Briefing for May 24-27, 2021 on COVID-19 and Low-Income Communities

Briefing for May 24-27, 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 May 27, 2021

Black and Hispanic Americans seeing higher COVID case rates as vaccinations lag: From Axios: “Black and Hispanic Americans are once again seeing higher coronavirus case rates than white Americans — as their vaccination rates continue to lag, per CDC data. As of May 1 — the most recent date for which the CDC has complete data — there were 50 weekly coronavirus cases per every 100,000 white Americans, 69 cases among every 100,000 Hispanic Americans, and 74 cases among every 100,000 Black Americans. At that time, 28% of white Americans had received at least one dose of the vaccine, compared to only 19% of Hispanic and Black Americans. The gap has remained over the last month. American Indians and Alaskan Natives saw the highest case rate among all races and ethnicities as of early May, but they’ve had the highest vaccination rate all year. Asian Americans are experiencing lower case rates and roughly the same vaccination rates as white Americans.” 
Medicaid fight resurfaces in multiple states: Roll Call reports that new federal incentives to expand Medicaid coverage “do not appear to be enough to convince 12 holdout states to broaden eligibility, leaving lawmakers and advocates weighing their next steps. Under the 2010 health care law, states can expand eligibility for their Medicaid programs for individuals who do not earn enough to qualify for marketplace insurance subsidies, with the federal government taking on most of the costs. The $1.9 trillion COVID-19 law enacted in March offers states an additional incentive to expand during the pandemic, with a temporary boost in the federal contribution. This builds on a different COVID-19 law, which temporarily increased Medicaid reimbursements by 6.2 percentage points for all states and territories that maintained coverage during the public health emergency. Andrew S. Kelly, an assistant professor in the Department of Health Sciences at California State University, East Bay, said the new incentive is an interesting idea but he did not think it would be enough to change the outcome in states that have held out. 38 states and the District of Columbia adopted expansion. Two of those 39 passed ballot measures to expand but have not implemented the expansion. Another 12 have declined to expand so far.” 
Shuttered hospitals close a crucial lifeline for rural Black communities: A special report from STAT: “A record 19 rural hospitals closed in 2020, according to research from the University of North Carolina at Chapel Hill — more than in any other year. Communities close to these shuttered hospitals similarly experienced disproportionate fatalities, according to a STAT analysis: COVID-19 death rates in counties where hospitals closed were 37% higher than in their states overall. Looking at the most rural counties — those with fewer than 50,000 residents and at least 50 miles from a major city — the death rates were 66% higher than in their states. Seven of the eight hospital closures in counties where the fatality rate was at least 80% higher than their state’s were in such rural counties. COVID-19 often requires prompt medical attention, and the closure of hospitals can be deadly. ‘You’re losing the ability to hospitalize locally and quickly,’ said Mark Holmes, professor of health policy at the University of North Carolina Gillings School of Global Public Health. Like Dawson, Ga., where Latasha Taylor, 42, lives, the communities affected when rural hospitals closed often have significant Black populations. ‘At every step in the pipeline, hospitals with a larger footprint in the African American community are more likely to shut,’ said Holmes. The closures are predominantly clustered across the South and Southeast where, more than a half-century since health care segregation officially ended, plenty of hospitals outside of Black communities have yet to earn the trust of African American patients, erecting another barrier to care.” 
How racial trauma affects your mental health and tips for coping: From CNBC: “Returning to ‘normal’ life amid COVID-19, like going back to the office or school, will not be business as usual. In addition to living through a pandemic that has killed more than 570,000 people in the United States, Black, Indigenous, and people of color have experienced immense racial trauma in the past year, from the murder of George Floyd exactly one year ago on May 25, 2020, to the Atlanta spa shooting in March. Racial trauma, or race-based traumatic stress, refers to ‘any kind of a mental or emotional injury that can be caused by encounters with racial bias, ethnic discrimination, racism, and hate crimes,’ Wizdom Powell, director of the University of Connecticut’s Health Disparities Institute, tells CNBC Make It.” Some strategies for coping: 

  • Know the symptoms: “Racial trauma manifests in some of the same ways as other forms of trauma. People who experience race-based trauma may experience: hyper vigilance, increased depressive symptoms, prolonged anger and outbursts, recurring thoughts of the events, as well as physical reactions like headaches, chest pains, and insomnia, Powell says.” 
  • Exercise your rights: “It’s up to organizations to acknowledge and hold space for individuals who have experienced racial trauma and are returning to the workplace.” 
  • Find a confidante: “Figure out who in your organization can be a confidant, or person for you to confide in or seek support from, Powell says. That could be your HR department, or anyone else who will provide a ‘safe brain space to actually discuss what’s going on with you and to get some advice about how to negotiate the workplace environment,’ she says.” 
  • Request flexibility: “Research has shown that people who have job control, flexibility, and more job autonomy are less likely to experience depressive symptoms in the face of discriminatory or inequitable workplace environments, Powell says.” 

Three ways Head Start programs can use stimulus dollars to boost economic mobility: Writing for Spotlight on Poverty and Opportunity, Meghan McCormick and JoAnn Hsueh of MRDC and Teresa Eckrich Sommer and Terri Sabol of the School of Education and Social Policy at Northwestern University outline three ways Head Start programs can use COVID-19 relief funds to increase economic opportunity for parents: 

  • Give staff specialized training to support families’ economic mobility: “Programs can provide specialized training to bolster front-line staff to help parents achieve their own educational and career goals. For example, Head Start programs in Tulsa took on CareerAdvance, a workforce development and training program intended to prepare parents for careers in healthcare.” 
  • Provide intensive education and career services for parents: “Head Start programs should increase the intensity of education and career services for parents in line with the high-quality early childhood programming that children already receive. Results from recent studies of postsecondary education and workforce development programs point to the value of sustained, intensive supports to help individuals meet their goals.” 
  • Improve coordination and collaboration with local service providers: “Head Start programs should build upon direct collaborations with referral partners and streamline service delivery. In our work, we have found that aligning intake, eligibility, and screening processes across different types of agencies can help families directly access the supports they need. For example, Head Start programs could develop common intake forms and eligibility verification requirements with partner agencies, so that parents do not need to go through the steps of reverifying eligibility each time they access new services.” 

Briefing for May 26, 2021

Flood of housing aid fails to get to the people who need it most: The Washington Post looks at how the more than $50 billion in pandemic housing assistance “has been slow to reach renters and landlords — though there’s no good estimate for how much has gotten in the hands of people who need it. Some of the delay is due to the magnitude of the task, which relies on more than 700 local partners to vet applicants and pass out the aid. ‘We’ve been standing up a new national infrastructure for preventing evictions and we’re building it at warp speed,’ said a senior Treasury official, who spoke on the condition of anonymity to discuss the internal dynamics of the program. On Friday, the Treasury Department said it had distributed $6.1 billion to on-the-ground partners in the past two weeks. The challenge has been getting that money into the hands of renters and landlords. In some cases, it has been hard for cash-strapped cities to build the capacity to spend the money quickly. A lack of clear guidance from Washington caused some grantees to develop ‘burdensome application requirements,’ which have increased processing times and limited participation, according to a March report from the Government Accountability Office.” 

Corporations encourage employee vaccinations but stop short of mandates: From Kaiser Health News: “Many of the companies with the largest number of employees say they’ll do almost anything to encourage their employees to get vaccinated. But a survey of some of them found that none would be inclined to mandate shots as a condition for holding a job. Almost all 15 companies surveyed — among the largest and most influential Fortune 500 companies — have strong pro-vaccine messages from their corporate leadership, emphasizing that the shots can both help protect individuals and bring the pandemic to a close. CVS Health, which administers COVID vaccines as part of the federal pharmacy distribution program, says it strongly encourages the shots for its employees ‘from a public health standpoint‘ but won’t mandate them. Starbucks is also encouraging the shots ‘to help mitigate the spread of COVID-19,’ but also doesn’t mandate them. Some companies are giving employees paid time off to either get shots or stay home if they have side effects, a trend that could increase now that the Biden administration has announced tax credits for smaller companies to offer up to 80 hours of paid sick leave until Sept. 30.” 

Drone companies prepare to help deliver vaccines in rural America: From the Washington Post: “Although more than one-third of Americans are fully vaccinated against the coronavirus, millions of people still have not received a single dose. Reasons for not getting a shot vary — some don’t want one, while others say they’ll wait a bit longer to decide. And then there are people who want to get vaccinated but are in areas so remote that they can’t easily get to a typical vaccination site. They include people working on oil rigs in the Gulf of Mexico or living in rural areas far from the nearest doctor’s office or pharmacy. Drone companies are positioning themselves to deliver refrigerated medical products to those people. If the plans don’t pan out in time to combat the coronavirus crisis, then they hope to be set up to assist swiftly in the world’s next big health scare. Draganfly, based in Saskatoon, Canada, and San Francisco-based Volansi are among the firms operating drones in the United States right now with medical delivery partnerships.” 

Lack of paid leave could be keeping some from being vaccinated: From ABC News: “As the government seeks to increase vaccination rates, especially among communities of color, some experts say a lack of paid time off is keeping many from getting the coronavirus vaccine. There are currently no federal laws that require employers to provide time off — paid or unpaid — in order to get a COVID-19 vaccine, according to Dorit Rubinstein Reiss, a University of California-Hastings law professor whose research focuses on vaccines and the law. ‘It’s one of the gaps in our vaccine access issue,’ Reiss told ABC News. ‘And if we’re looking for ways to increase vaccination rates, that seems like an easy, reasonable fix: requiring employers to provide leave.'” 

How medical jargon can make COVID disparities even worse: NPR reports: “The sudden global appearance in 2020 of COVID-19, a new and often lethal viral illness, has meant the scientific evidence on what to do to prevent and treat the virus has been changing rapidly. Simply keeping up with the latest understanding and guidance has been especially challenging for a number of groups in the U.S. — people who speak little or no English, many older adults, people with limited education or cognitive skills, and really anyone who finds the often-opaque language of health care too difficult to understand, says Michael Wolf. He’s a professor at Northwestern University Feinberg School of Medicine who studies the ways health communication can go wrong. ‘Confusion over what a health provider or website is trying to convey can actually lead to misinformation and mistrust of the very things people need to protect themselves,’ he says.” 

A little U.S. city, battered by the virus, tells its stories: The Associated Press tells the pandemic tale from Central Falls, R.I.: “The poorest and smallest city in the nation’s smallest state is also among the hardest hit by COVID-19. Sorrow reaches across the city: The dead husband. The mother who came from Guatemala in search of a better life, only to die in a new land. The Polish priest who buried parishioner after parishioner. The city has endured repeated waves of illness, with rates of confirmed cases that often dwarfed cities across New England. But the troubles of Central Falls extend far back, long before the coronavirus arrived: Moonshine in the 1920s, cocaine in the 1980s. Illegal gambling dens in the 1940s, when policemen who tried to shut them down were fired for misconduct. Cascading mill and factory closures in the years after World War II, starting an inexorable slide into poverty and, finally, city bankruptcy in 2011. So the people of Central Falls — mostly Latin Americans these days, and before that immigrant waves of French Canadians, Irish, Greeks, Syrians and others — are accustomed to hard times.” 

Briefing for May 25, 2021

Far-reaching economic effects of school closures: Axios reports that the long-term economic cost of school closures could reach into the trillions, according to a paper released this week. Researchers at the Wharton School of the University of Pennsylvania calculated that learning loss from school closures will reduce U.S. GDP by 3.6% and hourly wages by 3.5% by 2050. That’s a result of lowered labor productivity in the workers of tomorrow due both to disrupted education and the generally inferior substitution of remote learning, especially as it was practiced during the pandemic. There’s no easy way to get back the lost time for America’s students, but the authors recommend extending the 2021–22 school year by an additional month. They estimate that would cost about $75 billion, but would cut the GDP reduction to 3.1%. That would provide a net gain of $1.2 trillion, about a $16 gain for every $1 invested in extending the school year. 

How the pandemic pushed restaurant workers over the edge: The Washington Post looks at “the millions of workers who left the restaurant industry during the pandemic and haven’t come back. The industry has 1.7 million fewer jobs filled than before the pandemic, despite posting almost a million job openings in March, along with hotels, and raising pay 3.6%, an average of 58 cents an hour, in the first three months of 2021. Restaurant chains and industry groups say a shortage of workers… is slowing their recovery, as the sector tries to get back on its feet amid sinking COVID-19 cases, falling restrictions, and resurgent demand in many areas around the country. The issue has quickly become political, with Republicans blaming the labor crunch on the Biden administration’s move to boost federal unemployment insurance supplement, which has been a central part of the government’s response to the pandemic for most of the past year. GOP leaders and business groups such as the U.S. Chamber of Commerce say the extra unemployment insurance is a disincentive for some workers to return to work.” 

Pandemic has fueled eating disorder surge in teens, adults: From the Associated Press: “Many hospital beds are full. Waiting lists for outpatient treatment are bulging. And teens and adults seeking help for eating disorders are often finding it takes months to get an appointment. The pandemic created treacherous conditions for eating disorders, leading to a surge of new cases and relapses that is not abating as restrictions are loosened and COVID-19 cases subside in many places, doctors and other specialists say. ‘We are absolutely seeing massive increases,’ said Jennifer Wildes, an associate psychiatry professor and director of an outpatient eating disorders program at the University of Chicago Medicine. Some patients are waiting four to five months to get treatment such as psychotherapy and sometimes medication. Waits usually lasted only a few weeks pre-pandemic, Wildes said. Her program is treating about 100 patients, a near doubling since before the pandemic, she said. The Emily Program, a University of Minnesota-affiliated eating disorders treatment program, is experiencing the same thing. Daily calls from people seeking treatment have doubled, from roughly 60 in 2019 to up to 130 since the pandemic began, said dietitian Jillian Lampert, the program’s chief strategy officer. ‘We know that anxiety and isolation are typically very significant components of eating disorders,’ she said.” 

What happened to Mitt Romney’s child tax credit expansion plan? That’s the question Peter Nicholas of the Atlantic tries to answer in a piece that finds little indication Democrats are taking the Utah senator’s ambitious proposal seriously, despite initial encouraging words from White House Chief of Staff Ron Klain and others. Nicholas at least partly blames the looming specter of Donald Trump: “Maybe the roadblock isn’t so much the particulars of Romney’s plan but the behemoth who still controls the GOP from his exile in Mar-a-Lago. Romney remains an isolated figure inside his party, anathema to the rank and file for voting to oust Trump in both impeachment trials. Cutting a deal with Romney brings precisely one vote: Romney’s. It is doubtful that he can corral anyone else’s. (Senate Minority Leader Mitch) McConnell’s focus is on tanking Biden’s poll numbers. Which means that when it comes to smart policy making, the GOP is essentially leaderless. For all Biden’s talk of bipartisanship, he may have already concluded that his best shot at passing anything to help families is ‘reconciliation,’ the parliamentary move that allows the Senate to pass bills with a simple majority vote. If that’s the case, the White House doesn’t really need Romney or any Republican to come on board. ‘What Senator Romney has proposed is something that Biden could absolutely work with him on,’ Ryan Williams, a spokesperson for Romney’s 2012 presidential campaign, told me. ‘At this point, at least in the administration, they’re not serious about it. Given the low level of outreach to Senator Romney, there’s no indication that they’re interested.’” 

The rural county that defeated COVID: A fun read from Adam B. Giorgi at the Daily Yonder: “On June 8, 2020, someone blocked the main road leading into remote Cook County, Minnesota, with a large downed tree. In fraught pandemic times when so much was new, unfamiliar, and yet to-be-determined, the guidance from this hidden messenger rang simple and clear: Stay out. Scan the news from any corner of America, and you likely won’t have too much trouble finding stories about rural communities’ struggles concerning the coronavirus. Lately, you’ll see reports about rural counties where vaccination rates lag metropolitan or statewide levels and demand for shots is low. Earlier, you may have seen stories about rural businesses protesting orders to close and packing their dining rooms. Animus about masks has been a flashpoint from the start and remains one today. Whether it’s vaccine hesitancy or calls to reopen, an underlying theme of stories like this is almost as clear as the message sent by the tree: Rural places aren’t taking this whole COVID-19 thing as seriously as everyone else and we ought to do something about it. Yet, dropping a tree on the main thoroughfare, that is nothing if not serious. And turns out, it’s just one small moment in a remarkable rural story. What if I could show you a rural county where vaccination rates are leading the way, surpassing statewide trends and even beating out core metro counties? A rural county where transmission rates have remained low and local businesses helped lead the way on masking and social distancing? A rural county where, more than a year later, no local residents have lost their lives to COVID-19? You know where this is going. To show you all of these things, I would show you Cook County, Minnesota. And suffice to say, it took much more than a downed tree on a scenic highway to achieve those milestones.” 

Briefing for May 24, 2021

As pandemic eases, many seniors have lost strength, need rehabilitation: From Kaiser Health News: “One little-discussed, long-term toll of the pandemic: Large numbers of older adults have become physically and cognitively debilitated and less able to care for themselves during 15 months of sheltering in place. No large-scale studies have documented the extent of this phenomenon. But physicians, physical therapists, and health plan leaders said the prospect of increased impairment and frailty in the older population is a growing concern. ‘Anyone who cares for older adults has seen a significant decline in functioning as people have been less active,’ said Dr. Jonathan Bean, an expert in geriatric rehabilitation and director of the New England Geriatric Research, Education, and Clinical Center at the Veterans Affairs Boston Healthcare System.” 
Medicare telehealth use soars during pandemic: From AARP: “More than three times as many Medicare beneficiaries have had access to their regular medical professional over the phone or via a video visit during the COVID-19 pandemic than before the health crisis, according to a new study by the Kaiser Family Foundation (KFF). In recent years, telehealth visits have become an increasingly popular way for people, especially in rural areas, to have appointments with their medical professionals, but Medicare had limited telehealth coverage benefits. In early 2020, Medicare expanded its coverage of such visits to enable all enrollees to keep up with their medical care while minimizing their exposure risk to the coronavirus. These expanded benefits will continue as long as the COVID-19 public health emergency remains in effect. The emergency was extended in April and no expiration date has been set. According to the brief from the nonpartisan KFF, the expansion of telehealth benefits has been particularly important to people with disabilities who are low income and among communities of color. This suggests, the study says, ‘that the temporary expansion of telehealth coverage may be helping some of Medicare’s more disadvantaged populations continue to access needed care.’ A number of bills have been introduced in Congress that would make permanent some or all of the telehealth expansion for Medicare beneficiaries.” 
How America failed students with disabilities during the pandemic: The Washington Post reports: “More than a year after the pandemic began, officials in school districts across the country concede they failed during the crisis to deliver the quality of education that students with disabilities are legally entitled to receive. The consequences of this failure are likely to linger for years, if not decades, advocates and experts warn. More than 7 million students are eligible for special educational services under the federal Individuals with Disabilities Education Act (IDEA). These children, each of whom follow an individualized education program that spells out what extra or different services they need at school, account for an estimated 14% of all U.S. schoolchildren. While some thrived while learning from home during the pandemic — including a boy whose wheelchair left him feeling out of place at school but who became indistinguishable from his classmates on Zoom — most did not, and advocates and educators say many have suffered significant developmental setbacks. The pandemic forced schools and districts to acknowledge ways they have long struggled to meet the needs of their most vulnerable students. It spurred school officials in some places to get creative in reaching students stuck at home, leading to the development of technology, tactics, and techniques that will probably outlive the pandemic.” 
Over a quarter of Americans have worried about homelessness, poll shows: The fear of losing one’s home has weighed on the minds of many Americans at some point. A recent CBS News poll shows that more than a quarter say there has been some point in their lives when they worried about not having a place to live: this is true for 28% of Americans. And for some, that fear has become a reality at some point. 13% of Americans say that they have been evicted or have lost a home in their lives. Another 33% of Americans know someone else who has lost a home. But the fear of homelessness doesn’t loom over all Americans equally. Instead, concerns about losing one’s home is most pressing on lower-income Americans. Half of Americans with household incomes of under $25,000 — below the national poverty line for a family of four in the U.S. — say they have worried about losing their homes, and 22% in this income range have personally experienced it. In contrast, relatively few Americans earning $50,000 a year or more have had this worry. 
Digital gap leaves Latino students behind: Axios reports: “COVID-19 and the digital divide have taken a severe toll on Latino students’ education, from the U.S. to Patagonia. In the U.S., Latino students have fallen considerably behind during the last year, while in Latin America dropout rates are rising.” Some key points: 

  • U.S. Latinos started the semester up to five months behind in math and a month behind in reading, a lag that will probably grow, according to research from McKinsey. 
  • 40% of Hispanic homes in the U.S. had no computer or broadband access; 25% of Latinos depended solely on smartphones to connect. 
  • Nearly half of U.S. classrooms have begun reopening for in-person classes, though some districts remain closed as teachers seek extra COVID-19 protection. Some predominantly Latino districts, hard-hit by COVID-19, remain closed to allow students and staff to mourn family deaths

Mobile vaccination clinics roll across the country: From the New York Times: “From the East Coast to the West, health officials are taking the COVID-19 vaccines on the road. Across the country, nurses, technicians, emergency medical workers, and community partners are rolling up to the doorsteps, streets, and churches of people who are homeless, who live in areas without reliable transportation, or who have no internet access. Their goal: to reach the unvaccinated stragglers in overlooked neighborhoods, plugging a vulnerable gap in the nationwide effort to outmaneuver death. Some people are encumbered by jobs or the responsibility of child care. Others struggle with dire poverty. Many are adrift, out of reach, or uninformed. ‘Every person I can get through the line, every person I can get through the registration is one more person who is luckier than those who didn’t in the pandemic,’ said Denise Villamil, the director of youth development services at Alma Family Services in East Los Angeles.” 

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