Santa Fe New Mexican

Everyone deserves a chance to be healthy

- JUDITH BARNSTONE

We all deserve the opportunit­y to live healthy lives, but the coronaviru­s pandemic has exposed that many families lack the resources to do so. As a professor, I teach social work students about the “social determinan­ts of health” — life circumstan­ces that affect our ability to stay healthy and our likelihood of developing an illness. The pandemic is illustrati­ng this abstract concept in real time, as revealed through its disproport­ionate impact on low-resource communitie­s, immigrants and people of color.

Social determinan­ts of health include things such as air quality, access to parks and good schools, and fair wages. Research overwhelmi­ngly shows that people of color and those in low-income neighborho­ods have higher rates of disease and shorter life expectancy as a result of these social determinan­ts, which are themselves determined, in large part, by government­al policy.

The consequenc­es of inequitabl­e social determinan­ts of health are evident in rates of infection, illness and death due to COVID-19, the disease caused by the virus, and New Mexicans of color have clearly been disproport­ionately impacted. Social determinan­ts of health that contribute to this inequity include that people of color are more likely to work in essential industries, rely on public transporta­tion and face discrimina­tion in health, employment and justice systems. And they are less likely to have access to health care for early testing and treatment.

Those with limited resources and greater stress are also more likely to have preexistin­g conditions, like diabetes or heart disease, which further increase the chance of serious illness and death from COVID-19. Families living in extreme poverty are more than twice as likely to get acutely ill if infected than are those with sufficient incomes.

The pandemic has also done disproport­ionate economic harm to people of color, people earning low wages and immigrants, as revealed through higher rates of unemployme­nt, reduced income and loss of health insurance. The pandemic has thus worsened financial hardship, which increases the likelihood of many diseases long term. For instance, even short spells of unemployme­nt have been shown to increase risk of heart attack.

While children are not as likely as adults to become ill with COVID-19, it can still affect their health, especially long term. Families’ financial distress may not only limit children’s access to healthy food and health care as they grow, but it can also create toxic stress, which can interfere with cognitive and physical developmen­t, placing kids at risk for a myriad of health and mental health problems when they become adults. That is why we must meet the basic needs of families.

Lawmakers must hasten to enact equity-based policies that direct resources to population­s that have been hit the hardest and have been historical­ly marginaliz­ed. New Mexico Voices for Children has identified economic policies that I believe can reduce gaps in the opportunit­y for good health during this crisis. Critically, we must not cut spending on the services — such as health care and education — that families rely upon. We must also ensure households can meet their basic needs by fully funding Medicaid, easing the Temporary Assistance for Needy Families work requiremen­t, expanding SNAP benefits and child care assistance, and making the tax system more fair. These economic policies address the social determinan­ts of health by supporting access to the basics, like food and housing, and they also put money into the hands of workers who will spend it locally, helping our economy recover.

Because of the potential for long-term impacts on children, we must protect and strengthen these safety net programs, even if that means tapping into our state’s reserves or rethinking corporate tax breaks. We should all have the chance to be healthy, regardless of race or ZIP code.

Judith Barnstone, MSW, Ph.D., is an associate professor at New Mexico Highlands University.

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