A Familiar Trend

By Daniel Zhang

The world watched in horror as New York City’s Covid-19 infections exponentially skyrocketed. Within the epicenter itself, a different story was emerging — one now echoed across every urban area in the United States. Geographically, in a classic tale of haves and have-nots, Upper East Siders vanished while East Harlemers endured. Rich, predominantly white neighborhoods, such as Greenwich Village and Brooklyn Heights, emptied out by nearly 50%. While those New Yorkers laid low in the Hamptons, nearly 95% of their compatriots, residents earning household incomes lower than $80,000, remained in what they, now ironically, saw as ‘the greatest city in the world’. As a result, 30% of New York’s Covid-19 hospitalizations consist of African Amercians, who represent 18% of the state’s population. In New Mexico, 20% of Covid-19 cases consist of Navajo tribe members, who represent 5% of the state’s population. In Louisiana, 70% of Covid-19 deaths consist of Black residents, who represent 1/3 of the state’s population. The Brookings Institute reports that “Hurricanes hit the poor the hardest” and the Economic Policy institutes finds that the top 1% captured 85% of post-recession growth between 2009-2013. At seemingly every crisis — natural, social, or medical — low-income minorities lack the resources to avoid the effects. Analyzing this familiar trend through the microcosm of Covid-19 reveals the decades-long buildup to these circumstances: the astonishingly high cost of health prior to Covid and less insulation from the effects of this during Covid.

Before the first case of Covid-19 was discovered in Wuhan last year, low-income minorities were already disenfranchised in terms of health. As writer Eric Schlosser notes in his book, Fast Food Nation, never before has there been a time where a fit and healthy rich preside over an unfit and unhealthy poor. Being plump was once an indicator of financial prosperity, but it has now become a predictor of poverty. While lifestyle brands, such as the ever-popular Sweetgreen, charge upwards of $8.00 for a single salad, McDonalds and KFC provide affordable alternatives with dollar menus and value meals. It’s understandable why a low-income minority family would rather make a trip to a fast food outlet instead of forking over a week’s pay for a bowl of leafy greens. The high cost of fresh fruits and vegetables has created a dangerous plight: to meet the USDA dietary standards, low-income minorities would have to spend 70% of their food budget on fruits and vegetables alone. These findings, in combination with the low cost of fast food, reveal that a bowl of salad can be as indicative of wealth as a brand new Mercedes.

While eating healthy is unaffordable, access to quality healthcare is oftentimes unattainable. In addition to problems arising from affordability, low-income minorities face difficulties accessing the same quality of care as their white counterparts. The American Bar Association reports that even when controlling for factors such as class and eating habits, low-income minorities are less likely to receive effective treatments. They are less likely to be offered kidney transplants and less likely to receive innovative heart attack, stroke, and AIDS treatments. When examining medical professionals administering this care, the reason for these disparities emerges: only 5.8% of them are Hispanic and a mere 5% identify as Black. In fact, when Black doctors took care of Black men, a Harvard Business Review analysis found that the men were more likely to receive effective care. In essence, a lack of diversity within medicine means that low-income minorities are less likely to have been effectively treated or diagnosed prior to Covid, leading to a deteriorated state of health before the pandemic struck. 

Consequently, as Covid-19 infected our nation, low-income minorities' plight became further pronounced. A lack of sufficient national data on Covid-19’s impact separated by race and income level has led many states to conduct their own research. The results are overwhelmingly similar: poor minority-filled areas have the highest positive-test rates while wealthy communities possess the lowest. This stems from a number of reasons, ranging from employment to living conditions. While higher-income white collar workers could work from home or rely upon savings, low-income minorities often have to continue working contact-heavy jobs, leading to a higher chance of infection. Low-income minorities are overwhelmingly the ones who must deliver InstaCart orders to homes, drive Ubers in cities, and work fast food drive throughs. This is compounded by their higher rates of public transit, where infections are more likely when compared with personal cars. These findings, in addition to compact living conditions, mean low-income families are more likely to receive infections as well as affect each other. Disastrous results have emerged from these structural problems, indicating that an already worse state of health, in combination with less desirable employment and living conditions, have led to higher infection rates amongst low-income minorities.

When analyzing the government’s medical and financial response's effects on low-income minorities, several successes emerge, as well as several failures. For starters, the United States has achieved a ventilator surplus, a product of Trump’s evocation of the Defense Production Act and lower-use states shipping ventilators to places like New York and California, states with large amounts of Covid-19 cases as well as low-income minorities. Additionally, government aid has allowed Pharmaceutical companies to focus on developing Covid-19 vaccines and treatments. Notably, the Federal Drug Administration has already approved Remdisever, a treatment developed by American company, Gilead Sciences, which shortens the average hospital stay of a Covid-19 patient by four days. While the price of the treatment is around $3,120 for those with commercial insurance, it may prove to benefit the wallets of low-income minorities overall, as early intervention with Remdisever may help them avoid hospitalization altogether, a process which costs around $12,000. Despite these overall successes, the main criticism of Covid-19 response for low-income minorities has not necessarily been the absence of mask mandates or the abundance of harmful online ‘cures’. Rather it is the lack of focused resources. The federal government has failed to adequately direct a higher portion of resources towards low-income communities, often distributing an excess of resources to wealthier communities that do not require them. While this has not yet led to drastic consequences, the continued daily increase of Covid cases, especially in low-income neighborhoods, may require concentrated resource distribution.

Another pillar of government Covid-19 response has been financial stimulus packages, which deliver $1,200 to individuals earning less than $75,000. While these checks undoubtedly aid individuals financially, a larger issue remains: the most disadvantaged are often the ones still waiting to receive payment. Employed people, regularly filing taxes with the government, are easily pinpointed to receive proper aid. However, those earning too little to file taxes often did not receive the extra $500 families were promised for each child under sixteen years of age. This is because tax filers state dependents when doing so, while those who do not file are not able directly inform the government of their dependents. These financial oversights, in combination with the design of the stimulus package bill, provide aggrandized benefits to wealthy Americans. While the package could have provided an expanded set of benefits, common in other developed countries, wealthy corporations and Wall Street have been gifted a rescue fund that could be valued at 6 trillion dollars. These concerns indicate another criticism of the stimulus bill. Similar to medical resources, financial resources have been distributed in an untargeted manner. More specifically, it provides funds to those not requiring them while failing to provide enough for those requiring them the most. White-collar workers, who often already earn higher wages, are able to telecommute, not having to spend additional resources on arsenals of personal protective equipment. Blue-collar works, who are often low-income minorities, must continue to interact with others on production lines and delivery gates, having to allocate more resources to masks, gloves, and cleansing products. There are markedly different pandemic experiences for white-collared and blue-collared workers. Amongst those who received stimulus checks, individuals with less than $500 in bank accounts spent half of their payments within ten days, indicating the same check for white-collar families earning $100,000 and blue-collar families earning $1,000 annually creates difficulties for the latter.
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As winds howl and storms rage, disasters should, in theory, affect the rich and low-income minorities equally; both rich homes and poor homes are destroyed while rich families and poor families are both forced to evacuate. Despite this seemingly logical rationale, from Katrina in New Orleans, to Sandy in New Jersey, to even the 2008 financial crisis, low-income minorities often bear the brunt of the effects of every storm. Covid-19 appears no different; as a disaster that impacts mental and physical health, in addition to creating financial burdens, this pandemic disproportionately affects low-income minorities. Consequently, Covid-19 continues a familiar trend, where after natural and financial crises, disenfranchised minorities disproportionately suffer.