October 2020. GrowthPolicy’s Devjani Roy interviewed Marcella Alsan, Professor of Public Policy at Harvard Kennedy School, on COVID-19 and policy making, racial diversity and the health professions, and the importance of safety-net programs. | Click here for more interviews like this one.
GrowthPolicy: Your paper “Disparities in Coronavirus 2019 Reported Incidence, Knowledge, and Behavior Among US Adults” points to “the increased susceptibility to COVID-19 among low-income households and racial/ethnic minorities” (p. 8). In what ways has COVID-19 illuminated the fault lines in our public health systems apropos of systemic racism? And, a related question: at GrowthPolicy our focus is on policy solutions to economic disparities, to resource and wealth inequality, and for creating equitable employment opportunities. What lessons do you believe policy makers should take away from the COVID-19 pandemic in terms of addressing race-based health inequalities?
Marcella Alsan: The current pandemic exposes many weaknesses of our current medical and public health system. The fact that insurance is often tied to whether people are employed, and the mass layoffs that occurred during this recession especially among lower-wage workers is one such weakness. The lack of sick pay for many low-wage workers is another. The underlying differences in the distribution of chronic diseases, medical-care quality, and community resources is yet another.
Specifically, with respect to coronavirus, we lacked a coordinated federal response to provide personal protective equipment, consistent messaging, and testing supplies. As we look towards distribution of a potential vaccine or monoclonal antibody we can, and should, do better. We should coordinate with local and state authorities better, prepare and secure our supply lines better, inform people transparently about the benefits and potential harms of any intervention, and make those technologies that pass rigorous safety and effectiveness criteria freely available particularly to those communities who are most hard hit.
GrowthPolicy: You make a compelling case for physician workforce diversity in your research paper, “Does Diversity Matter for Health? Experimental Evidence from Oakland.” What policy measures do you believe are necessary to increase diversity in the physician workforce and improve the current supply of black doctors?
Marcella Alsan: Continuing to expand financial assistance to those from socially disadvantaged backgrounds and provide information on how to access such assistance, more diversity on admissions committees and faculty and peers to provide mentorship and community while going through the education system.
GrowthPolicy: In a recent paper, you study the connections between Hispanic citizens and non-citizens in terms of the impact on safety-net participation by Hispanic households in the presence of the enhanced immigration enforcement activity of the Secure Communities (SC) program. I have two questions on this phenomenon. First, why is the use of public assistance important for economists to study? Second, you note, “as a result of SC, Hispanic households forgo over $212 million and $77 million in food stamp and SSI benefits per year, respectively” (p. 27). As an economist who also studies public health, in what ways do you believe this phenomenon is exacerbating health disparities?
Marcella Alsan: Safety-net programs are a key component of an anti-poverty strategy. Food stamps (SNAP) for instance has been shown by other researchers to be a lifeline for many households during the Great Recession—other economists have shown that SNAP has benefits on child health. Thus, if households are fearful to take up these benefits it could indeed worsen health disparities and contribute to a perpetuation of poor health.
GrowthPolicy: How should we promote economic growth?
Marcella Alsan: In the near term, the U.S. needs to develop an effective federal and professional response to the coronavirus pandemic. A professional approach, guided by evidence-based science,to tackling the virus would reassure the public and put some brakes on the financial devastation hitting the American worker. Targeted assistance for those hardest hit by the COVID-19 recession is also important to limit increases in inequality.