The Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed by Congress in March 2020, provided various types of temporary financial assistance to millions of Americans. The November 2022 issue of Health Affairs features a collection of articles exploring the health effects of economic security policies, some funded by CARES, while other articles examine COVID-19 more broadly.
Economic Security
Alina Schnake-Mahl and coauthors find that after they controlled for demographic differences, cities with paid sick leave policies had a COVID-19 vaccination coverage rate 17 percent higher than the rates in cities without these policies. Disparities in vaccination rates between less and more vulnerable neighborhoods were also smaller in cities with paid sick leave policies.
Analyzing data from the period 2017–21, Kristen Harknett and Daniel Schneider determine that paid sick leave laws narrow gender gaps in access to leave for service-sector workers. “In the absence of a [paid sick leave] law, 43 percent of men and 38 percent of women reported access to paid sick leave,” they find. However, if these laws are present, up to 70 percent of men and 69 percent of women are covered.
Based on national data from 2020, Abdinasir Ali and George Wehby find “some evidence that state eviction moratoriums were associated with an improvement in mental health, based on a decline in number of days not in good mental health in the past thirty, and in the likelihood of reporting fourteen or more such days.”
In response to financial hardship caused by the COVID-19 crisis, many states expanded access to Temporary Assistance for Needy Families (TANF). Emily Dore and coauthors find that “providing emergency cash benefits to people not already participating in TANF, waiving work requirements, waiving or pausing sanctions, and automatically recertifying benefits” are associated with reductions of self-reported mentally and physically unhealthy days among likely TANF participants, relative to prepandemic levels.
Based on survey data from hourly workers in the retail, food service, and hotel sectors in Philadelphia, Elizabeth Ananat and coauthors find that Black and Hispanic workers are just as likely as White workers to experience material and mental hardship when laid off and to have that hardship relieved if they receive unemployment insurance (UI) benefits. However, they are less likely to receive UI, which “means that increasing equity in access to the program could help reduce the disparate effects of job loss on non-White workers and related racial health disparities.”
The American Rescue Plan Act of 2021 expanded the Child Tax Credit (CTC), a federal credit for qualifying families. Using survey data from the period 2017–21, Benjamin Glasner and colleagues find no evidence that the temporarily expanded CTC “translated into improved subjective well-being or mental health” for recipients, even among lower-income families and racially and ethnically minoritized groups, for whom the net benefit of the credit was larger.
Examining supermarket transaction data, Caitlin Lowery and coauthors find that Healthy Helping, a short-term fruit and vegetable incentive program implemented in North Carolina during the pandemic, led to enrollees spending more on fruit, vegetables, nuts, and legumes than similar shoppers not enrolled in the program.
Christopher Ruhm examines the underlying causes of changes in US mortality during the first year of the pandemic and concludes that the effects of the recession, which reduced death rates, partially offset the pandemic effect for most groups and causes. An accompanying Perspective by Ellen Meara focuses on drug overdoses, and one by Steven Woolf discusses the pandemic’s long-term consequences.
COVID-19
Neal Marquez and coauthors determine that during the first year of the pandemic, COVID-19 mortality rates for Black and Hispanic people in Texas prisons were 1.61 and 2.12 times higher, respectively, than for White people.
In March 2020 the US began immediately expelling certain immigrants at or near the southern border on public health grounds. Joseph Nwadiuko and Arturo Vargas Bustamante examine border crossing and COVID-19 case data and conclude that the “short-term inflow of immigrants to the US through the Southwest border or as agricultural guest workers was weakly correlated with COVID-19 infections, if at all, during March 2020–December 2021.”
Shira Fischer and colleagues determine that the share of patients willing to engage in video telehealth increased from 50.8 percent in February 2019 to 62.2 percent in March 2021, and “increases in willingness were especially pronounced among Black adults and adults with lower educational attainment.”
Acknowledgments
Health Affairs thanks Rita Hamad of the University of California San Francisco for serving as adviser on the economic security papers. We also thank the Blue Shield of California Foundation and the Episcopal Health Foundation for their financial support.