Literature Review
Many people in the United States continue to suffer from the public health and economic effects of the COVID 9 pandemic. The pandemic has robbed many of their economic power making it hard to finance shelter and meals (Shah et al., 2020). Such a lack of proper standards of lifestyle also affects the health and well-being of citizens. As such, the pandemic has exposed prevailing structural drivers of health inequalities such as economic disparities and anti-democratic political processes and institutions as well as precarious and adverse working conditions (Bernardini et al., 2021). Such determinants of health are coupled with other factors such as education level, gender, and ethnicity. In the past, there have been numerous warnings regarding the dangers of health inequalities (Ataguba, and Ataguba, 2020). One such concern was through the Aima declaration which mentioned that health for all can only be achieved through a new international economic order and participation of the people. Such an argument was later backed in the report by the Commission on the Social Determinants of health 2021 World Health Report (Paremoer, Nandi, Serag, and Baum, 2021). The report viewed that health inequalities would be best addressed when the inequitable distribution of resources, power, and money was addressed.
The pandemic has continued to widen the gap of inequalities across the world. It is estimated that around 435 million women and girls are living below $ 1.90 due to the effects of COVID-19. As such, the Blacks and Hispanic adults seem to be the worst affected compared to the white adults in all measures (Green, Fernandez, and MacPhail, 2021). For instance by the first quarter of 2022 around 74.% Blacks and 75.2% of Hispanics had difficulties in paying their household expenditures in comparison to 55.5% of white adults. 9.6% and 8.4% of black and Hispanic adults respectively were unable to make their monthly house payments compared to 4.0% of white adults. Also, 16.2% of Hispanics and 20.4% of blacks experienced insufficiency in their households compared to the 7.1% of the white adults. Moreover, a fifth of black adults and a quarter of Hispanics lost their jobs due to the pandemic compared to the 10.2% of the white adults (Jackson, and Johnson, 2020).
The social determinants of health according to McNeely, Schintler, and Stabile, (2020) are conditions in which people are born, age, work, and grow. Such factors range from health care, social support networks, employment, physical environment, neighborhood, education, and socioeconomic status. As such despite the care being a vital part of healthy living, there is a range of factors that determine the health outcome. Addressing social inequalities is important in improving health disparities. The failure to address the social determinants is what made the COVID-19 pandemic affect the health of the people of color and impact their social-economic factors disproportionately. Such factors are even worse for younger adults aged between 18 to 44 who have been seen to be doing worse than the older adults are (Vilar-Compte, Gaitán-Rossi, Félix-Beltrán, and Bustamante, 2022). It is reported that such a group had the most symptoms of anxiety and depression and were unable to pay the usual household expenses. The hardest hit among the group were those adults with children who reported even much more difficulty in paying household expenses. Such group was also prevalent in reporting food insufficiency and the symptoms of anxiety and depression as well as having no confidence in making house payments for the next coming months compared to the general population. Such families relied on borrowing from friends and family to make ends meet (Sandhu et al., 2021).
Social Determinants of Health
Data collected by (0 showed that the number of black and Hispanic people who were experiencing job loss, food insufficiency, depression, and anxiety as well as inability to pay for their houses increased from December 2020. The situation has been worsened by the increase in the prices of household goods (Wolfson, Leung, and Kullgren, 2020).
Precarious work and adverse working conditions
Another social determinant of the COVID 19 pandemic is the precarious work and adverse working conditions. The pandemic has brought to light the precarious work and adverse working conditions as they interact with other factors such as gender, class, migratory status, and ethnicity to influence the population and groups most exposed to COVID 19 infection (Takian, Kiani, and Khanjankhani, 2020). Populations who work in demeaning working conditions are less likely to get sick leaves and medical attention since they have low wages. Moreover, due to the low wages, they are unable to access quality housing, sanitation, water, and food. Such a group is also unable to quarantine themselves in case of a COVID 19 infection since they cannot afford to lose income or work from home. For instance, meat workers across the world have been considered to be the most affected by COVID 19. Such an outcome was inevitable since the working conditions in slaughterhouses are more hazardous even without the pandemic. The physical setup of slaughterhouses, communal housing, and transport further intensifies the risk of a pandemic as it makes social distancing almost impossible. Moreover, most workers are immigrants who lack the status of joining a union thus unable to challenge exploitative practices (Abrams et al., 2022).
The united states consist of 60% of people of color who work in delivery, and warehouses, and 74% work as cleaners. As such, people of color have been overrepresented in the COVID-19 cases and deaths. Such a realization is not new as similar patterns have been observed in the UK where the COVID-19 death and infection rates of black communities are twice as high as those of the white communities. Perhaps the most severe effect of the COVID 19 pandemic is in India where migrants were forced to retreat to their home villages once the lockdown was initiated which led to the loss of income. As a result, it was estimated that around 971 immigrant workers died due to starvation, lack of access to medical care, financial distress, suicide, and injury (Abraham, 2021).
About 70% of women around the world are employed in health and social work around the world. Sadly, the group is largely constituted of minorities, especially blacks. These women are poorly paid and are in the front line thus increasing their chances of getting the COVID-19 infection. For instance, community health workers are responsible for contact tracing and monitoring quarantine and isolation. Despised the high risk of exposure, they are inadequately compensated and in most cases are not provided with enough personal protective equipment. Also, about 40% of women across the world were working in sectors that were hardest hit by the pandemic leading to a loss of income (Turner-Musa, Ajayi, and Kemp, 2020).
Findings
The pandemic created a huge economic inequality and inadequate social protection, which continues to widen across the world. For instance, the world’s five richest billionaires had increased their wealth by 59% combined seven months since the pandemic was considered a threat. Such inequality has been brought about by weak financial and commercial regulations. Also, regressive taxation, illicit financial flows and the influence of national corporations in shaping the national economies contribute to the inequalities (Dongarwar et al., 2020). The increase in private wealth has influenced the decrease of social wages such as basic rights, goods, and service payments provided by the state, thus reducing social protection, devastating the condition of the vulnerable groups whose condition worsened during the pandemic especially the middle class. For instance during the pandemic, programs that were meant for relief such as food and nutrition assistance, unemployment benefits, cash transfers, and tax relief have been accessible to those who need them most such as the displaced and indigenous populations, young people, immigrants and informal workers (Singu et al., 2020).
The pandemic has also been used by the powerful and rich to manipulate processes in their favor. For instance, in India COVID-19 has been used as an excuse to reduce time set aside for public consultation, to give way to passing poor environmental protection laws. In the United States of America, the extractive industry is using the pandemic to suspend fuel efficiency standards and environmental laws (Takian, Kiani, and Khanjankhani, 2020).
Not only has the environment been the main target of manipulation, but women and girls also have not been left out. Many authorities have disproportionately implemented control measures that affect women and girls by restricting freedom of movement which in turn that disrupt sexual and reproductive health services. Such disruption is likely to lead to an estimated seven million pregnancies and deaths due to complicated births or unsafe abortions around the world. The lockdown has also aggravated the level of sexual violence that mostly affects those living in conflict settings, women with disabilities, indigenous women, and migrants with refugee backgrounds (Sandhu et al., 2021).
The lockdown has been also used as an excuse by some authorities to introduce anti-democratic measures such as shutting down courts, passing repressive emergency laws, and increasing surveillance. For instance, the use of digital surveillance for contact tracing of COVID-19 transmission might be used in the future to accomplish other activities that have political dissent (Abrams et al., 2022). Also while the government has enforced restrictive regulations in public health, they have failed to provide regulations that could govern the private health sector in increasing the access to healthcare facilities, medical technologies, vaccines, and covid-19 technologies. Such measures would have included progressive solidarity taxes and the production of COVID-19-related treatments. Such a scenario shows the inequalities that are caused by a profit-driven healthcare system for the minority groups who are already experiencing inequitable healthcare access. For instance, it was reported that in Australia, five deaths occurred in public care homes in 2020, while the privatized homes reported 900 deaths (McNeely, Schintler, and Stabile, 2020).
Unemployment for People of Color
Conclusion
In conclusion, the socio determinants of COVID-19 have greatly affected the lively hood of the minority groups. The impact has caused a magnification in inequalities that further downgraded their quality of life. However, the blame lies on the authority for introducing punitive laws against the less fortunate, while providing loose regulation for the wealthy in the society. Such inequality is the reason why the five richest people in the world had a combined 59% increase in wealth seven months after the pandemic was declared a threat. On the other hand, seven months into the pandemic, people were dying of hunger, suicide, anxiety, and depression. In addition, the pandemic left the blacks and Hispanics in worse conditions than before, as the loss of jobs made them unable to provide meals or even make house payments. It was even heartbreaking to see the effects of the pandemic hit harder on minority families that had children, compared to those who did not have families. Such situations contributed to the increase in cases of anxiety and depression among the minority groups, the Blacks and Hispanics.
References
Abrams, E.M., Greenhawt, M., Shaker, M., Pinto, A.D., Sinha, I., and Singer, A., 2022. The COVID-19 pandemic: Adverse effects on the social determinants of health in children and families. Annals of Allergy, Asthma & Immunology, 128(1), pp.19-25.
Abraham, P., Bishay, A.E., Farah, I., Williams, E., Tamayo-Murillo, D. and Newton, I.G., 2021. Reducing health disparities in radiology through social determinants of health: lessons from the COVID-19 pandemic. Academic Radiology, 28(7), pp.903-910.
Ataguba, O.A. and Ataguba, J.E., 2020. Social determinants of health: the role of effective communication in the COVID-19 pandemic in developing countries. Global Health Action, 13(1), p.1788263.
Bernardini, F., Attademo, L., Rotter, M. and Compton, M.T., 2021. Social determinants of mental health as mediators and moderators of the mental health impacts of the COVID-19 pandemic. Psychiatric Services, 72(5), pp.598-601.
Dongarwar, D., Ajewole, V.B., Oduguwa, E., Ngujede, A., Harris, K., Ofili, T.U., Olaleye, O.A. and Salihu, H.M., 2020. Role of social determinants of health in widening maternal and child health disparities in the era of COVID-19 pandemic. International Journal of Maternal and Child Health and AIDS, 9(3), p.316.
Green, H., Fernandez, R. and MacPhail, C., 2021. The social determinants of health and health outcomes among adults during the COVID?19 pandemic: A systematic review. Public Health Nursing, 38(6), pp.942-952.
Jackson, C.L. and Johnson, D.A., 2020. Sleep disparities in the era of the COVID-19 pandemic highlight the urgent need to address social determinants of health like the virus of racism. Journal of Clinical Sleep Medicine, 16(8), pp.1401-1402.
McNeely, C.L., Schintler, L.A., and Stabile, B., 2020. Social determinants and COVID?19 disparities: Differential pandemic effects and dynamics. World Medical & Health Policy, 12(3), pp.206-217.
Paremoer, L., Nandi, S., Serag, H. and Baum, F., 2021. Covid-19 pandemic and the social determinants of health. bmj, 372.
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Shah, G.H., Shankar, P., Schwind, J.S. and Sittaramane, V., 2020. The detrimental impact of the COVID-19 crisis on health equity and social determinants of health. Journal of Public Health Management and Practice, 26(4), pp.317-319.
Singu, S., Acharya, A., Challagundla, K., and Byrareddy, S.N., 2020. Impact of social determinants of health on the emerging COVID-19 pandemic in the United States. Frontiers in public health, p.406.
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Vilar-Compte, M., Gaitán-Rossi, P., Félix-Beltrán, L. and Bustamante, A.V., 2022. Pre-COVID-19 Social Determinants of Health Among Mexican Migrants in Los Angeles and New York City and Their Increased Vulnerability to Unfavorable Health Outcomes During the COVID-19 Pandemic. Journal of immigrant and minority health, 24(1), pp.65-77.
Wolfson, J.A., Leung, C.W. and Kullgren, J.T., 2020, July. Food is a critical social determinant of health among older adults during the coronavirus disease 2019 (COVID-19) Pandemic. In JAMA Health Forum (Vol. 1, No. 7, pp. e200925-e200925). American Medical Association.
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