Delivering Health: How Disinvestment and Sabotage at the USPS Threatens Public Health

By Christine Mitchell, Martha Ockenfels-Martinez, Jamie Sarfeh, & Sophia Simon-Ortiz

Cuts and slow downs at USPS threaten public health

Over the past month, much of the news surrounding service slow downs and impending budget cuts at the United States Postal Service (USPS) has focused on the threats posed to voting in the upcoming November elections. Voter disenfranchisement is a real and urgent concern, as so many will depend on mail-in ballots to safely cast their votes this year amidst the ongoing pandemic. Yet less attention has been paid to the wide-ranging public health impacts of budget cuts and changes to USPS service proposed by newly-appointed postmaster Louis DeJoy, a major Trump donor with hefty personal investments in private USPS competitors.

DeJoy’s moves are only the most recent chapter in a long pattern of divestment from the USPS, part of a broader trend of divestment from our most critical public services, all with dire impacts on health. And though DeJoy — in response to public outcry over impeding vote-by-mail in November — has temporarily walked back some of the sweeping changes that would further limit USPS service and lead to increased delays, he has not committed to reinstating all services. As the USPS continues to face perilous budget cuts, the public health risks of shrinking mail service remain.

Bolstered by massive outcry and support, advocates and USPS workers are leading the charge to preserve and protect USPS. Right now, they’re calling for congressional action to fully fund USPS by the end of the summer, removal of DeJoy as postmaster, and a full reversal of the dangerous policies implemented under his leadership. We fully support these actions as critical measures to protect public health.

Read on for a closer look at how a fully functioning and funded USPS is imperative to public health, along with actions you can take to support and advocate for solutions.

USPS service keeps our communities healthy

Timely and fully resourced USPS service supports public health in myriad ways, and is critical for the well-being of communities who are already most harmed by structural inequities — particularly in the context of COVID-19. For people who are incarcerated, USPS serves as a primary channel for communicating with loved ones and accessing resources that are necessary to maintain health. Across the country, many people also rely on timely USPS delivery of life-saving prescription medication, especially amidst the pandemic, when the risk of in-person trips to the pharmacy can be prohibitive for high-risk groups. And USPS-facilitated mail-in voting is necessary to protect public health and slow the spread of COVID-19 during election season this fall. Mail-in voting ensures voters across the country can safely cast their ballots without risk of exposure.

Cuts and slow downs at the USPS harm the health of people who are incarcerated

People who are incarcerated rely on the mail as a means of communicating with loved ones, legal counsel, and advocacy organizations on the outside, and are disproportionately impacted by cost cutting and delivery slowdowns at the USPS. In settings built for isolation and punishment, USPS provides critical connections to loved ones and resources beyond the walls that are essential for maintaining the health of people who are incarcerated in jails, prisons, and detention centers.

How do USPS delays impact the health of incarcerated people?

• For incarcerated people, mail communications via USPS are one of the few connections to loved ones and support networks on the outside. Social support — connections to family, friends, and community — can prevent mental health outcomes including depression, anxiety, and hopelessness.
• When someone who is incarcerated or formerly incarcerated thinks they don’t have strong social support, they are at higher risk of suicide attempts in prison, difficulties in re-entering the community after incarceration, and substance use relapse.
• Many people who are incarcerated depend on the USPS to mail legal information to their lawyers, in order to receive letters of support for parole, to appeal disciplinary and classification hearing decisions, and other legal reasons — all of which are important to shortening the time people spend incarcerated, and thus improving health.
• Incarcerated people share information about the conditions inside jails and prisons with community-based organizations via USPS mail service. This is essential to centering the needs of those incarcerated in advocacy work and ensuring that immediate material needs — like healthy food, clean water, and access to healthcare — are met and human rights abuses are exposed.

High-risk groups rely on USPS for delivery of prescription medications — and they’re suffering from service slowdowns

Recent service delays stretching as long as two weeks mean patients with chronic or acute illnesses are left without access to possibly life-saving medication. Timely delivery of medications by USPS is especially essential in light of the pandemic, as in-person pharmacy access can mean increased risk of exposure for those most vulnerable to the virus.

How do USPS delays impact the health of people who need prescription medications delivered?

• About 5% of prescriptions dispensed in 2019 were shipped via mail — a number that has increased by over 20% since the start of the COVID-19 pandemic — and about 80% of veterans rely on USPS for their medications.
• Missed doses of medications can lead to major health impacts; for example, nearly half of those who take medication to manage seizures reported having a seizure after a missed dose.
• When people get their prescriptions on time, and adhere to a consistent medication schedule, their risk of hospitalization decreases and their total medical costs are reduced.

USPS service disruptions harm our democracy, and the health of individual voters

As has gained attention in news coverage over the past month, USPS slow-downs also threaten our country’s democracy. Due to the pandemic, a comprehensive system for mail-in ballots is crucial to ensure that all who can vote can cast their ballots safely and have their votes counted this November. In 2014, Colorado became a state with all-mail voting, meaning every voter receives a mail-in ballot by default, and voting happens primarily through the mail. This change to mail-in voting increased voter turnout — meaning more voters were able to exercise their choice in policies and decisions that will directly impact their health.

But in recent primaries, states and counties across the country have seen higher rates of rejected mail-in ballots. More than half a million mail-in ballots were rejected during primaries across 23 states this year. The most common reason ballots are rejected? Because they arrived too late. When votes go uncounted, people’s right to have a say in the policies and decisions that directly impact their health — from employment, to housing, to education –– is taken away. Divestment from the USPS results in mail delivery slow-downs and gaps in service, which greatly contributes to voter disenfranchisement and harms health.

How do USPS delays impact the health of voters?

• Vote-by-mail is necessary to protect the health of communities across the country this November, and slow the spread of COVID-19. Reliably and timely mailed-in ballots ensure that all voters can safely cast a vote this year.
• The act of voting is important for both individual and community health — people who vote are more likely to be in better health, and have fewer depressive symptoms than those who don’t.
• Restrictions to mail service take away people’s right to vote, and disenfranchise already-marginalized communities. For example, many Indigenous communities already face disenfranchisement due to a widespread lack of postal services.
• Experts report that voters of color and younger voters are more likely to have their ballots rejected, increasing pre-existing voter inequities from long-standing racial voter suppression, which includes voter roll purges, redistricting, voter ID laws, and the way people in prison are counted in the census.
• Disenfranchisement and inequities in voting create a ripple effect for community health in each state. People who live in states with more voting inequity are more likely to self-rate their health as poor; whereas those living in states with more voter equity have better self-rated health.

Take Action to Support USPS

Advocates and USPS workers are mobilizing to preserve and protect the USPS, and are actively proposing solutions including full funding by the end of the summer, removal of DeJoy as postmaster, and a reversal of damaging policies implemented under his leadership. Inaction on any or all of these necessary steps threatens what’s left of the integrity of our democracy, and the health of everyone in the US — particularly the members of our communities already most harmed by health inequities. Here are ways you can support this critical public service:

Support postal workers’ organizing

Much of the organizing to save USPS and its critical services is being led by postal workers through the American Postal Workers Union. Up-to-date news and ongoing actions to support these efforts can be found on the APWU Save the Post Office website.

Actions to take:

• Call your senators to demand at least $25 million in stimulus funds for the USPS
• Record a message about why the USPS is a needed public health service
• Share these APWU actions and resources with your community
• Sign the Daily Kos petition demanding the USPS Board of Governors remove Postmaster Louis DeJoy, fully fund the USPS, and reinstate removed or destroyed mail sorting equipment
• Visit our Public Health Awakened Defend the Vote for Public Health page for actions to support vote-by-mail and other key election integrity measures

Christine Mitchell is a Research Associate with the Health Instead of Punishment program at Human Impact Partners. She values partnering with grassroots organizations doing liberative work on the ground and providing organizers with public health research support on the ways that incarceration and policing impact the health of people and communities.

Martha Ockenfels-Martinez is a Research Associate at Human Impact Partners. She supports the research needs of community partners across the country that are advancing equity and justice. She brings her background in local and state policymaking, community organizing, and advocacy to her work at HIP.

Jamie Sarfeh is the Communications Director at Human Impact Partners. She is passionate about the power of language to shape and build collective action, and brings her background in organizing and strategic communications to work towards a vision of health equity rooted in liberation.

Sophia (Sophie) Simon-Ortiz works on organizing and advocacy at Human Impact Partners and coordinates the Public Health Awakened network. She is passionately dedicated to building the organizing and advocacy power of public health workers across the country and to bridging health justice work with other social justice movements.

📌 Did you know? Human Impact Partners provides health equity capacity building to public health organizations. Contact us to learn more about our offerings at info[at]humanimpact.org.