S1–S3). Together, the results support contentions of a Matthew Effect, where pandemic precarity disproportionately affects historically disadvantaged groups, widening inequality. This economic crisis exacerbated inequities in ways that are masked by stock market activity or employment rates, because job opportunities during recovery were largely out of reach of historically marginalized groups. However, the trend has not been universal: in Ohio, Republican Governor Mike DeWine was swift in issuing orders to shut non-essential businesses and in responding to the crisis. In distributing funds made available by the CARES Act, Trump also appears to be playing favourites: New York received only a fraction of the $30 billion hospital relief funds from the bill ($12 000 per patient), while other states much more lightly affected received more ($300 000 per patient in Montana and Nebraska, and more than $470 000 per patient in West Virginia, all states that voted for Trump in 2016). Additionally, 11% reported being worried about having a place to live, and 27% worried about their ability to buy food due to the pandemic. Although the final dataset will be stripped of identifiers prior to release for sharing, there remains the possibility of deductive disclosure of participants. They were then recruited and consented into the study by phone. The first three measure respondents’ reported level of housing insecurity, food insecurity, and general financial insecurity attributed to the COVID-19 pandemic. The COVID-19 pandemic is sometimes described as an anomalous “perfect storm” (38). The COVID-19 follow-up wave was conducted during stay-at-home orders in Indiana in April and May 2020. COVID-19, which devastated some industries like leisure and hospitality, barely impacted others. They expose groups that are vulnerable due to prejudice, discrimination, and neglect. A summary of stakeholder insights into factors affecting the impact of coronavirus (COVID-19) on black, Asian and minority ethnic (BAME) communities. Housing insecurity, food insecurity, and general financial insecurity were measured in wave 2 by asking respondents the extent to which they agreed that COVID-19 has made them worry that they “may not have a place to live,” that they “may not have enough money to buy food,” and “about their finances, in general” (0 = strongly disagree, 1 = disagree, 2 = agree, and 3 = strongly agree). Covid-19: Control measures must be equitable and inclusive, Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 States, March 1–30, 2020, California releases racial data on coronavirus patients, Coronavirus batters younger Latinos and blacks in California, Infections and Inequalities: The Modern Plagues, Social Class and Mental Illness: Community Study, Health inequalities among British civil servants: The whitehall II study, Life after Hurricane Katrina: The resilience in survivors of Katrina (RISK) Project, Heat Wave: A Social Autopsy of Disaster in Chicago, Five years later: Recovery from post traumatic stress and psychological distress among low-income mothers affected by Hurricane Katrina, Effects of the Great Recession: Health and well-being, Sociodemographic inequality in exposure to COVID-19-induced economic hardship in the United Kingdom, Inequality in the impact of the coronavirus shock: Evidence from real time surveys, Socio-economic impacts of COVID-19 on household consumption and poverty, Snapshot of the COVID crisis impact on working families, Hispanic adults in families with noncitizens disproportionately feel the economic fallout from COVID-19, Understanding the unequal post-Great Recession wealth recovery for American families, Racial segregation and the American foreclosure crisis, Middletown: A Study in Contemporary American Culture, House of Debt: How They (and You) Caused the Great Recession, and How We Can Prevent It from Happening Again, Notes on labor markets after the great recession: Unemployment and policy for Indiana, The importance of selection bias in internet surveys, Pew Internet & American Life Project Surveys, Using the Internet to survey small towns and communities: Limitations and possibilities in the early 21st century, America’s health rankings analysis of America’s health rankings food insecurity measure. “It would be impossible to live through COVID and not be impacted by in some way by stress or grief,” said Bruder, manager of education at the GHS. The COVID-19 pandemic raises renewed concerns about inequality. Since Indiana is predominantly white, the P2P oversampled racial and ethnic minorities to provide more robust information about people from minority groups. Those in socially and economically marginalized groups and communities are more vulnerable to the impact of a disaster than their advantaged counterparts, and the damage extends beyond that expected by the nature of the crisis (36). –IANS. Published by PNAS. “The people in these communities have developed new strategies to promote their own wellbeing and resilience during the COVID-19 pandemic, but given the ongoing nature of the pandemic, official interventions are also needed to support them. Cluster-robust SEs are one of the most common methods for accounting for shared geography among members of a sample. Table 1 indicates that 10% of respondents attributed being laid off and/or unable to find a job in April or May of 2020 to the COVID-19 pandemic. Disasters are exogenous shocks to social systems that reveal enduring failings and inequities (8). The CARES Act also included US$8 billion to supplement the health and economies of Native Americans and Alaska Natives. The P2P is a face-to-face omnibus survey designed to study multilevel factors that shape health, using a stratified probability sample of households across the state of Indiana. A study suggests direct benefits to communities and community-led monitoring are among the best predictors of forest cover. Thank you for your interest in spreading the word on PNAS. Models are adjusted by sample weights and SEs clustered by shared county. This may require a pervasive and lasting shift in attitudes toward the role of organizations, institutions, government, and the poor, one that had yet to materialize in the US population’s cultural response to the Great Recession (49). Here, we show that many of the same groups who are most vulnerable to infection, hospitalization, and mortality are also experiencing disproportionate economic collateral damage. Sample means are estimated with survey weights. For example, COVID-19 has resulted in higher levels of housing insecurity and financial stress for students across the country, including the disproportionate number of trans and gender nonconforming students who rely on campus housing in … The P2P was in the field from October 2018 to March 2020, with 90% of observations collected between January 2019 and February 2020. In one unidentified American city, a survey of hourly service workers found two-thirds experienced income losses following stay-at-home orders, nearly half had been laid off, and many were unable to receive assistance regarding unemployment insurance, childcare, distance learning for their children, or basic necessities (17). Leveraging pre–post data from a population-representative sample of Indiana residents, we examine employment and food, housing, and financial insecurity. And, in fact, the COVID-19 variants from the United Kingdom and South Africa (officially B.1.1.7 and B.1.351, respectively) are featured in several models and play an exacerbating factor. Cluster-robust SEs by shared county allow for intragroup correlation in our parameter estimates while still assuming no correlation in SEs across counties (53). The 2008 Great Recession widened socioeconomic inequities among young adults, people of color, and those without a college degree. Key risk and protective factors for LGBTQ mental health may be uniquely affected by COVID-19 and campus closures, exacerbating pre-COVID inequalities. Racial and educational disparities in COVID-19 precarity, P2P (n = 994). However, we do have rare precrisis data on a representative sample of adults, combined with information about how those same individuals fared early in the COVID-19 pandemic (8). Study data are available by request and under a data-sharing agreement. Martin Bizzarro tells what zircon crystals reveal about the geological history of Mars. designed research; B.A. A total of 1,026 eligible P2P respondents took part in the follow-up (response rate 69%). Thus, we will make the data and associated documentation available to users by request and under a data-sharing agreement. Tables of models with parameters for intercepts are provided in SI Appendix, Tables S2–S5. Leveraging pre–post data from a population-representative sample of Indiana residents, we examine employment and food, housing, and financial insecurity. Investigating the exacerbating and mitigating factors that affect healthcare professionals’ mental health in pandemics is important, but Gold’s editorial overlooks a distinct subgroup in the clinical environment: healthcare students.1 Healthcare students share many risk factors with staff; they are also affected by shortages of personal protective equipment, and many have children. What these findings from Indiana reveal, with important but minor nuances, is the same story observed during and following Hurricane Katrina (8, 10), the Chicago Heatwave (9), the Buffalo Creek Flood (11), and, most recently, the Great Recession (12, 22, 23, 35). Most attrition was due to inability to reach a respondent by phone after multiple contact attempts and voice messages. Comparing data before COVID-19 reached the state and during the initial stay-at-home orders, we find socioeconomic shocks disproportionately affecting vulnerable groups, controlling for prepandemic status. Data collection began on March 28 and was completed on May 31, 2020, during the height of the first wave of the pandemic in Indiana. Key risk and protective factors for LGBTQ mental health may be uniquely affected by COVID-19 and campus closures, exacerbating pre-COVID inequalities. We do not capture any email address. Florida Governor Ron DeSantis, a Republican Trump ally, was slow to implement social-distancing measures and close non-essential businesses, and Georgia Governor Brian Kemp ordered beaches closed by local authorities to be reopened on April 3. Rurality was measured at the county level using Indiana Office of Management and Budget designations of rural and urban. Image credit: Mathieu Caffin on behalf of Bailey Ferguson/Schmidt Ocean Institute. Wealth allows individuals and families to move to safer neighborhoods, invest in their children’s future success, and save for retirement (46, 47). Education had a large and relatively linear negative association with economic precarity. The P2P dataset includes identifying information, biological specimens, and protected health information. © 2020 Elsevier Ltd. All rights reserved. Similar to national trends, although simple indicators (e.g., private sector job growth) suggest that Indiana had recovered by 2014, the structure of the state’s economy shifted during the Recession, reducing opportunities for middle-wage jobs and widening gaps between workers with different educational credentials (26). Parameter estimates for all multivariate models provided in Fig. As COVID-19 hit the United States, the study pivoted toward a follow-up wave assessing effects of the pandemic, resulting in panel data collected in the year before the pandemic and during the height of the first wave of stay-at-home orders. The disproportionate effects of COVID-19 on deprived population groups are well documented.1 Not only are case and fatality rates for COVID-19 higher than among people living in less deprived areas, policies that are aimed at preventing spread, such as social restrictions and lockdown, have a greater effect on vulnerable populations.2 Using longitudinal data (n = 994) from the Person to Person Health Interview Study, fielded in 2019–2020 and again during Indiana’s initial stay-at-home order, we provide a representative, probability-based assessment of adverse economic outcomes of the pandemic. Overall, we expect unemployment to be at its peak during the snapshot provided by these data, although economic and material insecurity may have been offset by savings, Economic Impact Payments, and supplemental unemployment payments that likely had short-term protective effects. ↵†Regarding the pandemic, the COVID-19 test positive rate (1,431/100,000) in Indiana was similar to the median for the country as a whole (Utah at 1,696/100,000) during the time of data collection (55). Rates of unemployment in the year prior to COVID-19 (4%) matched national averages during 2019, and about 24% reported being food or housing insecure, suggesting substantial economic vulnerability even before the pandemic. In regression analyses, the weights were treated as sample weights that alter the extent to which each data point influences the fitting criterion. Individuals with less than a bachelor’s degree reported significantly higher odds of enduring all indicators of economic precarity. We focus our analytical sample on respondents who answered all questions included in our models (n = 994). Since failing to control for intragroup correlation in error terms can lead to misleadingly small estimations of SEs, we used cluster-robust SEs with the sandwich estimator by shared county. * Particularly striking is the rate of pandemic-related food insecurity among Black respondents (55%), which is 134% higher than the rate among Whites (24%) and 308% higher than the rate in Indiana in 2019, prior to the pandemic (14%) (33). We do so with data from a representative sample of residents in Indiana, a state that is home to “Middletown” (i.e., Muncie, IN), made famous by the Lynds’ classic field studies of culture in America’s small cities (24). Economic precarity variables dichotomized into 1 = agreed or strongly agreed and 0 = disagreed or strongly disagreed. Pointedly, research across a wide range of natural and man-made disasters, including hurricanes, floods, and economic downturns, repeatedly demonstrate the greater health burden that falls on those in disadvantaged social and geographic locations when large-scale calamities occur (8⇓⇓⇓–12). Copyright © 2021 National Academy of Sciences. All respondents who agreed to future contact were recruited from the P2P sample between March 28 and May 31, 2020, to assess social, psychological, and economic outcomes of the pandemic (n = 1,026; response rate = 69%). Baseline P2P data were collected primarily in the year prior to the pandemic (October 23, 2018 to March 3, 2020). This article is a PNAS Direct Submission. Studies show that cancer patients have a higher risk of Covid-19 complications, due in part to factors such as older age, higher smoking rates, comorbidities, frequent health care exposures, and the effects of cancer therapies. “We knew the White House wanted to give us nothing”, Allis said. However, comparing May and October, trends in daily case, death, and unemployment rates for rural versus urban counties were similar, with rural counties experiencing lower rates than urban counties in both May and October (SI Appendix, Figs. To address clustering at the county level, we used cluster-robust SEs. S4). All models are estimated with ordinal logistic regression, with the exception of Fired/Unemployed, which is estimated with logistic regression. analyzed data; and B.L.P. Eligible participants were contacted through postal mail and email to invite participation. ↵*We also examined patterns of inequality with a financial strain index, which combines multiple dimensions of economic insecurity (food, housing, and general). Stars represent statistical significance at *P < 0.05, **P < 0.01, and ***P < 0.001 via sample-weighted t tests, with racial reference = White and educational reference = bachelors. To ensure that our analyses are representative of individuals across the state of Indiana, we applied poststratification weights to all analyses. Pandemic precarity and sociodemographic statistics (n = 994). NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. 4/9/2020 by Kendra Bozarth and Angela Hanks. Distributional effects of the great recession: Where has all the sociology gone? Each model only differs in its outcome; all models include the same set of predictors and the same sample of respondents. Age also had a negative association with food insecurity (b = −0.17), with financial insecurity (b = −0.29), and with being fired or unemployed (b = −0.85) due to the pandemic. To determine differences in financial strain by race following the COVID-19 pandemic, we measured four dichotomous race variables: White, Black, Latino, and other. where i denotes the ith individual in a sample and E[u]i=0, then an OLS model with robust clustered SEs could be formalized asyig=xig'β+uig. As forecast in 2020, Africa is coming up short in the Covid-19 environment, fiscally and in terms of social policy provisions. The 2008 Great Recession widened socioeconomic inequities among young adults, people of color, and those without a college degree. Although there is a provision of the CARES Act stimulus bill that is intended to cover those costs, it is unclear how effective it would be if someone covered by the IHS is transferred to a non-IHS facility. While the exact racial, gender, ethnic, or otherwise socially categorized groups may change by place or over time, those who are “categorically unequal” will disproportionately bear the burden of natural and unnatural disasters (40). As with these disasters, additional surges are likely to escalate short-term hardships, revealing the axes of social devastation that translate into durable inequality. Black individuals, compared to other race/ethnic groups, reported significantly higher levels of both food and financial insecurity (b = 1.23 and 0.50, respectively), as well as a greater likelihood of being fired or unemployed (b = 0.61) due to the pandemic. A total of 1,677 individuals completed the P2P study (wave 1), and 1,579 of these consented to be contacted for future studies. 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