As the Covid-19 Emergency Declaration Expires, Health Inequities Remain an Ongoing Crisis
Housing, economic security, labor protections, and decarceration are core public health tools
By Clara Long
As of today, the federal Covid-19 public health emergency declaration is no longer in effect. Issued in March 2020 just as the US recorded its 100th Covid mortality, this declaration and a hodgepodge of federal state and local actions enabled a range of policies and benefits in response to the pandemic, measures that extended far beyond health care access. These policy interventions illuminate a path toward a comprehensive public health approach that could have powerful impacts on our society and collective health. They are a measure of what’s possible, and exactly the kind of interventions we still urgently need.
Among the many temporary governmental measures taken in response to Covid-19 were public health interventions aimed at housing, food, economic security, and racial justice — particularly for the most vulnerable — in recognition that these are key to our collective health. These and other “social determinants of health” account for 80 percent of health outcomes, according to the National Academy of Medicine.
Housing justice interventions
Consider the pandemic eviction moratoriums, rent freezes, and emergency housing for unsheltered individuals. These policies provided stability for millions of renters and mitigated the health consequences of a massive eviction crisis. Indeed, research shows that if eviction moratoria had been implemented across the country from March-November 2020, such policies could have reduced COVID infections by 14.2% and deaths by 40.7%. Federal protections ended due to a concerted push by the landlord lobby to repeal the national CDC eviction moratorium, and most remaining local and state protections are now being rolled back as well.
But housing instability — including eviction, foreclosure, and homelessness — was and continues to be a public health crisis. Housing instability leads to numerous physical and mental health issues, compounded by stress that exacerbates chronic conditions. States and local jurisdictions should adopt permanent tenant protections including rent control, just cause eviction protections, tenant right to counsel, and stronger housing code enforcement to keep people in their homes and prevent harms to health.
Economic security and labor justice interventions
Emergency orders and legislation were also implemented to ensure economic security, provide food aid, and improve working conditions. One notable example is paid sick leave, which is not guaranteed at the federal level. The 2020 Families First Coronavirus Response Act (FFCRA) temporarily granted some workers two weeks of paid sick leave, until the mandate expired in December 2020. Still, the impact of this brief intervention is notable: one study showed that in states previously lacking paid sick leave, access via the FFCRA decreased COVID rates in each state by around 400 confirmed cases per day. My organization, Human Impact Partners (HIP) estimated in 2021 that more than 7,500 Covid-19 infections and 133 deaths could have been prevented if Walmart — a company not covered by the FFCRA — had offered employees sufficient paid sick leave.
COVID may not dominate the news cycle as it once did, but people still get sick, and workers still need access to paid sick leave. Our public health research has shown that paid sick leave policies can significantly benefit public health, reduce disease transmission, and prevent financial hardship among low-income workers in particular. Congress enacting permanent paid sick and family leave now would go a long way towards addressing economic insecurity that unfairly exposes workers and their families to risk, and toward protecting community health.
Community safety interventions
The pandemic also underscored an urgent need for decarceration as a public health strategy. Overcrowded jails, prisons, and detention centers quickly became primary hotspots for COVID cases and deaths. Early in the pandemic, jail and prison populations in the US dropped by 14 percent. But these improvements were inadequate, and incarcerated populations have since returned to pre-pandemic levels or higher. As the American Public Health Association has already recognized, the policies fueling globally-unparalleled levels of incarceration in the US cause serious harms to public health. We must urgently reduce the incarcerated population and invest in housing, employment, and social services — both as a preventative approach, and for those returning to their communities.
For a brief moment in the last few years, some “public health” interventions seemed to better reflect that the key to protecting the public’s health lies in addressing the underlying living and working conditions and systems that inequitably expose people to serious and ongoing health harms. Today is an opportune time to pause and consider what the pandemic response taught us about how best to protect the public’s health, and to push for a public health system with the capacity, authority and motivation to ensure housing, food, fair employment and true community safety.
Clara Long (@clarychka) is the Director of Policy and Organizing at Human Impact Partners, where she develops and implements HIP’s overall strategy for policy, advocacy, organizing and research in support of social movement partners. As a human rights lawyer, her strategies, research and advocacy contributed to campaigns to abolish an immigration detention system in which people are dying because of medical neglect, transform border policies that criminalize and abuse migrants, and bring back people deported to harm in the racially discriminatory deportation machine, among others.