Inequity/Social Determinants

After a bit of last-minute legislative maneuvering, the list of propositions that California voters will be asked to weigh in on has been — more or less — finalized.

The global economic disruption caused by covid-19 has harmed poorer people and poorer countries the most, particularly in Africa, pushing an estimated 100 million people into extreme poverty in 2020 and reversing more than two decades of progress. Famines again threaten to affect countries across Africa and the Middle East as the virus destroys lives and livelihoods.

Patient portals offer great potential to improve patient engagement and participation in their health care.² However, while use of portals has continued to rise in the aggregate, this growth has not been distributed evenly across Americans, with low-income, African American, rural, and older adults repeatedly showing lower rates of use of these technologies.

Forget the notion of a V-shaped recovery. Unemployment leveled off around 16% in May, but a retreat to isolation and the end of some relief funds could lengthen the state’s economic recovery — and deepen inequality.

California’s year of pandemic, recession and civic unrest also includes angst over the outcome of the 2020 census. The state likely will lose at least one congressional seat and perhaps two.

Los Angeles spends billions of dollars yearly on contracts for commodities, professional services and construction. The City’s purchasing power presents a tremendous opportunity to invest in local small businesses, and businesses owned by women and people of color, but Los Angeles is not as effective as it could be in connecting small businesses and businesses owned by historically disadvantaged groups to contracting opportunities.

The COVID-19 pandemic precipitated catastrophic job loss, unprecedented unemployment rates, and severe economic hardship in renter households. As a result, housing precarity and the risk of eviction increased and worsened during the pandemic, especially among people of color and low-income populations.

Months after advocates warned that the coronavirus pandemic could take a severe toll on LGBTQ people, Gov. Gavin Newsom’s administration is telling health professionals to track the disease’s impact on the community.

Now,  more than ever, broadband internet access (BIA) must be recognized as a social determinant of health. Disparities in access should be treated as a public health issue because they affect, "the health of people and communities where they live, learn, work and play."

There is plenty of evidence to support that women leaders are needed in the health and pharmaceutical sectors, although most of the leadership positions in global health are predominantly occupied by men.

California, with its multilingual populations and rural communities that lack medical care, is the perfect place to implement telehealth.

The COVID-19 pandemic is magnifying decades of inequities in communities of color that have less access to health care.

Although the ultimate course and impact of Covid-19 are uncertain, it is not merely possible but likely that the disease will produce enough severe illness to overwhelm health care infrastructure. Emerging viral pandemics “can place extraordinary and sustained demands on public health and health systems and on providers of essential community services.”

Recent clinical SARS-CoV-2 studies link diabetes, cardiovascular disease, and hypertension to increased disease severity. In the US, racial and ethnic minorities and low socioeconomic status (SES) individuals are more likely to have increased rates of these comorbidities, lower baseline health, limited access to care, increased perceived discrimination, and limited resources, all of which increase their vulnerability to severe disease and poor health outcomes from SARS-CoV-2.

COVID-19 is an equal opportunity virus, but exposure to this virus does not take place in an equal opportunity context. Although only some states and counties provide COVID-19 cases and outcomes by race, the data available indicate that disparities are stark.

These 3 events, the pandemic, massive unemployment, and the recent protests, have occurred concurrently. Federal and state officials offer daily summaries of coronavirus disease 2019 (COVID-19) cases and deaths. At the same time, millions of people across the country have been adversely affected by unanticipated unemployment, with higher unemployment rates among black and Hispanic workers compared with white workers. The resurgence of anger at long-standing racism and racial inequities was added to the anxiety and tension of the pandemic, creating a combustible scene of national civil unrest.

People of color have faced economic inequality for generations, and the recent wave of Black Lives Matter protests has renewed discussions on these disparities.

Compared to White families, other races have lower levels of income and net worth. They are also less likely to hold assets of any type. In fact, 19% of Black families have zero or negative net worth, while only 9% of White households have no wealth.

A “CEO tax” targeting San Francisco’s most unequal salaries. A signature-gathering campaign to tax Palo Alto’s millionaires. And now, a new statewide bill that would levy a yearly 0.4 percent tax on every Californian worth more than $30 million.

The spread of the new coronavirus has affected people all over the world, and state and local governments are taking sweeping actions to halt the spread of the disease and mitigate the public health and economic impact of the outbreak.

HLS scholars and legal experts consider the important legal and policy concerns and challenges that have emerged—including those involving civil liberties, privacy, historical precedent, and economic impact—as cities, states and countries respond to the epidemic.

In the richest nation in the world, King saw no justification for the evil of rampant poverty and chastised the government’s efforts against the ill as “piecemeal and pygmy.” Housing efforts were subject to the whims of the legislature, educational reforms were sluggish, and family assistance programs were neglected; all failed to reach the most profound needs of the poor.