COVID-19 pandemic exacerbating social inequality

Philosopher George Santayana once said: “Those who cannot remember the past are condemned to repeat it.” At the onset of the coronavirus disease (COVID-19) pandemic, many scientists compared its effects to the 1918 Spanish flu outbreak. A century ago, this unusually virulent influenza infected more than 500 million people across the globe and claimed the lives of 50 million. Since then, epidemiologists have been trying to glean insights into how it spread and to identify the most susceptible people. Some interesting research has surfaced.

The Spanish flu has been commonly classified as a “crowd disease,” in that it spread easily and swiftly when people came into close contact with infected individuals, either in poor urban areas, like in crowded housing, or high density areas, such as schools or workplaces. Additionally, poor nutrition and sanitation, stress, long working hours and pre-existing health conditions were all contributing factors to weakening the body’s immune system and its ability to fight off the disease. Furthermore, health care services were limited and expensive, accessible mostly to the middle or upper classes, leaving poorer populations to succumb to the disease without proper, timely care.

In short, people from low socioeconomic backgrounds suffered the most during the 1918 pandemic. Thus, as a first step to preventing and managing future outbreaks, many governments reformed their public health systems in the subsequent years by establishing dedicated agencies aimed at providing free, equal and accessible health care services to their citizens.

For example, in July 1918, the Soviet government established the People’s Commissariat of Public Health, which is recognized as the world’s first state body for overseeing all public health services in a country. The entity was charged with providing free medical services for all, in addition to focusing on disease prevention and public health campaigns. Other countries, such as the UK, Germany and France, quickly followed suit. In 1948, the World Health Organization was founded to coordinate international health efforts and its constitution aptly states: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”

In modern times, research has informed us that the COVID-19 virus affects different sections of society in very different ways, with people who are older, have pre-existing health conditions and/or low socioeconomic status being the most vulnerable. This means that those with limited education, health coverage, financial security, adequate housing, and other well-being factors are more likely than others to get infected or die from the virus.

COVID-19 has highlighted the harsh realities of social inequality. As we begin to rebuild and imagine a new post-pandemic world, policymakers need to prioritize policies aimed at ending inequality.

Sara Al-Mulla

As a result of the nationwide lockdowns enforced by governments worldwide earlier this year in an effort to curb the spread of the virus, 94 percent of workers across the globe lived in countries that had seen some workplace closures, with significant job and earnings losses for low-income groups, according to the International Labour Organization. Consequently, the World Bank estimates that the pandemic could push 71 to 100 million people into extreme poverty this year. While many governments — such as those in Singapore, the UK and US — have provided financial relief to affected individuals, the harsh reality is that governments’ budgets are overstretched, application systems are overwhelmed, and the eligibility criteria are strict, thus limiting the number of beneficiaries and the amounts dispensed. This has left the disadvantaged in an extremely difficult situation as they look to sustain their livelihoods.

Populations living below the poverty line are more likely to suffer chronic health problems, thus increasing their chances of dying from the virus tenfold, according to research by the Chinese Center for Disease Control and Prevention. Health disparities among low-income groups follow a similar pattern in European countries and the US. For example, a report for the UK government observed a disproportionate death rate for black and minority ethnic individuals as a result of pre-existing health inequalities, housing conditions, racism, and jobs that require interactions with the public.

Furthermore, the added stresses of living in poverty and with limited access to affordable health care services have aggravated the health conditions of lower-income groups. Stagnant public investments in universal health care have resulted in unaffordable services, longer waiting times for consultations and treatments, and limited prevention strategies that address risky behaviors and lifestyles. Additionally, limited state investment in affordable housing has also meant that people of lower socioeconomic status live in crowded or unhealthy accommodation, thus increasing their susceptibility to the virus.

The COVID-19 pandemic has highlighted the harsh realities of social inequality. As we begin to rebuild and imagine a new post-pandemic world, policymakers need to prioritize policies aimed at ending inequality. It is vital that governments offer universal K-12 education and university grants in order to allow people to pursue better employment opportunities in the future. Additionally, governments can partner with the private sector to create more jobs, increase the minimum wage, and promote fair wage growth for low-income groups. In terms of social services, family-friendly policies must be enacted at workplaces to allow parents to work while also caring for their children, without the need to resort to expensive child care services. Governments also need to increase the coverage of social services, such as unemployment benefits, housing grants and health care coverage, to support vulnerable groups.

All of these policies have the potential to dramatically improve opportunities for disadvantaged groups and grant them their right to a better quality of life.

• Sara Al-Mulla is an Emirati civil servant with an interest in human development policy and children’s literature.