This guest blog post was written by Melissa Jones, MPA, Executive Director of The Bay Area Regional Health Inequities Initiative (BARHII), the coalition of the 11 Bay Area governmental public health departments.

The COVID-19 pandemic has shown us how deeply our health and economic well-being are connected–and how inequitable policies and practices put all of us at risk. Too quickly, we have become polarized by a debate about shelter at home or reopening the economy. Today, as California’s death toll hits new records, we must rethink and retool our response and recovery to meet the challenge of economic and health care inequities head on. The Bay Area Regional Health Inequities Initiative (BARHII), the coalition of the Bay Area’s public health departments, has designed a Rapid Response and Rolling Recovery  platform that plans for the dual health and economic pandemic in our midst. 

This Labor Day, we owe a special debt to essential workers. While many debated about how open the economy should be and how to stay safe, every day, approximately 30 percent of workers continued working, often times at great personal risk. The food chain supply is one example: farmworkers continued to pick our food, food processers continued to pack it; truck drivers made sure it got to the grocery store, and grocery store workers served hundreds of thousands of us; or in some cases, gig workers delivered it to our homes. All of these people kept working to make sure we could eat.

Now that 70 percent of the new cases in California are in working age people, we are seeing the devastating effects for these Californians who didn’t have the option to work from home or shelter in place. And the consequences are staggering: the mortality rate for Black, Latinx and Pacific Islanders under the age of 65 is between 2 ½ to 4 times their share of the state’s population. Cal/OSHA has received over 3,500 complaints about workplace safety concerns since the launch of the pandemic.

Our discussions about re-opening are a public health issue, an economic issue, and fundamentally a moral and racial justice issue. Every local government has the power to prioritize worker protections—helping workers who deserve protections now—and making it safe for other workers when they, too, re-enter the workplace. These are some of the essential protections that BARHII champions and believes are crucial:

• Embed full-time Equity Officers into core Emergency Operations Centers (EOCs) and Incident Command Structures. Equity Officers, when deployed effectively, identify hot spots, create safety plans with communities, and make sure communities that are most impacted get what they uniquely need to control spread. Equity Officers are uniquely qualified to understand how social issues such as housing and transportation are inextricably linked to health outcomes. To learn more read our brief here: Embedding Equity Officers Brief. 
• Ensure Paid Leave for Every Worker. Everyone’s health is protected if everybody can get paid to stay home if they’re sick. Without a federal or state-wide comprehensive effort to protect workers, local governments must act to fill in the gaps. Offering paid leave, safe isolation spaces, and accessible testing, as well as culturally competent outreach efforts, are important safeguards that would allow workers to stay home if they’re sick and slow the spread of the virus in all communities.
• Keep Everyone Housed. Californians were already struggling to pay for housing before the pandemic. Temporary eviction and foreclosure moratoriums must be extended, and while we wait for federal or state action, local governments can act to prevent homelessness now. Read more: Public Health Officer Discusses Local Moratorium.
• Expand access to county mental health services:  The big three requests right now for people accessing 211 services are for food, housing, and mental health services. It’s time to invest in access to these critical services, whether via telehealth or additional community outreach. We must ensure these services are accessible now and that those most impacted know they exist and are connected quickly.
• Consider basic income:  People are struggling to feed their families, stay housed and pay their bills. The city of Stockton began a basic income pilot pre-COVID, and now they’re seeing an increase in the amount of food being purchased with this basic income, meaning people have been able to use that flexible money where it is most needed. As advocated by Mayors for a Guaranteed Income: cash is the simplest yet most powerful way to do the most good for the most people in these uncertain times. Cash moves quickly and allows for flexibility; it helps fill gaps in the social safety net and ensures everybody who needs help gets it.

Counties have an array of tools to protect, treat, and strengthen the public’s health. Even though we are in the midst of a pandemic, it’s important to acknowledge we should only learn deadly lessons once. The price for our communities is too high.

The Bay Area Regional Health Inequities Initiative (BARHII) is the coalition of the 11 Bay Area governmental public health departments. It is our mission to transform public health practice for the purpose of eliminating health inequities. We use a broad spectrum of evidence-based principles and actions to create healthy communities and economic prosperity for all.