Those on margins will bear brunt of virus toll
BU public health dean decries inequities the pandemic is exposing
WHILE THE CORONAVIRUS PANDEMIC seems certain to extend its reach to all corners of the globe, its impact will not be felt evenly. Those on society’s margins and lower economic rungs will bear a much greater burden of the toll taken by COVID-19. That’s the urgent message from Dr. Sandro Galea, dean of the Boston University School of Public Health, and guest on this week’s Codcast.
Galea, who trained as an emergency medicine physician, has focused his career on the social determinants of health — the ways health status is closely linked to economic status and other social factors — and the coronavirus crisis is casting that relationship into stark relief.
“We cannot have a conversation about coronavirus without talking about those who are bearing most of the brunt of its consequences,” he says.
“We have a country that is best described as having health haves and health have-nots, and the health have-nots, which are, depending on how you count, the poorest 50 percent or the poorest 80 percent of the population, are going to also suffer most of the consequences of this, of the coronavirus and the approaches to mitigate it,” says Galea.
Galea is co-chair of The Emergency Task Force on Coronavirus and Equity, a coalition of nearly 100 organizations across Massachusetts that issued a call last Friday for state leaders to address four urgent recommendations: ensuring access to coronavirus testing for all, including immigrants; a moratorium on evictions and foreclosures; plans to provide access to quarantine lodging for those who need it; and emergency provision of 15 additional sick days for all workers in the state.
“I think the mistake that we make is that we think, well, this is a small group … and it’s regrettable that there are challenges, but it’s their problem, not our problem. Well, them is us.”While throughout history those who are better off have always enjoyed better health, Galea says the pandemic is also exposing the ways that everyone’s well-being is connected. “I have been trying to make the case for years that there is no such thing as health for some, that health ultimately is a shared good and that we need to treat health as a public good, and if any group is suffering poor health, it’s going to affect all of us.”
“We know that your risk of dying in a car accident is affected not so much by your driving as much as by the driving of others,” he says. “It’s always been there in front of our eyes. And this pandemic is inevitably elevating it and putting it front and center in our consciousness. It’s hard to think of silver linings when you’re going through a pandemic, but just to think together, this is elevating issues that we should just not forget once we get over this pandemic — and by the grace of God, we will. We need to keep thinking about these issues and say, what are the choices we want to make to create a healthier world?”