The ongoing Covid-19 pandemic is exposing and exacerbating health disparities in America, with Black and brown communities hit especially hard.
This was the theme of a Congressional hearing held June 23 by the House Budget Committee. Among the witnesses was Sir Angus Deaton, Dwight D. Eisenhower Professor of International Affairs, emeritus, at Princeton University’s School of Public and International Affairs.
Chairman John Yarmuth (D-KY) began the hearing with an opening statement about the unprecedented challenges facing the U.S. In addition to the pandemic and subsequent economic fallout, Yarmuth said Americans face a “crisis of conscience as we grapple with the deadly effects of entrenched, systematic racism.”
“Nowhere is the disproportionate impact of coronavirus clearer than in the virus’ death rates,” Yarmuth noted.
Deaton echoed concern for these disparities and how they have been amplified by Covid-19.
“The pandemic may turn tolerable inequalities into intolerable inequalities. There is a danger of social unrest, but there are also opportunities to address old problems,” Deaton said. “The need to repair our policing has already become urgent. Other outstanding issues include health care, antitrust policy, and our system of unemployment benefits.”
Deaton stressed that lower levels of education contribute to inequality overall.
“In the past half century, the lives of Americans have become increasingly divided according to whether people have a four-year college degree; those with a bachelor’s degree have prospered and are living longer, while those without are foundering,” Deaton said.
This data is featured in a book Deaton co-authored this year, “Deaths of Despair and the Future of Capitalism,” with Anne Case, Alexander Stewart 1886 Professor of Economics and Public Affairs, emeritus, at the Princeton School of Public and International Affairs.
In the book, Case and Deaton describe “deaths of despair” as deaths from suicide, drug overdose, and alcoholism. Overwhelmingly, the dramatic rise in these deaths of despair occurred among those who do not have a bachelor’s degree. This — along with higher rates of divorce, unemployment, and loneliness for Americans without a bachelor’s degree — highlights the issues surrounding the widening education gap, Case and Deaton argue in the book.
Other factors driving the disproportionate mortality rates of Covid-19 include “segregation of housing, population density, transportation, and the pattern of pre-existing health conditions,” testified Deaton during the hearing.
Hispanics and non-Hispanic Blacks are also overrepresented in service and health care industries compared to whites, which Deaton says makes them more vulnerable to contact with the virus and has put them in a difficult position during the pandemic.
“People without a college degree keep their jobs, if they are essential workers, but may risk infection, or, if they are not essential, lose their jobs and risk their earnings, but stay safe,” Deaton said.
Looking forward, Deaton hopes for health care reform that will reduce the exorbitant cost of health care and remove the burden that it places on individuals — especially low-income individuals — as well as on state and federal governments whose ability to serve people is compromised.
“The pandemic has exposed the folly of tying health insurance to work; African Americans and Hispanics were less likely to have insurance pre-Covid, and they, and the millions who became unemployed found themselves at risk,” Deaton said. “America needs what other rich countries have, health care that is not tied to employment, that covers everyone from birth, and that controls costs.”
In addition to Deaton, the witnesses included Patrice Harris, former president of the American Medical Association; Damon Jones, associate professor at the University of Chicago Harris School of Public Policy; and Avik Roy, president of the Foundation for Research on Equal Opportunity.
View the full hearing, “Health and Wealth Inequality in America: How COVID-10 Makes Clear the Need for Change,” and Deaton’s testimony.