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The Great Unequalizer: Initial Health Effects of COVID-19 in the United States

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  • Marcella Alsan
  • Amitabh Chandra
  • Kosali Simon

Abstract

We measure inequities from the COVID-19 pandemic on mortality and hospitalizations in the United States during the early months of the outbreak. We discuss challenges in measuring health outcomes and health inequality, some of which are specific to COVID-19 and others that complicate attribution during most large health shocks. As in past epidemics, preexisting biological and social vulnerabilities profoundly influenced the distribution of disease. In addition to the elderly, Hispanic, Black and Native American communities were disproportionately affected by the virus, particularly when assessed using the years of potential life lost metric. We provide a conceptual framework and initial empirical analysis that seek to shed light on contributors to pandemic-related health inequality, and we suggest areas for future research.

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  • Marcella Alsan & Amitabh Chandra & Kosali Simon, 2021. "The Great Unequalizer: Initial Health Effects of COVID-19 in the United States," Journal of Economic Perspectives, American Economic Association, vol. 35(3), pages 25-46, Summer.
    • Handle: RePEc:aea:jecper:v:35:y:2021:i:3:p:25-46
    DOI: 10.1257/jep.35.3.25
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    Cited by:

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    2. Propper, Carol & Kunz, Johannes, 2022. "Is Hospital Quality Predictive of Pandemic Deaths? Evidence from US Counties," CEPR Discussion Papers 17365, C.E.P.R. Discussion Papers.
    3. Angus Deaton, 2022. "The great divide: education, despair, and death," Business Economics, Palgrave Macmillan;National Association for Business Economics, vol. 57(4), pages 161-168, October.
    4. John Brownstein & Jonathan H. Cantor & Benjamin Rader & Kosali I. Simon & Christopher M. Whaley, 2022. "If You Build it, Will They Vaccinate? The Impact of COVID-19 Vaccine Sites on Vaccination Rates and Outcomes," NBER Working Papers 30429, National Bureau of Economic Research, Inc.
    5. Pathak, Prakash & Schündeln, Matthias, 2022. "Social hierarchies and the allocation of development aid: Evidence from the 2015 earthquake in Nepal," Journal of Public Economics, Elsevier, vol. 209(C).
    6. Hasan, Iftekhar & Krause, Thomas & Manfredonia, Stefano & Noth, Felix, 2022. "Banking market deregulation and mortality inequality," Bank of Finland Research Discussion Papers 14/2022, Bank of Finland.
    7. Rishi Patel, 2023. "The Transformation of the Healthcare Business through the COVID-19 Pandemic (2020–2021)," JRFM, MDPI, vol. 16(7), pages 1-13, July.
    8. Anneliese N. Luck & Irma T. Elo & Samuel H. Preston & Eugenio Paglino & Katherine Hempstead & Andrew C. Stokes, 2023. "COVID-19 and All-Cause Mortality by Race, Ethnicity, and Age Across Five Periods of the Pandemic in the United States," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(4), pages 1-29, August.
    9. Amy Finkelstein & Geoffrey Kocks & Maria Polyakova & Victoria Udalova, 2022. "Heterogeneity in Damages from A Pandemic," NBER Working Papers 30658, National Bureau of Economic Research, Inc.
    10. Wolfgang Frimmel & Gerald J. Pruckner, 2024. "The COVID-19 pandemic and health care utilization: Evidence from Austrian register data," Economics working papers 2024-03, Department of Economics, Johannes Kepler University Linz, Austria.
    11. Max Nathan, 2023. "Critical Commentary: The city and the virus," Urban Studies, Urban Studies Journal Limited, vol. 60(8), pages 1346-1364, June.
    12. Kairon Shayne D. Garcia & Benjamin W. Cowan, 2022. "The Impact of U.S. School Closures on Labor Market Outcomes during the COVID-19 Pandemic," NBER Working Papers 29641, National Bureau of Economic Research, Inc.
    13. Susan Athey & Kristen Grabarz & Michael Luca & Nils Wernerfelt, 2022. "The Effectiveness of Digital Interventions on COVID-19 Attitudes and Beliefs," Papers 2206.10214, arXiv.org.
    14. Duffy, Katie & Connolly, Sheelah & Maitre, Bertrand & Anne Nolan, 2022. "Unequal chances? Inequalities in mortality in Ireland," Research Series, Economic and Social Research Institute (ESRI), number RS145, June.
    15. Feng Huang & Hong Liu, 2023. "The impact of the COVID‐19 pandemic and related policy responses on non‐COVID‐19 healthcare utilization in China," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 620-638, March.
    16. Tamás Hajdu & Judit Krekó & Csaba G. Tóth, 2023. "Inequalities in regional excess mortality and life expectancy during the COVID-19 pandemic in Europe," CERS-IE WORKING PAPERS 2316, Institute of Economics, Centre for Economic and Regional Studies.
    17. Kunz, Johannes S. & Propper, Carol, 2023. "JUE Insight: Is hospital quality predictive of pandemic deaths? Evidence from US counties," Journal of Urban Economics, Elsevier, vol. 133(C).
    18. Engy Ziedan & Kosali I. Simon & Coady Wing, 2022. "Mortality Effects of Healthcare Supply Shocks: Evidence Using Linked Deaths and Electronic Health Records," NBER Working Papers 30553, National Bureau of Economic Research, Inc.
    19. Anne Case & Angus Deaton, 2021. "Mortality Rates by College Degree Before and During COVID-19," NBER Working Papers 29328, National Bureau of Economic Research, Inc.

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    More about this item

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • J15 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Minorities, Races, Indigenous Peoples, and Immigrants; Non-labor Discrimination

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