INEQUALITY AND PANDEMICS
Inequality is not a tool that creates impact during pandemic. It is also the reason behind the outbreak itself.
The poorest sections of society in any country have to share a disproportionate burden when a disease outbreak takes place.
In times of natural disasters or global epidemics like the one we are currently facing, a common platitude that is often heard is that of these events being a great equalizer. At first glance, it seems like a convincing argument since they do not discriminate based on the colour of the skin, the community to which one belongs or their accumulated wealth. The Covid-19 pandemic has been seemingly uniform in its devastation crossing borders around the world in a flash and killing millions in its wake. If anything, the richer nations have been relatively more affected until now than their less developed counterparts. However, upon closer inspection, it becomes evident how the most vulnerable sections of society are usually the most affected in times of such crises.
But, first, let us back up a little bit. The level of inequality in any society – weather it be social or economic – has a significantly intricate relationship with pandemics. Inequality is not simply a tool that creates differential impact across society during pandemics and further exacerbates the gap. Quite possibly, it is also the reason behind the outbreak of the disease itself. Although the hypothesis needs to be further tested, there is a school of thought which argues that pandemics are more likely in times of growth inequality.
The argument focuses on several trends that have preceded each pestilence in history. These play out in the following manner. Initially, sustained population growth results in a rise in population density, which pushes the basic reproduction number of all diseases upwards. At the same time, overpopulation leads to excess supply of labour, which pushes wages downwards.
This immiseration has several effects across society. It reduces the nutrition levels of the poor making them less capable of fighting pathogens. The poor also migrate vast distances to cities in search for jobs. The increasing concentration of people in cities becomes a breeding ground for diseases while their movement makes it easier for diseases to travel across regions.
On the other hand, the richer sections of society, which usually own capital, become richer on account of the falling labour wages in society. They tend to spend more on luxurious purchases that are traded from far-off regions and travel to different places, which connects the world in a more integrated manner. Apart from people and goods, germs travel in a more fluid manner along these routes around the world.
The historian Peter Turchin has tested out this theory and found strong statistical association between the level of global connectedness, levels of inequality in society and pandemics thorough history. In the second century BCE, for instance, the Chinese and the Roman empire were at their peak. Trade was flourishing across the two regions as symbolised in the development of the ancient Silk Road during the period. With rising commerce and riches, the poor were becoming poorer in both the places. Then the Antonine plague broke out in Rome in 165 BCE. Within a decade, the plague reached China causing widespread devastation. As a result, both empires went into a steady decline.
A similar pattern can be traced prior to the emergence of the plague of Justinian in the 6th century and the Black Plague in the 14th century. In 2020, it is not hard to notice that the same forces are at work. In fact, globalisation and inequality are at their peak in human history. So, it can be argued that these factors had a driving role to play in the development of the COVID-19 pandemic. The role of inequality in pandemics, unfortunately, does not end there. It has a disturbing and lasting contribution once the outbreak takes place.
The poorest sections of society in any country have to share a disproportionate burden when a disease outbreak takes place. This is led by a variety of factors that are associated with poverty. Irrespective of where the poor reside, they have the least access to quality healthcare systems. The situation is worse in low- and middle-income countries where the out-of-pocket expenditure is typically quite high due to a rudimentary insurance infrastructure. Also, the weak healthcare systems and their limited capacities to handle disease outbreaks leave the poor with the short end of the stick. Next, the poor tend to live in densely packed areas where the likelihood of the virus rapidly spreading across their neighbourhoods is extremely high. Moreover, the households in poor neighbourhoods lack access to basic services like access to continuous running clean water as well, which makes hygiene a luxury for the most vulnerable sections of society.
Inequality further plays a damning role in the face of measures taken to control the spread of the pathogen (and beyond it). While the reasons for the genesis of the COVID-19 pandemic and its impact on outbreak has been similar to pandemics that have ravaged through the world before this, the current outbreak has been unique in terms of one aspect. In an unprecedented coordinated global effort, almost the entire world population went into a lockdown to slow the spread of the disease. These efforts were undertaken to reduce the pressure on healthcare systems and eventually save lives. However, people have unequal capacities to comply with such measures, which has an uneven impact on livelihoods and exacerbates the inequities in the process.
The poorer sections of societies around the world have jobs that provide them with subsistence wages on a daily basis. Since most of their wages are spent on basic necessities, they have lower savings to survive upon in times of lockdowns. So, they are also most likely to not comply with lockdown or put themselves in harm’s way as soon as they are eased since their survival depends on it.
Even if the poor have salaried jobs, the low levels of education and skilling puts them at the highest risks of being fired from employment. In the United States, for example, the unemployment rate has reached as high as 16 percent in May as per the government’s estimate. The burden was heavily biased towards less educated workers. Against an unemployment rate of 7.2 percent for workers with a bachelor’s degree or higher, 18.5 percent of the workers without a high school diploma were unemployed in the same month. The situation is worse for developing nations that do not have strong social security systems on which the poor can fall back upon.
The injustices of inequality do not end even at this point. They find their way into action at a point when the vaccines come out as well.