Responses to the COVID-19 catastrophe could turn the tide on inequality
Even as all of humanity confronts COVID-19, it is becoming increasingly clear that pre-existing inequalities along various dimensions are differentiating its impact. At the same time, inequalities within and across countries also stand to widen because of the crisis. Such outcomes are not inevitable: past experience shows that sufficiently bold measures that put people at the centre of crisis response and recovery can lead to better, more equitable and resilient outcomes for all.
Living and working conditions determine the chances of infection
Interventions that reduce the chances of being infected, such as social distancing, are more difficult where population densities are high, as in major urban centers with packed transit systems, or for people living in small, crowded households, slums, migrant worker housing or refugee camps. Frequent handwashing is challenging for the 3 billion people without basic handwashing facilities at home (World Health Organization, 2020a). Poorer people, and those from marginalized groups are more likely to live in these conditions. In many developing countries, this can include much of the population.
Occupations requiring frequent human contact, and which must be carried out even during a pandemic-induced lockdown—for example, those providing services such as health care, public transit, and food and grocery supplies—are also associated with a higher risk of infection. Many (though not all) of these occupations are disproportionately carried out by poorer people. Smartphone location data show that people with lower incomes have remained more mobile under social distancing guidelines than those with higher incomes, who can more easily stay away from densely populated areas.
Vulnerabilities to covid-19 are unequal
Knowledge about the biological pathways through which COVID-19 attacks the body is still evolving. However, the empirical data to date show that, once people are infected, outcomes tend to be more severe for older adults, men, and those with weaker immune systems or pre-existing health conditions such as obesity, diabetes and cardio-vascular disease.
Several of these pre-existing conditions tend to occur more frequently in disadvantaged groups, who may also be less likely to have access to quality health care, or more likely to live and work in conditions that increase the risk of infection. In the United States, for example, African-Americans—known to have higher rates of pre-existing health conditions and poverty—comprise 21.2 per cent of COVID-19 deaths and 28.9 per cent of known cases despite comprising only 13 per cent of the population (Centers for Disease Control and Prevention, 2020). Indigenous peoples, often living in isolated communities that lack access to health care and with high rates of pre-existing conditions, are also particularly vulnerable—in Brazil during the 2009 H1N1 influenza pandemic, the death rate of indigenous peoples was 4.5 times higher than among the general population (Zavaleta, 2020).
The UN DESA COVID-19 policy briefs can be found at bit.ly/UNDESACovid.