A Social Equity Lens for COVID-19 Action: 10 Key Questions

Tweet

By Phillip J. Cooper, Fellow, National Academy of Public Administration and Douglas and Candace Morgan Professor of Local Government, Mark O. Hatfield School of Government, Portland State University  

A Social Equity Lens for COVID-19 Action: 10 Key Questions for Local Governments or State and Federal Agencies Working with Them

The Pacific Northwest has experienced COVID-19 ahead of other areas of the country and had to respond quickly. Its local governments and states have been working to address the impacts from the virus and to meet the needs of residents. Even so, it is not clear how well everyone is doing in terms of dealing with the social equity impacts. That requires a perspective that sees and meets the particular kinds of needs and problems experienced by persons of color, women, the elderly, those with disabilities, lower income residents, and the homeless. Consider the following 10 questions that have grown out of our experience to date. These are important not only for the local governments on the front lines, but also for states or federal agencies that want to work with them.

1. Does your organization apply a social equity lens when you are considering policies or plans in response to a serious situation like the public health emergency posed by COVID-19, and, if so, when and how? Is there someone in your incident response team specifically tasked with reminding the team and the local government of the need to apply that lens to proposed actions?

For many local governments, the reaction to a serious problem is to find what appears to be a workable response. However, too often, that does not include thinking through how that response or the problem itself affects particular groups of people within the community. Instead, the tendency is to think of the community as an entity and assume that the policy or administrative action will work for everyone. Such assumptions can miss key differences among people and situations.

 

2. When leaders are defining the problems and needs in the current situation, are they considering differences in how persons of color, ethno-cultural groups, women, the elderly, those with disabilities, and the homeless are affected by the current situation in order to shape responses?

Not everyone bears the same consequences in a crisis or encounters them at the same pace. For example, since these individuals and groups already tend to deal with lower and less secure incomes than others in the community, they encounter problems quickly and sharply in a crisis. Since many women and persons of color work in service industries, like restaurants and hotels, major closures and cancellations of large events hit quickly and hard. (Even for those who do not lose employment or have their hours drastically reduced, many lack healthcare insurance or other kinds of income security protection.) Because they tend to be paid less, even in good times, they often have little or no financial cushion that they can use to get through even relatively short-term loss of wages. Persons with disabilities can be particularly hard-hit since their level of employment tends to be lower than almost any other group and the expenses for their needs can be significantly higher than for others, even with public programs to assist.

Some small communities in Oregon may seem too small to have social equity challenges, but one look at the number of seniors, persons with disabilities, and women who face a disproportionate danger of job loss because of closure of service business, indicates that these communities have significant challenges. Many also have ethnocultural minority residents and, because their numbers are small policymakers may not be aware of their challenges.

 

3.  Do any of the closures of facilities or programs particularly impact vulnerable populations with respect to, for example, nutrition, healthcare access, or safety?  If so, are there alternatives built into the response?

An obvious response to COVID-19 has been to close programs and institutions in order to increase social distance and reduce spread of the disease.  These have included schools, libraries, senior centers, recreation centers, and other public gathering places. However, schools have become a key point of contact between many families in the community and social services, including nutritional services and even school-based health clinics. Already, at least in the Northwest, one of the challenges has been to maintain free and subsidized breakfast and lunch programs, since many children rely on these services.

Also, when these kinds of facilities are closed, it can mean that places where many residents obtain information about the situation and how to cope with it are no longer available. Libraries provide a great many services beyond books to be loaned.  They are community study halls and community computer centers, among other things. Many children rely heavily on them as a place to do their homework, and quite a number have volunteers on hand to help. Many adults count on access to the computers to seek employment, since they lack computers or broadband access at home. These are also venues that local governments and nonprofit service providers visit to inform local residents about important services that are available.

For some, closure also means social isolation because they lack communication and contact with others. Physical isolation is part of the purpose, but the downside is the negative effects of social isolation. It also means that people are not organized to receive assistance or perhaps to provide help to others. Thus, the question is whether plans have been made to deal with the impacts of closures and isolation.        

 

4.  Do all members of the community have access to medical care and services other than visiting an emergency room or calling the fire department? If not, can some alternative be established at least on a short-term, shared basis with neighboring jurisdictions or a state agency?

Many public service announcements by governments and news media advise people to call their primary care providers if they are worried, but many do not have health insurance or regular medical care. Even if they do, many lack funds to purchase medicines and supplies. At a time when hospitals are facing overwhelming demands and lack surge capacity, there simply is not an ability to handle the level of emergency room walk-in patients they normally see, and it is always extremely expensive to have that be a primary care venue in any case. Fire departments have become one of the largest healthcare providers in the nation, but they are needed for a variety of calls and it is extremely expensive to depend upon responses from fire departments.

These avenues of service also increase the danger of spread of the virus to city employees who are not medical personnel. An effective response here often requires regional or statewide collaboration.

 

5.  Are there barriers to people’s willingness to come forward to engage with service providers and healthcare professionals?

There are tensions in various communities with respect to government units that have grown up over time that lead to serious concern or even outright fear about calling government agencies or departments. These include undocumented persons and many others.  Unfortunately, local governments can be caught between the desire to help the community and, for example, the current policies of the federal government. When anxiety is high because of a crisis like COVID-19, the fear of coming forward can be not only a serious problem for a person or family suffering from the disease, but also for the community, given the dangers of community transmission. A virus does not care about anyone’s immigration status, but current fears about federal authorities and their enforcement actions in sensitive contexts like courthouses and other venues drive people away from needed diagnosis and treatment.

 

6.  Are attempts to deal with the economic impacts of the problem considering social equity challenges?

To date, there has been discussion of assistance to small business. Certainly, helping small businesses to survive, since they employ so many people, particularly women and persons of color, is essential, but there are important social equity needs apart from the normal stresses in society. Because many people of color, women, the disabled, and seniors are particularly hard-hit both by this disease and by the closures and constraints on programs noted earlier, there are serious rapid impacts and these populations need direct assistance. Since many people are now in the so-called “gig economy” and considered contractors rather than employees, they find themselves without employer provided benefits or the ability to qualify for public services.  One of the responses by a number of jurisdictions in the Northwest has been to suspend the termination of utility service for late payment. There have also been calls for suspension of law enforcement-supported evictions from apartments or other residences. However, this kind of indirect assistance is too little and too delayed.

 

7.  Are communities of color, ethno-cultural groups, the elderly, those with disabilities, and homeless persons getting the information they need?

To date there has been a heavy reliance by local governments, states, and the federal government on the Internet to communicate key information on COVID-19. This is also happening at the organizational level, with many employees of government agencies and schools trying to keep up with a flurry of Internet postings or blast e-mails. Broadcast news services are carrying multiple announcements, but they are brief and limited. Moreover, they can only report what they receive from key agencies. However, it is clear that there is a social equity problem here in that there is a major digital divide even in places like the Pacific Northwest which is home to so many tech industries.

The fact that someone has a cell phone does not mean that he or she has the kind of Internet access needed or the skills and knowledge to navigate things like the CDC website or state or local health agencies’ sites to access information.  One question is whether key information is available at places and in forms that they often are able and likely to access. In addition, there are large numbers of people who are not primary English speakers and others who do not normally access the Internet or social media. Broadcast media can be helpful, including for particular ethno-cultural communities, but the communications relationships need to be established and managed. Again, libraries, recreation centers, senior centers, and schools are key venues for communicating local, state, and federal government information as well as for contact with nonprofit service providers, but if they are closed, as many are, then the question is how to communicate to everyone.

 

8.  In identifying action plans, do decision-makers address implementation issues with a social equity lens?  Has anyone considered the resources available to address those challenges? Is there a way to learn of unanticipated social equity problems during implementation?

The methods of implementation that are chosen for a full city, county, or state may reach many people, but they may also miss many as well. The implementation tools used in a large city will be very different from a smaller community. And given the tensions within communities, it is often essential to have the cooperation of community organizations who can ensure that information about new policies and assistance actually gets to the people who need it. There is also often a need for assistance to access it, such as translation services or alternative communications access for those with disabilities.

It is also important to have some sources of information in the community to know what kinds of social equity issues are arising in the course of implementing a particular policy. Although key decisionmakers will try to anticipate such problems, given the constraints in an emergency setting and limited time for action, it is often not until a particular decision is implemented that it will become clear to those in the community that there are social equity problems with the move. If the local government has a small set of community members from key groups, they can be a ready source of information and problem identification.

 

9.  Have decision-makers considered key differences between urban and rural communities?

Again, even in the Pacific Northwest there are dramatic differences and distances between larger urban areas and smaller or rural communities. The kinds of advice and options that work in King County (Seattle) or Multnomah County (Portland) will not work in smaller rural communities. For one thing, the relationships between large cities and their counties are very different from rural communities and their counties. For another, the sheer size of larger communities means that in times of emergency there is a larger set of people and resources that can be managed and deployed, usually with greater degrees of freedom to reconfigure operations in emergency situations. Many smaller communities rely on special districts for key services and do not manage those services themselves. Sometimes key first responder activities are staffed in significant part by volunteers who are not available full-time for deployment. Most small cities have extremely limited staff to communicate with other agencies and jurisdictions while simultaneously trying to deal with emergency needs in their own community.

It may seem a small matter, but the sheer distances between service providers in rural areas are magnified in emergency situations. Again, this calls for coordinated efforts regionally within states and careful and sensitive coordination by the state with those local governments.

 

10. Are social equity considerations addressed in intergovernmental collaboration under conditions like the COVID-19 situation?

In today’s context, many programs originate at the federal level and come to the states in the form of grants with a host of requirements attached. The state in turn adds its own demands and management requirements before sending the policies to the counties, cities, or special districts for implementation and service delivery. Those local governments often contract with nonprofit or, in some cases, for-profit service providers to deliver the programs at the point of service. It is key to understand how to make those intergovernmental networks work effectively across policy domains like healthcare, housing, education, and more. One key question here is whether nonprofit, charitable, and faith-based organizations are considered in those intergovernmental and inter-organizational operations? The danger is that picket-fence federalism leads healthcare providers to work with other healthcare organizations, schools to work with other educational agencies, and police to work with other law enforcement agencies. The key, particularly in times of crisis, is effective leadership and coordination across these silos. However, there is a danger than any kind of social equity lens gets lost in the complexity.

The intergovernmental challenges are often particularly complex for smaller communities and those in rural areas. In that regard, it is important to realize that there are many special districts, such as water and fire protection districts, that need to be a part of local responses to COVID-19. Ensuring that the cities and counties are working with the special districts will be extremely important to effective response.

Here in Oregon, the nine regions established by the League of Oregon Cities to provide information and conduct collaborative meetings would seem to be a ready tool for intergovernmental information sharing and as a forum for regional collaboration among smaller local governments.

There is also an important intergovernmental question of working with tribal governments during these kinds of situations.  Even though Native American tribes and nations are sovereign entities who engage on a sovereign-to-sovereign basis with the federal government, many Oregon local governments have a history of important relationships with tribal governments in the area.  It is not clear at present whether the tribal communities are being asked to play a role in the COVID-19 response.

 

Going Forward—The intensity of the moment creates so much pressure on decision-makers that it can be difficult to think through all of these dimensions, but the payoffs are so great that it is worth the effort to consider these challenges with a social equity lens.