Undergraduate Students Discuss Impacts of COVID-19 on Social Determinants of Health

Woman wearing a mask working on a computer.

Social determinants of health are key influences in shaping health outcomes. With this in mind, a group of six undergraduate students from the University of Michigan School of Public Health came together to discuss how the COVID-19 pandemic will impact various social determinants of health as we look toward the future and the virus continues to spread. 

Emily Guo, Claire Sandler, Eliyas Asfaw, Sarah Jang, Swathi Komarivelli, and Katherine Lewis, all majoring in public health, used their idea to publish a paper in Health Education & Behavior on the topic. Roshanak Mehdipanah, assistant professor of Health Behavior and Health Education, served as senior author of the paper. We spoke to several of the paper’s authors to learn more about their perspective on lessening the growing disparities caused by COVID-19.

What are some of the ever-widening disparities you highlight in the paper that have been worsened by the pandemic? 

Claire Sandler: The pandemic has exposed many cracks in our healthcare and safety net system. Our paper highlights several of the disparities worsened by the coronavirus pandemic, including:

  • Education. The technological divide in access to laptops, internet/wifi, and online school resources. Children of lower-income families might face more stress in accessing technology.
  • Access to food/food insecurity. Students who are eligible for school meals are not attending schools. In addition, going to grocery stores might be dangerous for certain populations.
  • Housing instability. How are homeless populations affected by COVID-19? Eviction moratoriums will eventually end, leaving people still responsible for all the rent they have not been able to pay for due to loss of income during the pandemic.
  • Racial and socioeconomic inequalities. Research has shown increased unemployment among racial minorities and striking disparities in COVID-19 infection rates among minority populations.

Your paper mentions how COVID-19 was initially described as “the great equalizer.” What does that mean and how has that changed over the course of the pandemic so far?

Emily Guo: Dangerous diseases are often seen as forces that are so outside of our control that they treat all people equally regardless of social or economic inequities. Calling COVID-19 the “great equalizer” means that it would, in theory, infect any person without regard to their race, class, gender, etc. However, this has not been the case, as most of the severe cases of COVID-19 are in people who are not able to socially distance at home or at work, and who have pre-existing conditions often caused by living in a poor environment. Beyond the pathology of the disease itself, the unequal access in resources demonstrates how COVID-19 does not affect all populations equally. 

As future public health practitioners and leaders, what do you see as the best way to address these disparities exacerbated by the spread of COVID-19?

Eliyas Asfaw: The pandemic has only amplified the disparities that are chronic, so it is important to increase efforts to alleviate inequities at a larger scale. One key way we can close the gap is through community partnerships for research and interventions. We need to involve disadvantaged communities to create the change that they would like to see within their areas. We will also need to be more innovative to improve health outcomes with products like value-based insurance that realign healthcare spending and expand access to a larger population.

What is one thing you want people to know about your paper?

Eliyas Asfaw: We wanted to communicate how our public health future is being impacted by the COVID-19 pandemic and how it has amplified pre-existing inequities in our communities. We hope that the paper will allow readers to consider how COVID-19 will impact the future of the field of public health and how the inequities exposed by the pandemic must be addressed. 

As students in public health, has the COVID-19 pandemic changed your view of public health or the career path you would like to take?

Katherine Lewis: We believe that the COVID-19 pandemic has shown the general public the importance of public health as a field. The field has a broader social recognition now, which is exciting, but it is also being politicized, which we worry could hurt future public health campaigns. It can be very difficult to direct people in health, and in public health specifically, we must work with various sectors to ensure that we are satisfying the needs of community members while also protecting the population’s health.

Our perspective is unique because we all chose public health as our field of study shortly before the entire field shifted as a result of the pandemic. We will all enter the public health workforce with an education that was fundamentally shaped by COVID-19 and the world’s response to the pandemic. This drastic change and sudden public spotlight can be stressful, but we are hopeful that we can use society’s newfound recognition of the importance of public health to inspire positive change in our future careers. 


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