Opportunity for Health

Our lab and the COVID-19 pandemic

Our lab has collaborated with researchers across the United States to lend insights on the impacts of the COVID-19 pandemic on health and well-being. This research has helped us better understand the intersection between economics, social policy, and health, and has revealed a number of lessons for policymakers that will be relevant even after the pandemic ends.

Here, we provide a brief summary of some of the studies we worked on that directly inform pandemic-era policy:

Risk factors, preventive behaviors, and mitigation policies

Early in the pandemic, Alex Tsai led a study titled  “Social distancing to slow the US Covid-19 epidemic: Longitudinal pretest-posttest comparison group study.” This work was among the first to show that statewide social distancing measures and decreased COVID-19 infection and death rates. In a follow-up study, Alex and his team found that COVID-19 case rates increased after these mitigation measures were relaxed.

In addition to statewide policies, we also examined institutional factors that shaped disease risk. Atheendar Venkataramani collaborated on a study led by Adam Dean (George Washington University) and Simeon Kimmel (Boston University), which found that unionized nursing homes in New York State had much lower rates of resident mortality from COVID-19 than non-unionized nursing homes.

We also collaborated on studies examining COVID-19 risk behaviors. In the paper “Better Late Than Never: Trends in Covid-19 Infection Rates, Risk Perceptions, and Behavioral Responses in the USA,” Atheendar Venkataramani teamed up with Alyssa Bilinski at Harvard and colleagues to analyze Facebook survey data from nearly 10 million respondents over a nearly 1 year period. They found that, on average, Americans responded to rising infection rates by adopting precautionary behaviors such as masking and physical distancing. This research highlights the importance of accurate public health messaging and information, particularly given that the public is clearly responding to such information. In a paper with Nolan Kavanaugh and Rishi Goel (both from Penn) “County-Level Socioeconomic and Political Predictors of Distancing for Covid-19”, our team looked to further expand our understanding of precautionary behaviors. By integrating anonymized cell phone tracking data with county-level indicators over a 1 year period, this study showed significant gradients in engagement with physical distancing by income and political beliefs. The fact that gradients in these behaviors continued to persist during pandemic suggests that efforts to encourage broad adoption precautionary behaviors have left much to be desired.

We conducted research that sought to understand differential infection risks faced by workers with different occupations in the health care industry. In research led by our lab’s Sasmira Matta, we studied at the relationship between health care worker income (which tracks closely to occupations) and mortality risk on the eve of the pandemic. We found that lower income health care workers (which includes, for example, home health aides, food service workers, or clerical workers) faced much higher mortality risks than higher income workers (e.g., physicians and executives), and that these gradients were steeper than in other industries. This income-based patterning of health risks among foreshadowed higher COVID-19 infection risks seen among underrepresented minority health care workers, who are more likely to be employed in lower-income occupations.

Spillover effects on health, well-being, and the economy

We investigated the indirect impacts of the COVID-19 pandemic on child health. In a paper led by Robin Ortiz (Penn) and colleagues, “Assessing Child Abuse Hotline Inquiries in the Wake of Covid-19: Answering the Call, we found a substantial uptick in the number of calls to a child abuse hotline in late January of 2020 as the pandemic rose to prominence in the United States. The demographics of callers during the pandemic also differed from past years. In particular, calls from school reporters decreased while those from other social networks (neighbors, relatives, and friends) increased. These findings clarify the spillover effects on children, as well as the need to use novel data sources to better surveil threats to threats to child health and well-being.

COVID-19 drastically impacted the economic fortunes and employment status of millions of Americans, all of which have implications for health and well-being. In collaboration with Julia Raifman (Boston University) on the study, “Association Between Receipt of Unemployment Insurance and Food Insecurity Among People Who Lost Employment During the Covid-19 Pandemic in the United States”, we analyzed the role of policy in mitigating the effect of the pandemic. We found that enhanced unemployment insurance benefits led to large reductions in food insecurity among low- and middle-income Americans in the early stages of the pandemic.

Generous benefit programs alone are not enough to guarantee better economic security during hard times. These programs need to be accessible In work led by our lab affiliate Aditi Vasan, we examined how barriers to accessing key public programs (e.g., WIC) affected take-up of benefits during the COVID-19 pandemic – a time when low-income families needed these benefits the most. We found that participation in the WIC program was substantially lower in states that mandated beneficiaries to renew and refill their benefit cards in person or via post as compared to states where these activities could be done online. These insights contributed to a body of work that informed President Biden’s 2021 Executive Order to reduce administrative burdens faced by potential beneficiaries in federal benefit programs.

Finally, we synthesized the myriad connections between the Covid-19 pandemic, the economy, racial and socioeconomic disparities, and health, in this international presentation (from November 2020).

Note: This content was originally posted in May 2021 and updated in Dec 2021 to reflect ongoing research by OfH team members.