back from them seems a bit wishful thinking.’” 

State, local officials distributed just 6.5% of rental aid in first half of year: From Politico: “State and local officials disbursed $1.5 billion in federal rental assistance in June, the Treasury Department reported Wednesday morning, bringing the total rental aid distributed over the first six months of the year to a little over $3 billion — about 6.5% of the total aid Congress has allocated. While officials have picked up the pace of disbursal — serving 290,000 households in June, up from 160,00 the previous month — they remain woefully behind demand, with a little over 633,000 households served by a program meant to help millions. About 7.4 million tenant households reported being behind on rent in June, according to the latest survey data from the Census Bureau, with 3.6 million households saying they were ‘somewhat likely’ or ‘very likely’ to face eviction in the next two months. The bottleneck in getting aid to tenants and landlords has become an urgent issue, with just 10 days left before expiration of the Centers for Disease Control and Prevention’s nationwide moratorium on eviction for nonpayment of rent. President Joe Biden in June extended the eviction ban for a month, to July 31, amid lingering concerns about how much of the aid had reached landlords, but the administration has signaled that extension would be the final one. The White House is holding its second ‘eviction prevention summit’ of the month on Wednesday.” 

In the largest cities, the digital divide is a poverty problem: From a data visualization by Bloomberg Cities: “When COVID-19 forced school and work and so much else to move online, high-speed internet became no less important to peoples’ lives than having electricity or water. Indeed, broadband itself surfaced as a critical public health asset as doctors switched to telehealth and the strength of our social connections — critical to mental health — became dependent on the strength of our internet connections. Yet millions of Americans went without this critical lifeline. And as this Bloomberg Cities analysis of the 100 largest U.S. cities shows, it’s people living in poverty who were most cut off from seeing doctors, cut off from connection with family and friends, cut off from school — cut off from life as they knew it. The relationship couldn’t be clearer: The cities with the highest rates of poverty, such as Detroit, Miami, or Laredo, Texas, also have among the lowest rates of broadband adoption. In these three cities, just 63 to 67% of residents have both a broadband subscription and a computer to use it. Meanwhile, communities with the lowest poverty rates, such as Fremont, Calif., Gilbert, Ariz., or Plano, Texas, have broadband penetration rates far exceeding 90%.” 

Briefing for July 21, 2021

California makes it easier for low-income residents to get and keep free health coverage: Kaiser Health News reports: “A provision in California’s newly approved state budget will eliminate the asset test for the two million Californians enrolled in both Medi-Cal and Medicare, the federal health insurance program for people 65 and older and people under 65 with certain disabilities. Instead, their financial eligibility will be based solely on income, as it is for the millions of other people in Medi-Cal. The elimination of the test will be a game changer for aging or impaired Californians who need long-term care but are caught in a common conundrum: They don’t earn enough to cover the high costs of ongoing nursing home care and can’t rely on Medicare, which does not cover extended nursing home stays. They can get that care through Medi-Cal, but they would have to wipe out their savings first. The 2021-22 state budget deal includes several provisions that will make it easier to get on and stay on Medi-Cal, including the elimination of the asset test. Everyone 50 and over will be eligible, regardless of immigration status. And new mothers will be allowed to remain on Medi-Cal for one year after giving birth, up from 60 days. The budget also includes $15 million over the next three years, starting this year, to develop online enrollment forms and translate them into multiple languages, and $8 million for counties to help some people who get in-home care to stay enrolled. California has a strong Medi-Cal takeup rate, with 95% of eligible people enrolled, said Laurel Lucia, director of the health care program at the Center for Labor Research and Education at the University of California-Berkeley. But of the remaining uninsured people, about 610,000 qualify for Medi-Cal, she said.” 

Wildfire smoke may add to COVID risk: From the Associated Press: “A study published last week by scientists at the Desert Research Institute found that coronavirus infection rates increased disproportionately during wildfire season in 2020, when smoke from fires in neighboring states blanketed much of northern Nevada. In a paper in the Journal of Exposure Science & Environmental Epidemiology, Desert Research Institute Assistant Research Scientist Daniel Kiser and four co-authors note the test positivity rate in Washoe County increased significantly during periods when monitors measured high levels of particulate matter in the air from wildfire smoke. For every 10 micrograms per cubic meter of small particulate matter known as PM2.5 in the air, the positivity rate increased about 6.3% two to six days later, the study found. Kiser said the study was observational and noted that the uptick could be attributed to other factors, like last year’s second surge, students returning to schools, or changes in local restrictions. But he said momentary upticks during periods of high pollution suggested a connection between smoke and the spread of the virus. ‘That temporary association in the midst of a large uptick in cases overall is what convinced us that something’s going on,’ he told the Associated Press. The authors argued that the association between wildfire smoke and the coronavirus likely suggested pollution made people more prone to viruses more broadly.” 

D.C. City Council considers ‘baby bonds’ program: WAMU reports that “thousands of low-income D.C. children could start getting annual payments of up to $1,000 later this year under a ‘baby bonds’ program that D.C. Council Chairman Phil Mendelson is including in the city’s budget. Funding it is part of what Mendelson is calling ‘transformational’ changes to Mayor Muriel Bowser’s $17.5 billion budget proposal. Lawmakers will vote this Tuesday on the first spending plan as D.C. emerges from the COVID-19 pandemic, which exposed and exacerbated existing inequities in the city. ‘I think about what are we doing with this budget that would be transformational, that will make a difference in terms of quality of life or the equity situation in the District or in terms of jobs,’ Mendelson said in an interview. But his proposed changes may fall short of what some progressive groups have called for in the form of tens of millions of dollars of additional funding for homeless services, early childhood education, and financial assistance for undocumented workers. On Monday night a trio of lawmakers said they would propose a tax increase on residents who make more than $250,000 a year, with the revenue targeted for those programs. Councilmember Brianne Nadeau (D-Ward 1), one of the lawmakers pitching the tax hike, said she is ‘very optimistic’ about its fate.” 

Ohio State study finds pandemic heightened disparities in food access: From WOSU NPR News: “An Ohio State University study indicates existing disparities in access to food only grew during the COVID-19 pandemic. Researchers used anonymized cell phone data to track traffic to grocery stores around the city. Lead author Armita Kar is a doctoral student in geography, and she explains people in low income areas often face long trips to grocery stores. ‘During COVID-19, since they didn’t have these nearby grocery stores and supermarkets, they used to depend on dollar stores and local stores a lot,’ Kar said. The study shows grocers in affluent areas saw traffic plummet as patrons limited in-person trips, presumably buying in bulk or ordering online. But in lower income areas residents didn’t have the same flexibility. Kar said traffic patterns showed them continuing to make regular trips to nearby discount stores for food. Kar and her co-authors argue their findings underscore the need for better access to healthy food and transportation. ‘Provide access to healthier food options in these low income areas,’ Kar suggests. ‘We can always improve transportation and provide really good public transportation services from these communities to the superstores we currently have.'” 

The cities where chain restaurants dominate: From Bloomberg’s CityLab: “Whether they’re boarded up, bustling, or newly rebranded, restaurants are among the clearest symbols of the pandemic’s impact on urban economies. Nearly 17% of U.S. eateries shuttered permanently or long-term during the first year of COVID-19, according to the National Restaurant Association, and those closures were not borne equally. As customers turned to low-cost take-out, fast-food outposts like McDonald’s and Chipotle saw sales soar. Deep-pocketed dining chains like Texas Roadhouse are now moving into new markets as the economy recovers and indoor dining resumes. Independently owned restaurants, far more vulnerable to the financial stress of months with few customers, closed at higher rates. What kind of landscape do those trends portend? A recent mapping project led by Clio Andris, assistant professor of city and regional planning and interactive computing at the Georgia Institute of Technology, and planning graduate student Xiaofan Liang, gestures at the corporate dining terrain that already defines much of the country. Using a dataset of nearly 800,000 independent and chain restaurants for the contiguous U.S., Liang and Andris crunched the total number of restaurants with the same name and created an average ‘chainness’ score, which measures the likelihood of finding the same venues in other parts of the country depending on the geographic scale. For example, the national score is 1,247, but just 28 in San Francisco, where there is a high concentration of independent restaurants. In parts of the South, the score is over 1,900.” 

Briefing for July 20, 2021

Biden legal team decides inmates must return to prison after COVID emergency: From the New York Times: “The Biden administration legal team has decided that thousands of federal convicts who were released to home confinement to reduce the risk of spreading COVID-19 will be required by law to return to prison a month after the official state of emergency for the pandemic ends, according to officials. The administration has come under pressure from criminal justice reform activists and some lawmakers to revoke a Trump-era memo by the Justice Department’s Office of Legal Counsel, which said inmates whose sentences lasted beyond the ‘pandemic emergency period’ would have to go back to prison. But the Biden legal team has concluded that the memo correctly interpreted the law, which applies to about 4,000 nonviolent inmates, according to officials who spoke on condition of anonymity about sensitive internal deliberations. Several officials characterized the decision as an assessment of the best interpretation of the law, not a matter of policy preference. The official state of emergency is not expected to end this year because of a rise in new infections caused by the coronavirus’s Delta variant. But the determination means that whenever it does end, the department’s hands will be tied. That leaves two options if those prisoners are not to be sent back into cells: Either Congress could enact a law to expand the Justice Department’s authority to keep them at home beyond the emergency, or President Biden could use his clemency powers to commute their sentences to home confinement. The Biden team is said to be wary of a blanket, mass commutation, however, both because it would represent an extraordinary intervention in the normal functioning of the judicial system and it could create political risks if any recipient who would otherwise be locked up commits a serious crime. Another option is case-by-case assessment for commutations, but the volume of work required to individually evaluate so many people is daunting.” 

COVID creates additional challenges for those leaving incarceration: From North Carolina Health News: “When Jeff Walker came out of incarceration, all he had were the clothes on his back. He was directionless, stigmatized. He didn’t have support. He didn’t have anything. That was five years ago. People leaving jails and prisons and reentering society during the COVID-19 pandemic faced the same stigma, the same lack of direction — all while attempting to navigate a global pandemic. For those leaving prison, vital in-person connection is hard to come by, even in regular times. Finding a job has proven more difficult due to the pandemic-generated lag times for identification and Social Security cards, not to mention broadband disparities that make WiFi moot in some rural areas. Walker gets those struggles. After reentering society but still experiencing substance use issues, he was able to find solace in transitional housing and the connections he made there five years ago. Now, he works to give other formerly incarcerated people another chance as the programs manager for Wilkes Recovery Revolution in North Wilkesboro, and a member of the Peer Justice Initiative, a group of formerly incarcerated people who advocate for others reentering society and within the jail and prison systems.” 

Hospitals see rise in alcohol-related liver disease during pandemic: NBC News reports that the number of Americans being treated for severe liver disease increased during the pandemic. “’What we’ve seen during COVID-19 is really a dramatic increase in hospital admissions for alcohol-associated liver disease,’ said Dr. Brian Lee, an assistant professor of clinical medicine and a liver transplant specialist at the Keck School of Medicine at the University of Southern California. ‘Because of things like lockdowns or being stressed out at home, people started to drink more, didn’t realize that they were drinking harmful amounts,’ he said. And then they come ‘into the hospital with life-threatening liver disease.’ Lee said that USC has seen a 30% increase in hospital admissions for alcohol-related liver disease since March 2020. That includes people who had a previously under-control alcohol problem as well as those who had no history of issues with alcohol, a trend Lee said is worrisome. The typical patient, Lee said, is a young woman under the age of 35 with no prior history of alcohol problems. Women have been disproportionately affected by the pandemic, and that may cause them to drink more, especially those with the added burden of child care.” 

Black Americans are facing three pandemics: From CNN: “Higher unemployment rates, lower household incomes, and lack of access to health care left Black Americans more vulnerable to the COVID-19 pandemic and there is an urgency to address these structural inequities, according to a new report on the state of Black America released last week by the National Urban League. The report titled ‘The New Normal: Diverse, Equitable, & Inclusive,’ concluded that Black people are facing the burden of ‘three pandemics,’ which include racial inequity in health care, economics, and public safety. The authors of the report also point to overpolicing — including frequent targeting of young Black men — and lower vaccination rates due to a dearth of health care facilities and poor internet access as key challenges for the Black community that have been unmasked by the pandemic. Police brutality against Black people was back in the spotlight after the deaths of George Floyd and Breonna Taylor sparked a nationwide reckoning on racism last year even as the country battled a pandemic, the report said. Black people are 6.5 times more likely to be stopped by police while driving and 20 times more likely to be searched during a stop than White people, according to the report. Marc Morial, president of the National Urban League, said the country is at a ‘crossroads of racial reckoning.'” 

Why the new Child Tax Credit is more likely to be spent on children: The New York Times’ Upshot looks at questions about whether parents will actually spend money from the expanded Child Tax Credit on their kids. “Money labeled for children — the deposit that arrived in parents’ bank accounts Thursday was called CHILD CTC — is more likely to be spent on children, research shows. The previous child tax credit was one of many payments and credits folded into a final tax number each April, so it was easy for taxpayers to lose track of a credit meant for children. An influential study on a child allowance sent to mothers in Britain in the 1970s found that unlike previous benefits not designated for children, it was more likely to be spent on things like clothing and toys for children. Other studies suggest that when mothers are given money, they are likely to spend it on food and other necessities for their children. Also, labeling the purpose of the money guides people on how to spend it. The behavioral economist Richard Thaler described in 1985 the ways in which people keep mental accounts, allocating money for different purposes, even though this ‘violates the economic principle of fungibility’ — the idea that money is interchangeable. People tend to use monthly payments for daily expenses and lump sums for long-term investments, like education or a car, said H. Luke Shaefer, a professor of social work studying antipoverty policy at the University of Michigan.” 

Briefing for July 19, 2021

Plans for free pre-K and community college could be a ladder into the middle class: From the New York Times: “What was once considered a progressive dream for the nation’s education system could be headed toward reality as Democrats push forward to broker a deal on a new spending plan containing President Biden’s most ambitious domestic policy goals. Included in the list of programs Democrats agreed this week to include in their $3.5 trillion budget blueprint are Mr. Biden’s campaign proposals to offer prekindergarten enrollment for every 3- and 4-year-old in the country, and tuition-free community college to every young adult. So far, both proposals are drawing widespread support from the Democratic coalition and are expected to remain priorities as the party’s top leaders seek to deliver on bedrocks of Mr. Biden’s $4 trillion economic plan. ‘Infrastructure’s about roads and bridges, but it’s about the other things we need to have a fully engaged and active work force,’ said Senator Elizabeth Warren, Democrat of Massachusetts. ‘That means child care for parents. It means early childhood education, giving our kids the right start. And that means post-high school education or training. That’s what it’s going to take in the 21st century.’ The deal reflects a watershed moment in a movement that for at least a decade has called for expanding the public education system to level the playing field for students from ‘cradle to career.’ ‘This is changing how we think about our expectations for public education for our society,’ said John B. King Jr., a former education secretary under President Barack Obama who is now the president of the Education Trust, an equity-focused think tank. He added, ‘Making a universal commitment to 17 years, rather than 13 years, of schooling is a ‘New Deal’ style vision for what a healthy and thriving society looks like in the 21st century.’” 

Pandemic, income loss put many in medical debt: Nearly half of adults in the United States diagnosed with COVID-19 or who lost income during the pandemic struggled to keep up with medical bills, a survey released Friday by the Commonwealth Fund found. These financial hardships were particularly common among people of color, with 55% of Black adults and 44% of Hispanic adults surveyed reporting problems with medical bills and debt, compared to one-third of White adults, the data showed. One-third of adults surveyed said their income fell during the pandemic, but this was true for 44% of Black adults and 45% of Hispanic adults, the researchers said. Even those with health insurance were affected, with more than one-third of insured adults and half of uninsured adults indicating that they were paying off medical debt, according to the researchers. Just over one-third of working-age adults with employer-based health insurance coverage reported medical bill or debt problems, as did 46% of those with individual and marketplace plans, the survey found. “Even before the pandemic, people were struggling with inadequate health coverage and mounting medical debt,” Commonwealth Fund president Dr. David Blumenthal said in a press release. 

In undervaccinated Arkansas, COVID upends life again: The New York Times reports: “While much of the nation tiptoes toward normalcy, the coronavirus is again swamping hospitals in places like Mountain Home (Ark.), a city of fewer than 13,000 people not far from the Missouri border. A principal reason, health officials say, is the emergence of the new, far more contagious variant called Delta, which now accounts for more than half of new infections in the United States. The variant has highlighted a new divide in America, between communities with high vaccination rates, where it causes hardly a ripple, and those like Mountain Home that are undervaccinated, where it threatens to upend life all over again. Part of the country is breathing a sigh of relief; part is holding its breath. While infections rose in more than half the nation’s counties last week, those with low vaccination rates were far more likely to see bigger jumps. Among the 25 counties with the sharpest increases in cases, all but one had vaccinated under 40% of residents, and 16 had vaccinated under 30%, a New York Times analysis found.” 

Rural Tennessee is losing more hospitals than anywhere in the country: From 100 Days in Appalachia: “COVID-19 took an incalculable toll on rural communities. In the first months of the pandemic, says Jacy Warrell, executive director of the Rural Health Association of Tennessee, ‘a lot of rural communities thought it was a bigger-city issue and that they didn’t have to worry about it because they were more isolated.’ But when it did hit, it spread quickly. By September, the death rate in rural America had surpassed that of urban centers. Tennessee’s hospitals, like those across the nation, experienced a dramatic drop in revenue throughout the pandemic and continue to lose money. A recent American Hospital Association report estimates the pandemic could cause hospitals to lose as much as $122 billion this year. Tennessee has experienced more rural hospital closures per capita than any state. In 2018, the state legislature passed the Tennessee Rural Hospital Transformation Act to support rural hospitals ‘in assessing viability and identifying new delivery models, strategic partnerships, and operational changes’ to support health care services in rural communities.” 

Without statewide orders, Mississippi schools to set their own COVID policies as cases surge: Mississippi Today reports that as infections continue to increase and in some cases hospitalize children, “Mississippi schools are grappling with what COVID-19 restrictions, if any, should be made for the upcoming school year. State Health Officer Dr. Thomas Dobbs recently expressed his concerns about a ‘surge of cases in kids’ as a result of the spread of the Delta variant. This week seven minors were hospitalized after becoming infected with the variant, and the state on Wednesday saw its highest single-day caseload since March. Gov. Tate Reeves has signaled he will not be issuing any mandates around masks or other COVID-19 protocols in schools, so Mississippi districts are left to grapple with what restrictions to put in place in a state where only 31% of the population is vaccinated. Of that, just 6% of children ages 12-15 and 12% of kids ages 16-17 are fully vaccinated, according to the Mississippi Department of Health. At the same time, the Mississippi State Board of Education on Thursday passed a policy stating schools must return to in-person learning as the primary mode of learning in the 2021-2022 school year. The board also approved policies outlining how the district can offer school- or district-wide virtual instruction during a COVID-19 outbreak, weather event, or other situation, and outlined requirements for students who are learning virtually due to a medical condition or other reason.” 

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