COVID-19 and Inequality: How Do Pandemics Disproportionately Impact the Most Vulnerable Sectors of Our Population?
Written by Nikol Nikolova
Edited by Allison Chen, Yunshu Li, Isha Jain and Camila Arias
This pandemic has undoubtedly been detrimental to people globally, but more specifically, it has disproportionately affected the most vulnerable parts of our population. Dismissing this fact would mean disregarding those who have been hit the hardest by the adverse results of this pandemic and brushing aside the social, economic, and political disparities that have put these specific groups at a grave disadvantage. However, there is a silver lining: the inequalities that COVID-19 has brought to light have the potential to convince governments around the world to work collectively towards establishing equality.
Black, Asian and Ethnic Minorities
Viruses do not discriminate, but our social system does. Recent statistics have confirmed that in the United Kingdom, Black, Asian, and other ethnic minorities have been disproportionately affected by the virus. Additionally, data from the Intensive Care National Audit and Research Centre (ICNARC) shows that a third of the COVID-19 patients who were admitted to critical care units in the UK are BAME,¹ even though this group makes up only 14.5% of the English population.² These groups of people also have lower survival rates in comparison to their counterparts.
To interpret these results, we must understand the racially-biased framework that underpins our society. BAME communities tend to come from poorer socioeconomic backgrounds as they face hardships due to systematic racism. These initial setbacks kickstart a succession of adversities that impact all aspects of their lives.
Therefore, many people from the BAME communities often work in jobs within the essential service sector, where they’re at a higher risk of being exposed to COVID-19. In a survey of 2,585 adults in Great Britain, more than a quarter of individuals from the BAME group classified themselves as key workers* in comparison to the only 23% of white British people from the same survey.³
Historically, BAME groups have also had to endure inadequate healthcare as a result of racial bias. Similar to the ICNARC study, Public Health England published a review where it was revealed that the death rate from COVID-19 is 4.3 times higher in individuals of Black African origin compared to those of white British ethnicity.⁴ The review cites historic racism as one of the causes of these staggering finds. In the context of seeking medical help, Black individuals have been repeatedly neglected by being admitted to care later than their white counterparts. Consequently, the Black population has developed a stigma against the healthcare system that has failed them time and time again.
Seeing how our health services are rigged to be racist, governments must undertake collective action to remodel the discriminatory healthcare system so that everyone can have equal access to the medical attention that they need.
*Individuals who provide an essential service, such as health and social care, national security, and production of food and essential goods.
The East Asian Community
Panic began after the first wave of news broadcasted that COVID-19 had started to spread outside of China. Suddenly, prejudiced individuals distanced themselves from East Asian people and thousands of reports of attacks on Asian people began to surface. Even certain political figures began to refer to COVID-19 as the “Chinese virus.”
One story that encapsulates the abhorrence and xenophobia directed towards East Asians is that of a man named Abraham Choi, who was in a Penn Station on the 13th of March when a man behind him began to cough and spit on him, whilst spewing hate speech.
“All of you should die, and all of you have the Chinese virus.”⁵
In the aftermath of the incident, Choi reported the hate crime in hopes of receiving assistance from the police. Instead of help, he was met with complete apathy as the policeman told Choi that spitting wasn’t a crime by law and that reporting the perpetrator was not worth the paperwork. Just like Choi’s experience, many of these episodes of hate are neglected by the justice system, making discrimination against the East Asian community even more problematic, threatening, and normalized.
One must understand that this virus, like all others, does not belong to a particular race, ethnicity, gender, or nationality; this pandemic is a worldwide crisis that needs to be tackled without scapegoating individuals and projecting hate.
Refugees
During this pandemic, political leaders have used the health crisis as a means of justifying anti-migrant ideologies. But with or without COVID-19, conflict in areas of political unrest has persisted, which can have dire consequences for the individuals living there. Hence, the integration and support for all refugees and migrants shouldn’t be impeded. Migrants and refugees are forced to choose between leaving their home during the pandemic or staying in a country where their life is at risk every day.
Over the last decade, the number of people displaced by war and violence has doubled to reach 80 million.⁶ At the same time, with the pandemic hitting hard at global economies, resources available to humanitarian organizations have become scarce. This means that millions of refugees are at risk of not having access to essential humanitarian assistance.
The UN High Commissioner for Refugees, Filippo Grandi, revealed that in Lebanon, 7 out of 10 refugee households are on the brink of survival due to extreme poverty and hunger. Many refugees rely heavily on the distribution of resources to survive, thus, the lack of government support in such countries can have devastating consequences. The same situation is found in refugee camps, which are often overcrowded with an undersupply of vital funds.
Governments need to make it one of their utmost priorities to support these vulnerable communities globally, ensuring refugee camps have access to essential resources, including nutritious food and sanitizing products, as well as adequate personal protective equipment, such as masks.
Immigrants
The economic support which some governments have provided throughout this pandemic has reached many citizens, but what about those that the system considers “illegal”?
Many immigrants don’t have the option to work safely from home as they are employed in jobs that require them to be on site. Not only do they have zero official protection from the law, but they also live in constant fear of being deported. Simply put, they have no safety net to fall back on.
Karla Estrada, an immigrant from Mexico who makes masks for frontline workers, was enduring this anxiety during the pandemic for a long time until she finally had her application for permanent residency accepted.⁷ However, this was a long and grueling process that continues to trouble many others.
This documentation is essential due to the fact that being branded as “undocumented” means many immigrants often don’t have access to insurance, proper healthcare, and an array of other government-provided facilities. Furthermore, reports have surfaced of immigrants hesitating to seek medical attention during the pandemic out of fear of being deported. And how could they not? It’s impossible to trust a system that was never created to protect you in the first place.
Key organizations have put together resources to help immigrants during the COVID-19 crisis through information packs on medical, housing, and legal advice, in an array of languages. Here are a few of their links:
- This website provides updated information on COVID-19 in various languages, intending to reduce the linguistic barrier that may arise for immigrants: https://covid19healthliteracyproject.com/
- A page targeted at non-UK nationals aimed at providing language resources and giving details on rights and access to government-provided infrastructure: https://www.london.gov.uk/what-we-do/european-londoners-hub/information-coronavirus-covid-19-non-uk-nationals
- A page for US immigrants created to provide healthcare, legal, and work advice: https://iamerica.org/covid-19-resources-immigrants
The Homeless
Picture this: overcrowded shelters with scarce nutritional and medical resources, low standards of hygiene, and a lack of masks and hand sanitizers. In essence, a COVID-19 outbreak hotspot waiting to erupt.
Studies have estimated a 0.3% to 1.9% potential COVID-19 fatality rate among people experiencing homelessness in the US, the equivalent of 3,454 deaths.⁸ The high numbers are also due to people experiencing homelessness being more susceptible to other infections, which are known to be risk factors for COVID-19.⁹
The abrupt closures of shelters and other crucial services mean that these individuals are consistently at a higher chance of being infected. Therefore, governments must reassess their preventative measures as many of the protocols put in place are near impossible to follow by homeless people. Isolation, avoiding crowded places, and regularly wearing masks is not an option for many. It’s critical to keep services for these groups open and concurrently restructure how they function. Rearranging dorms to abide by the physical distancing rules and ensuring all spaces are kept sanitary with no shortage of masks are all promising steps to take.
Various organizations have taken it upon themselves to provide helpful resources for the global population to educate themselves in support of the homeless community:
- Shelter offers an overview of all measures and protocols relevant to the issue of homelessness with regularly updated housing advice and contact information for help: https://england.shelter.org.uk/legal/housing_options/covid-19_emergency_measures/homelessness
- Homeless Link is working to support the homelessness sector by providing information on the latest key developments surrounding COVID-19 — a critical step in allowing this sector to adapt to the fast-changing social climate: https://www.homeless.org.uk/covid19-homelessness
Domestic Abuse
When lockdown was announced, staying home for work and taking classes in bed seemed idyllic. Nonetheless, being home is paradoxically not the safest place for millions of individuals, the majority of whom are either women, children or LGBTQ+. For these groups, going outside daily is their refuge from mental and physical abuse back at home. So, while lockdown remains an essential part of our fight against this pandemic, it is a severe threat for these individuals.
In a report published by the United Nations (UN), the Department of Global Communications cites that helplines in Singapore and Cyprus have detected more than a 30% increase in calls and in France, the cases of domestic violence increased by 30% since the beginning of the lockdown. Meanwhile, during the first three weeks of lockdown in the United Kingdom, 14 women and two children have been killed.¹⁰ Since we’re not aware of the accurate degree of the problem, the actual number of victims is likely to be higher since many individuals are not able to contact the authorities.
Children also remain exceptionally susceptible to domestic violence since they’re able to be isolated more easily. As a result, a high percentage of them can be exposed to physical and mental abuse, gender-based violence, and sexual exploitation.
Additionally, the newfound dependency on technology at home has led to an increase in cyberbullying, grooming, and the creation and distribution of child pornography. The European Commission released a statement confirming that in some EU Member states, the demand for child sexual abuse materials has increased by up to 30% during lockdown.¹¹
Therefore, with the closing of schools, some children will be forced to look for work on the streets, increasing the probability of them being abused and sexually exploited for trafficking, child labor and child marriage.
LGBTQ+ Community
A topic initially neglected in the media is the impact of COVID-19 on the LGBTQ+ community. Nevertheless, it is vital to recognize that pre-existing discrimination against these individuals already establishes barriers for them to gain access to essential services.
A survey by the Centre for American Progress conducted in 2017 revealed that among lesbian, gay, bisexual, and queer (LGBQ) participants who had visited a health care provider in the year 2016, 8% said that the provider refused to see them due to their sexual orientation. Similarly, among transgender people who had visited a health care provider in the past year, an astonishing 29% revealed that the doctor refused to see them due to their gender identity.¹² This discriminatory climate discourages LGBTQ+ people from seeking services from a system that repeatedly turns them down. However, finding healthcare elsewhere is difficult due to the shortage of physical and emotional support during lockdown.
More recently, the LGBTQ+ community has fallen victim to cases of abuse at home and in public. A United Nations report suggests an increase in homophobic and transphobic rhetoric across multiple countries.¹³ For example, in Panama, the lockdown measures have dictated for men and women to go out on separate days. These measures entailed that services could be denied to transgender people simply because of conservative, ignorant views about gender. This was seen in the case of Mónica, who was denied access to a supermarket when she went out for groceries on a day that was designated for women.¹⁴
As many transgender people have a different gender assigned at birth on their identity documents, they have no option to defend themselves and have to rely on expensive courier services for basic supplies. Many also don’t have supportive networks from family and thus, cannot depend on having emotional assistance either.
In the case of intersectional identities within the Black LGBTQ+ community, a 2015 US Transgender Survey revealed that Black transgender people are facing the most severe economic and housing disparities. Key findings to support this included that 38% of Black participants were living in poverty, which is more than three times the rate of people in the general US population. Likewise, 42% had experienced homelessness at some point in their life in comparison to 30% of the people in the overall sample.¹⁵ These statistics reveal the astounding economic and housing barriers that Black LGBTQ+ individuals endure.
In more recent times, the deaths of two Black trans women, Riah Milton in Ohio and Dominique “Rem’Mie” Fells in Pennsylvania echo the fact that transgender women of color are especially threatened since they face severe marginalization due to racism, sexism, and transphobia.¹⁶
Novel Resources to Keep in Mind:
- The Silent Solution: With abusers going through their victim’s phone to track their calls, contacting help is not as easy as it sounds. The Silent Solution has been launched in order to make contact with authorities as easy as possible during the lockdown.
The most important thing to remember is to reach out to people and stay connected if you feel that a child (or anyone else) may be suffering from physical or mental abuse at home. The American Academy of Paediatrics has shared valuable information on how to spot child abuse and how you can support families and children during this time.
The Trevor Project supports the Black LGBTQ community through various resources aimed at tackling mental health issues and offering mental health support. They also have a helpline number, a confidential online instant messaging and a text messaging service.
Mental Health
Amid a pandemic that primarily concerns our physical health, we were all quick to neglect the importance of maintaining our mental health. With schools being closed and healthcare services becoming scarce in many locations, there is a critical shortage of support systems for those who have pre-existing mental health conditions and those who are more susceptible to developing them.
Mental health has always been one of our biggest global challenges. Studies reveal that depression affects 264 million people globally, and suicide has become the leading cause of death in people age 15–29.¹⁷ Recent statistics have researched the impact of the pandemic by analyzing the percentage of US adults showing symptoms of anxiety and/or depression. Pre-COVID-19, the percentage of the population with an anxiety disorder was 8.2% compared to 28.2% amid the pandemic.
Essentially, individuals who were able to cope pre-COVID-19 due to having access to the necessary support networks are now left to manage in isolation and unfortunately may resort to alternative treatments, such as consuming increased amounts of alcohol and drugs. In Canada, a report revealed that 21% of people between the age of 18–34 have increased their alcohol consumption during the pandemic.¹⁸ This can make their mental and physical recovery after the pandemic even more challenging.
Ultimately, keeping our mental health in check is essential in our fight against this pandemic and to the recovery of the world post-COVID-19. With the increasing demand for mental health resources, governments need to ensure that there is a sufficient amount of remote and free networks to support these groups. Here are two key resources:
- The Centers for Disease Control and Prevention (CDC) website has published information and helplines targeting a wide range of concerns, such as how to cope with stress, trauma, alcohol and substance use, misinformation and anxiety, and many others: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
- The World Health Organization (WHO) has also published updated information on how to cope mentally with COVID-19. The reliability of the articles helps to not only reduce the spread of misinformation but also to manage the stress surrounding the pandemic: https://www.who.int/teams/mental-health-and-substance-use/covid-19
Final Thoughts
The analyses depicted here are in no way put in place to prioritize one struggle over another. They’re simply highlighting that some groups are indeed more susceptible to the effects of the pandemic than others and that society should be putting measures into place to ensure these groups are supported.
Pandemics don’t just expose the already pre-existing inequalities in our system, but they also significantly heighten them. Rather than pondering on these revelations, governments and individuals should take this opportunity to work collectively towards abolishing the social and economic disparities that exist in our population.
References:
¹ https://www.cebm.net/covid-19/bame-covid-19-deaths-what-do-we-know-rapid-data-evidence-review/
² https://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity/national-and-regional-populations/population-of-england-and-wales/latest
³ https://www.bbc.com/news/health-53651954
⁴ https://www.financialexpress.com/world-news/historic-racism-to-blame-for-higher-covid-19-risk-to-minorities-uk-report/1993856/
⁵ https://time.com/5858649/racism-coronavirus/
⁶ https://www.unhcr.org/news/latest/2020/6/5efb5c754/enhanced-support-syria-refugees-vital-amid-covid-19-pandemic-unhcr-chief.html
⁷ https://www.youtube.com/watch?v=hQtdkHvhSHA
⁸ https://endhomelessness.org/wp-content/uploads/2020/03/COVID-paper_clean-636pm.pdf
⁹ https://www.cmaj.ca/content/192/26/E716
¹⁰ https://www.bbc.com/news/uk-52433520
¹¹ https://ec.europa.eu/commission/commissioners/2019-2024/johansson/announcements/opening-statement-commissioner-johansson-schengen-migration-and-asylum-policy-and-eu-security_en
¹² https://www.americanprogress.org/issues/lgbtq-rights/news/2018/01/18/445130/discrimination-prevents-lgbtq-people-accessing-health-care/
¹³ https://www.ohchr.org/Documents/Issues/LGBT/LGBTIpeople.pdf
¹⁴ https://www.bbc.com/news/stories-52668174
¹⁵ https://www.transequality.org/sites/default/files/docs/usts/USTS-Black-Respondents-Report.pdf
¹⁶ https://time.com/5853325/black-trans-women-killed-riah-milton-dominique-remmie-fells-trump/
¹⁷ https://news.un.org/en/story/2020/05/1063882
¹⁸ https://www.globenewswire.com/news-release/2020/04/15/2016460/0/en/CCSA-Finds-Canadians-Under-54-Drinking-More-While-at-Home-Due-to-COVID-19-Pandemic.html
