We all deserve the opportunity to live healthy lives, but the COVID-19 pandemic has exposed that many families lack the resources to do so. As a professor, I teach social work students about the “social determinants of health” – life circumstances that affect our ability to stay healthy and our likelihood of developing an illness. The COVID-19 pandemic is illustrating this abstract concept in real time, as revealed through its disproportionate impact on low-resource communities, immigrants and people of color.
Social determinants of health include things like air quality, access to parks and good schools, and wages. Research overwhelmingly shows people of color and those in low-income neighborhoods have higher rates of disease and shorter life expectancy as a result of these social determinants, which are themselves determined, in large part, by governmental policy.
The consequences of inequitable social determinants of health are evident in rates of infection, illness and death due to COVID-19, and New Mexicans of color have clearly been disproportionately impacted. Social determinants of health that contribute to this inequity include that people of color are more likely to work in essential industries, rely on public transportation and face discrimination in health, employment and justice systems. And they are less likely to have access to health care for early testing and treatment.
Those with limited resources and greater stress are also more likely to have pre-existing conditions, like diabetes or heart disease, which further increase the chance of serious illness and death from COVID-19. Families living in extreme poverty are more than twice as likely to get acutely ill if infected than are those with sufficient income.
The pandemic has also done disproportionate economic harm to people of color, people earning low wages and immigrants, as revealed through higher rates of unemployment, reduced income and loss of health insurance. The pandemic has thus worsened financial hardship, which increases the likelihood of many diseases long-term. For instance, even short spells of unemployment have been shown to increase risk for heart attack.
While children are not as likely as adults to become ill with COVID-19, it can still affect their health, especially long-term. Families’ financial distress may not only limit children’s access to healthy food and health care as they grow, but it can also create toxic stress, which can interfere with cognitive and physical development, placing kids at risk for myriad health and mental health problems when they become adults. That is why we must meet the basic needs of families right now.
Lawmakers must hasten to enact equity-based policies that direct resources to populations that have been hit the hardest and have been historically marginalized. New Mexico Voices for Children has identified economic policies which I believe can reduce gaps in the opportunity for good health during this crisis. Critically, we must not cut spending on the services – like health care and education – that families rely upon. We must also ensure that households can meet their basic needs by fully funding Medicaid, easing the TANF work requirement, expanding SNAP benefits and childcare assistance, and making the tax system more fair. These economic policies address the social determinants of health by supporting access to the basics, like food and housing, and they also put money into the hands of workers who will spend it locally, helping our economy recover.
Because of the potential for long-term impacts on children, we must protect and strengthen these safety-net programs, even if that means tapping into our state’s reserves or rethinking corporate tax breaks. We should all have the chance to be healthy, regardless of race or ZIP code.