This column originally appeared in Michigan Advance on May 8, 2020
A local Meals on Wheels program receiving 75 new requests for home-delivered meals every day. Suddenly unemployed workers hounded for repayment on payday loans. Local food banks scrambling to meet unprecedented need in their communities. A restaurant server scammed out of a rental deposit check by someone posing as an out-of-state landlord. Domestic violence survivors trapped with their abusers.
These are just a few reports from our partners across Michigan and the country over the last few weeks on the challenges people are facing right now. But these stories also expose the tightrope upon which so many families walk every day.
As policymakers and advocates mobilize against COVID-19, our actions should not just be about surviving the immediate health and economic crisis. They should also be about building a future that leaves all of us more resilient to the next societal shock.
Even before anyone had ever heard of coronavirus, 43% of Michigan households struggled to afford their basic needs like food, housing, utilities and child care. These are all social determinants of health — the conditions under which we are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life. Access to these things is distributed inequitably based on income, race, geography, disability, age and gender, creating shocking health disparities that are widened by the impact of and response to COVID-19.
We’re all facing the threat of coronavirus, but we’re not all in the same boat.
In garnering the tragic distinction as a coronavirus hotspot, Southeast Michigan serves as a poignant example. Much has been written about the connection between persistent structural racism and the disproportionate impact of COVID-19 infections and deaths on the region’s people of color, particularly African Americans.
Redlining and other discriminatory practices by government and private industry continue to push people of color into neighborhoods blatantly exposed to air pollution and overcrowded or substandard homes — a perfect storm for the spread of contagious respiratory disease.
African Americans, Native Americans and Latinos disproportionately face systemic barriers to nutritious food that boosts the immune system and prevents health conditions that increase vulnerability to the dangerous symptoms of COVID-19.
Austerity measures instituted under the auspices of emergency financial management in Detroit — the nation’s largest majority-Black city — have left thousands of families without a primary defense against infectious disease: clean water. Given these and other factors like bias within the health care system, it’s not surprising that coronavirus has taken the heaviest toll on individuals and communities of color.
Health disparities are often compounded by the way we collect and use data. For example, at only about 2% of the U.S. population, Native Americans are often considered statistically insignificant and lumped into the category of “other.” This obscures the many ways in which the federal government’s long history of genocidal policy and failure to uphold its treaty obligations has left tribal citizens more vulnerable to COVID-19 and Native communities lacking the resources to mount the necessary response.
That’s not to say COVID-19 should concern only people of color or those living in urban southeast Michigan. The systemic factors that negatively impact health in more densely populated, racially diverse areas are often similarly prevalent in whiter, rural communities that haven’t yet been as affected by coronavirus. In fact, more rural counties in Michigan are beginning to be impacted by COVID-19.
For example, even before COVID-related business closures sent unemployment skyrocketing, northern Michigan counties tended to have higher rates of poverty, food insecurity and underlying health conditions than their suburban counterparts in the lower part of the state.
Furthermore, the sparse health care infrastructure in rural areas could be quickly overwhelmed during an outbreak. Proactive measures are key to blunt the acceleration of COVID-19 and spare these areas the devastation experienced in Southeast Michigan.
That’s why it’s essential that Michiganders reject politicians’ tired trick of pitting white people against people of color and rural residents against city dwellers. We must unite to demand better from our elected policymakers, both in weathering the crisis at hand and building a better future.
We need policy that fortifies health and economic defenses for all. That’s why the Michigan League for Public Policy (MLPP) supports Gov. Gretchen Whitmer’s Fiscal Year 2021 budget proposal to invest $11.7 million in closing gaps between all of the providers and services that address the social determinants of health — a critical first step in addressing many preventable health issues devastating Michigan families and perpetuating social inequities.
Embracing social determinants of health and investing in services to address them is a way to help counter some of the impact of COVID-19 and improve health outcomes for people across the state.
But we can go even further. The MLPP has outlined our COVID-19 policy recommendations to help all residents during the health crisis and in the economic aftermath. There are also many policy needs that preceded COVID-19 but are more important than ever because of the pandemic.
Let’s institute a fair tax structure so all Michiganders have access to: safe homes; affordable energy, water and food; family-supporting wages and safe working conditions; and basic survival needs for the 100% of Americans who are either disabled now or could be in the future.
Here at the MLPP, we describe our local, state and federal budgets as moral documents. They’re statements about what, and more importantly, who matters to us as a society. Let’s make sure those budgets demonstrate the value of all Michigan lives, regardless of race, place or income.