Centering Equity in Urban COVID-19 Recovery

Even before the outbreak of the novel coronavirus, socioeconomic inequality plagued cities across the globe. The pandemic itself has both deepened those existing wounds and ripped open new ones. In the United States, neighborhoods predominantly inhabited by people of color have experienced the highest rates of both infections and deaths, while thousands of small businesses and storefronts have locked their doors permanently.

The urban policy responses to COVID-19 have varied by state, city, and even street. Data from the Illinois Department of Public Health show that South and West Side communities in Cook County have been hit particularly hard during the pandemic. If Mayor Lightfoot’s INVEST South/West revitalization project is any indication, those communities were already suffering before the pandemic. Meanwhile, the city treated some North Side communities to open-air street fairs and socially-distanced block parties. It is not up to individual residents to address the inequity of those responses. It is the government’s duty to craft policy responses that ensure equity and prosperity for all neighborhoods.

In short, the data are clear: communities of color have suffered the most during the pandemic. In the city of Chicago, African-Americans constituted 70% of early COVID-19 deaths despite comprising only 30% of the city’s population. What’s more, deaths continue to cluster in neighborhoods where more than 90% of the residents are African-American. Peek et al., in their forthcoming paper, underscore the probable source of such suffering: existing socioeconomic inequalities which find their historical roots in segregationist housing, zoning, and lending policies.

In particular, Peek et al. assert that the counties which are suffering so profoundly have “more crowded living conditions and lower social distancing scores, higher unemployment, lower rates of health insurance, and higher burdens of chronic disease” (Peek et al. 2021, 286).

Policies to combat COVID-19 in urban areas must take this history and this suffering into account. As Peek et al. emphasize in their paper, policies “must use both place-based and individual risk-based strategies grounded in public health practices that utilize data, boost public health infrastructure, leverage cross-sector collaboration, and mobilize community partnerships” (ibid., 286). This is what it means to place equity at the center of urban policy responses to COVID-19: to abide by “the bioethical principles of fairness, distributive justice, and reciprocity to provide guidance for understanding resource allocation and the sharing of burdens and benefits across society” (ibid., 286-287).

Policymakers and community leaders must step back and consider not only the policy responses to the pandemic which have been implemented thus far, but also the urban policies that will be implemented going forward. It is vital that these policies place equity at their center, ensuring that communities like Chicago’s South and West Sides emerge from the pandemic stronger than they were before.

As Corbie-Smith et al. assert in their recent paper, these policy responses must also acknowledge the socioeconomic disparities that led these hardest-hit communities to where they are today. In particular, Corbie-Smith et al. emphasize that every leader’s response should include a commitment to “self-examination of privilege and power, self-education on antiracist approaches, and responsibility for and accountability to system change” (Corbie-Smith et al. 2021, 63).

Before considering paths towards a COVID-19-free and equitable future though, policymakers should begin by considering the responses to the pandemic thus far and the effects those policies have had on communities. Cave et al., in their recent paper, analyzed the policy responses in four international cities as of mid-2020, and delineated three primary policy types:

1. Disease control through strengthening core public health interventions: identifying, isolating, testing and caring for all cases, and tracing and quarantining all contacts.
2. Non-pharmaceutical interventions to slow the spread of the disease and to protect the capacity of the healthcare system to cope with predicted rises in COVID-19 cases: restrictive large-scale public health interventions; environmental measures; and personal measures.
3. Public policy measures to protect social and economic infrastructure and financial support packages to businesses and individuals.

Most importantly, Cave et al. note that the countries that implemented all three of the above policies had the most success, as of June 2020, in keeping COVID-19 case numbers low.

The United States struggled to implement these three kinds of policies. In fact, both public health interventions and non-pharmaceutical interventions continue to be the subject of national debate as citizens vulnerable to conspiracy theories and misinformation campaigns find themselves convinced that mask mandates and social distancing measures are a threat to fundamental rights and freedoms. The tragedy of such a national response is that the areas which would have benefited most from policies like a national mask mandate and social distancing measures — dense urban communities like Chicago’s South and West Sides — were left out of the policy conversation.

Mayor Lightfoot’s Racial Equity Rapid Response Team, on the other hand, has done a fair job at placing racial equity at its ideological center, despite having a relatively small community impact thus far. As Mayor Lightfoot herself said, “We are all in this crisis together, but we haven’t experienced it in the same way … this crisis has doubled-down our longer mission to fight poverty, end racial inequality, and ensure every Chicagoan has access to a bright future we all deserve.”

RERRT’s primary goals, as stated in the press release and summarized in Peek et al.’s recent paper, are twofold: to flatten the COVID-19 mortality curve in African-American and Latinx communities in Chicago, and to build a groundwork for future work to address long-standing and systemic inequities in African-American and Latinx communities.

So far, RERRT’s greatest achievements have been improving testing availability and overall testing rates: as a result of social media campaigns, COVID-19 testing in RERRT target neighborhoods increased 13%. Additionally, eight testing sites were opened in RERRT target neighborhoods — primarily in the South and West Sides. Through RERRT, community partners also received $3.1 million in grants for COVID-19 relief. However, recent reporting on the American Medical Association‘s website reveals that roughly $2.3 million remains to be distributed.

In short, even RERRT’s commitment to “flattening the curve” for African-American and Latinx residents has had a smaller impact than anticipated. It goes without saying though that an initiative like RERRT is still a step in the right direction. At the moment, however, it is just not enough. On the heels of reports that the city failed to distribute up to $68 million in CARES Act funding while funneling roughly $280 million of the funding to the Chicago Police Department, it is clear that the city, despite the merit of the ideological message behind RERRT, is continuing to fail its South and West Side residents.

Of RERRT’s two primary goals, it is the latter that takes center stage as we enter into what many hope to be the final stage of the pandemic: vaccine distribution. If community leaders and policymakers are to address the pandemic as it is today and lay the groundwork for future equity initiatives, ensuring that it is just as easy for residents of Chicago’s West and South Side neighborhoods to get the vaccine as it is for North Side residents is not enough. Taking into account the disastrous and hyper-localized effects of the pandemic with regard to these socioeconomically disadvantaged communities, the city of Chicago — and cities globally — should take special care to emphasize services like community vaccination centers in hard-hit areas in order to ensure that the residents of vulnerable neighborhoods make the strongest possible recovery.

While pundits across the political spectrum have begun to dash towards the light at the end of the tunnel, the pandemic continues to plague residents in our hardest hit communities. Centering principles of equity and justice, and emphasizing the importance of addressing existing systems of socioeconomic inequality, should be the top priority of community leaders and policymakers across the globe.

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Cave, Ben, Jinhee Kim, Francesca Viliani, and Patrick Harris. 2020. “Applying an equity lens to urban policy measures for COVID-19 in four cities.” Cities & Health: 1-5. https://doi.org/10.1080/23748834.2020.1792070.

Peek, Monica E., Russell A. Simons, William F. Parker, David A. Ansell, Selwyn O. Rogers, and Brownsyne T. Edmonds. 2021. “COVID-19 Among African Americans: An Action Plan for Mitigating Disparities.”American Journal of Public Health 111: 286-292. https://doi.org/10.2105/AJPH.2020.305990.

Corbie-Smith, Giselle, Mary K. Wolfe, Stephanie M. Hoover, and Gaurav Dave. 2021. “Centering Equity and Community in the Recovery of the COVID-19 Pandemic.” North Carolina Medical Journal (January 2021) 82 (1): 62-67. https://doi.org/10.18043/ncm.82.1.62.