As the coronavirus spreads across the globe, it appears to be setting off a devastating feedback loop with another of the gravest forces of our time: economic inequality. In societies where the virus hits, it is deepening the consequences of inequality, pushing many of the burdens onto the losers of today’s polarized economies and labor markets. Research suggests that those in lower economic strata are likelier to catch the disease. They are also likelier to die from it. And, even for those who remain healthy, they are likelier to suffer loss of income or health care as a result of quarantines and other measures, potentially on a sweeping scale. At the same time, inequality itself may be acting as a multiplier on the coronavirus’s spread and deadliness. Research on influenza has found that in an epidemic, poverty and inequality can exacerbate rates of transmission and mortality for everyone. This mutually reinforcing cycle, experts warn, may be raising the toll of the virus as it is widens the socioeconomic divides that are thought to be major drivers of right-wing populism, racial animosity and deaths of despair — those resulting from alcoholism, suicide or drug overdoses. “These things are so interconnected,” said Nicole A. Errett, a public health expert who co-directs a center on extreme event resilience at the University of Washington. “Pre-existing social vulnerabilities only get worse following a disaster, and this is such a perfect example of that.” Because each low-income family forced to accept a higher risk of exposure can infect others, she added, the consequences of inequality, while most obviously felt by the poor, “put the broader society at risk.” Two major risk factors are thought to make the coronavirus deadlier for those who catch it: old age and pre-existing health conditions. But a body of research points to a third: low socioeconomic status. Even for those well above the poverty line, studies find that low income relative to the rest of society is associated with higher rates of chronic health conditions such as diabetes or heart disease. This has not always been the case. As inequality has risen, health disparities have widened. Preventive care and health education have steadily tilted toward the educated and the well-off. As a result, people at the lower ends of society are about 10 percent likelier to have a chronic health condition. Such conditions can make the coronavirus up to 10 times as deadly, according to recent data from the Chinese Centers for Disease Control and Prevention. Taken together, these two statistics suggest that Covid-19 can be about twice as deadly for those along their society’s lower rungs. At the same time, people with lower incomes tend to develop chronic health conditions between five and 15 years earlier in life, research finds. Put another way: Health organizations have said that people over 70 are at drastically greater risk of dying from the coronavirus. But the research on chronic health conditions suggests that the threshold may be as low as age 55 for people of lower socioeconomic status. Those numbers capture only a sliver of the ways that inequality can make the coronavirus deadlier. In China, many workers are employed informally and so cannot count on social services if they take time off — especially those in service jobs that require regular contact with other people. As a result, the people who can least afford care are often at greatest risk of transmission. In Italy, some workers, like Lorena Tacco, who works at a factory near Milan, have gone on strike over their employers’ failure to establish what they consider sufficient health protections as the epidemic spreads. “Who cares about the workers’ health, while the rich run away,” she said. “But then poor people, who need to bring bread home, go out and take risks.” Domenico Marra, who works at the same plant, said fear of the outbreak was rampant there. He worries about carrying an infection back to his children, particularly a daughter who has a weakened immune system. “We do want to work, but we are scared of going home, we are scared to touch our family,” he said. Government-imposed shutdowns, like those announced by France and Spain this weekend, do come with some worker protections. But small businesses will probably struggle to keep paying employees beyond any guaranteed sick days, particularly those in retail or other sectors that cannot work from home. In Japan, which has some of the lowest inequality of any major economy, people with jobs such as taxi driving enjoy a degree of security that rarely exists in other countries. Families reliant on hourly work are already running out of money, forcing many back out to look for jobs. Because communities tend to cluster by economic status, Dr. Errett said, the people who are both at the greatest risk of infection and likely to suffer most from the virus are all in proximity, multiplying the risk. Longer-term consequences are coming into view. New York City officials have said that closing local schools would leave many of the system's 114,000 homeless students without hot meals or medical care. Even small pockets of mutually reinforcing poverty and ill health make everyone more susceptible. Research conducted during an influenza outbreak in New Haven, Conn., found that the rate of infection nearly doubled in census areas where a high proportion of residents live below the poverty line. Question: Explain what the government can do to overcome or at least minimize the problems raised in the article.

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As the coronavirus spreads across the globe, it appears to be setting off a devastating feedback loop with another of the gravest forces of our time: economic inequality. In societies where the virus hits, it is deepening the consequences of inequality, pushing many of the burdens onto the losers of today’s polarized economies and labor markets. Research suggests that those in lower economic strata are likelier to catch the disease. They are also likelier to die from it. And, even for those who remain healthy, they are likelier to suffer loss of income or health care as a result of quarantines and other measures, potentially on a sweeping scale. At the same time, inequality itself may be acting as a multiplier on the coronavirus’s spread and deadliness. Research on influenza has found that in an epidemic, poverty and inequality can exacerbate rates of transmission and mortality for everyone. This mutually reinforcing cycle, experts warn, may be raising the toll of the virus as it is widens the socioeconomic divides that are thought to be major drivers of right-wing populism, racial animosity and deaths of despair — those resulting from alcoholism, suicide or drug overdoses. “These things are so interconnected,” said Nicole A. Errett, a public health expert who co-directs a center on extreme event resilience at the University of Washington. “Pre-existing social vulnerabilities only get worse following a disaster, and this is such a perfect example of that.” Because each low-income family forced to accept a higher risk of exposure can infect others, she added, the consequences of inequality, while most obviously felt by the poor, “put the broader society at risk.” Two major risk factors are thought to make the coronavirus deadlier for those who catch it: old age and pre-existing health conditions. But a body of research points to a third: low socioeconomic status. Even for those well above the poverty line, studies find that low income relative to the rest of society is associated with higher rates of chronic health conditions such as diabetes or heart disease. This has not always been the case. As inequality has risen, health disparities have widened. Preventive care and health education have steadily tilted toward the educated and the well-off. As a result, people at the lower ends of society are about 10 percent likelier to have a chronic health condition. Such conditions can make the coronavirus up to 10 times as deadly, according to recent data from the Chinese Centers for Disease Control and Prevention. Taken together, these two statistics suggest that Covid-19 can be about twice as deadly for those along their society’s lower rungs. At the same time, people with lower incomes tend to develop chronic health conditions between five and 15 years earlier in life, research finds. Put another way: Health organizations have said that people over 70 are at drastically greater risk of dying from the coronavirus. But the research on chronic health conditions suggests that the threshold may be as low as age 55 for people of lower socioeconomic status. Those numbers capture only a sliver of the ways that inequality can make the coronavirus deadlier. In China, many workers are employed informally and so cannot count on social services if they take time off — especially those in service jobs that require regular contact with other people. As a result, the people who can least afford care are often at greatest risk of transmission. In Italy, some workers, like Lorena Tacco, who works at a factory near Milan, have gone on strike over their employers’ failure to establish what they consider sufficient health protections as the epidemic spreads. “Who cares about the workers’ health, while the rich run away,” she said. “But then poor people, who need to bring bread home, go out and take risks.” Domenico Marra, who works at the same plant, said fear of the outbreak was rampant there. He worries about carrying an infection back to his children, particularly a daughter who has a weakened immune system. “We do want to work, but we are scared of going home, we are scared to touch our family,” he said. Government-imposed shutdowns, like those announced by France and Spain this weekend, do come with some worker protections. But small businesses will probably struggle to keep paying employees beyond any guaranteed sick days, particularly those in retail or other sectors that cannot work from home. In Japan, which has some of the lowest inequality of any major economy, people with jobs such as taxi driving enjoy a degree of security that rarely exists in other countries. Families reliant on hourly work are already running out of money, forcing many back out to look for jobs. Because communities tend to cluster by economic status, Dr. Errett said, the people who are both at the greatest risk of infection and likely to suffer most from the virus are all in proximity, multiplying the risk. Longer-term consequences are coming into view. New York City officials have said that closing local schools would leave many of the system's 114,000 homeless students without hot meals or medical care. Even small pockets of mutually reinforcing poverty and ill health make everyone more susceptible. Research conducted during an influenza outbreak in New Haven, Conn., found that the rate of infection nearly doubled in census areas where a high proportion of residents live below the poverty line. Question: Explain what the government can do to overcome or at least minimize the problems raised in the article.
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