Pandemic to Prosperity: South

FOREWORD

Dr. Jeanine Abrams McLean, Vice President, Fair Count

Dr. Sarah Beth Gehl, Research Director, The Southern Economic Advancement Project

A civic ecosystem has been burgeoning for decades in the South, and it offers a path to turn the tragedy of this pandemic into an opportunity to build prosperity and progress for all. Data and civic engagement will be critical. Together, the Southern Economic Advancement Project (SEAP) — which works to lift up policies that address particular vulnerabilities in the South — and Fair Count — whose work focuses on strengthening pathways to continued civic participation — partnered with the National Conference on Citizenship to document the state of the South during the pandemic. State and local governments prioritizing projects for the American Rescue Plan (ARP) can use these findings to target disparities that ultimately undermine community resilience.

The nation is nearing a grim milestone, with nearly 1,000,000 Americans dead of Covid. At the same time, more and more Americans are resuming activities of normal life, and their perspectives about the pandemic have shifted— now considering it to be a manageable problem.1 The economy and jobs have been rapidly growing, and multiple federal programs are rolling out that can support the most vulnerable and build the nation’s capacity for resilience. 

Still, many impacts of the pandemic are just now becoming clear, including multiple manifestations of an ongoing mental health crisis, growing inequities, and increasing threats to our democracy. Our review of 28 indicators related to the Covid crisis and the nation’s civic health revealed: 

Covid impacts. As Covid swept the nation, many patients were unable or afraid to seek treatment for their medical conditions. Moreover, alcohol-related deaths, overdose deaths, and even vehicle fatalities spiked. For every 3 known Covid deaths, there has been 1 additional excess death since March 2020. In addition, long Covid is affecting an estimated 10-30% of all Covid patients. 

Pandemic to Prosperity April 21, 2022 1

Economic impacts. The economy recovered from the Covid crisis in record time, with job levels now likely to reach pre-Covid levels in Q2 2022. But the labor force has shrunk, giving workers newfound power, and quits rates are at all-time highs.2 Employers have raised wages by 4.9% since last year, but inflation is up 8% and workers are demanding even greater wage increases. Such increases could lure retirees back to work, and help women who can’t afford childcare to resume working, but long Covid may sideline an increasing number of workers as new variants 

of the coronavirus spread. Inability to rejoin the workforce plus inflation are contributing to food insecurity. In AR, FL, and MS, where officials have rejected emergency Supplemental Nutrition Assistance Program (SNAP) benefits, adults have reported among the highest rates of hunger in the nation. 

Student loan debt. In the 2 decades before Covid struck, a growing number of college students incurred student loan debt. By 2019, 30% of Black households had student loan debt. In March 2020, student loan payments were paused. Once student loan payments resume after August 2022, an estimated 18 million borrowers will lose $85.5 billion of their income annually. 

Mental health and health care. Anxiety and depression levels rose from 11% in 2019 to 32% in March 2022. In AL and WV, ⅓ of adults reported anxiety or depression, yet these states have far fewer mental health providers than the national average. Seven southern states have refused to expand Medicaid, leaving 15% of working-age Southerners without insurance and as high as 18-19% without in FL, GA, and MS. Many rural hospitals in these states have closed and, in 2021, 60% of rural counties had no pediatricians. In addition, by December 2020, credit bureau data revealed that 20% of Southerners had medical debt in collections. In some Southern counties, half of residents have medical debt in collections. 

Housing. The nation faced a severe housing shortage before Covid hit, such that 1 in 4 renters spent half their household income on housing. When Covid hit, the federal government declared an eviction moratorium but the Supreme Court struck it down in August 2021. Many states and localities have kept evictions low by quickly dispersing federal Emergency Rental Assistance funds. Southern states have lagged, distributing only 49% of these funds through Feb 2022 compared to 59% across non-Southern states. In March, among Southerners who were late on rent or mortgage, 35% were concerned about losing their housing. Moreover, 70% of Southerners live in a county that has had at least one climate disaster since March 2020, and housing prices tend to increase after disasters — highlighting the need for robust strategies to create and preserve housing across the South. 

Information access. 31% of Southern counties have poor internet access — meaning ¼ of households have no internet. In MS, 21% of households lack internet access entirely and in AR, LA, and WV, 18% of households have no internet access. In the South, 2 out of 3 counties are “news deserts,” meaning they lack the local news that Americans count on for reliable information — allowing mis- and disinformation to spread. 

Data quality. The decennial census has persistently undercounted people of color. In 2020, undercounts for Black or African American people remained high at -3.3%. For Hispanic communities, the undercount more than tripled from -1.5% in 2010 to -4.9% in 2020. These undercounts reduce communities’ political representation as well as the federal funding they’ll receive for the next 10 years. For example, MS, GA, and LA had among the highest rates of undercount, causing their residents to lose between $20 million and $47 million in annual Medicaid funding. Similarly, the Census Bureau’s American Community Survey (ACS) saw a dramatic decline in response, particularly among low-income households. The ACS response rate fell from 96% in 2015 to 71% in 2020. 

Democracy. In response to the pandemic, nearly every state moved to make voting easier, through mail-in voting, ballot drop-boxes, and increased early voting. Voter turnout was at 67%, a record high in the 2020 election with increases among both Democratic and Republican voters. Since then, rather than building upon that progress, 19 states enacted voting laws that make it harder for Americans to vote, including AL, AR, GA, FL, KY and LA. Also key to our democracy is the balance of power between executive, legislative, and judicial branches of government, which 35 states are trying to upset as legislators introduce bills to limit the power of state courts. 

As disasters do, Covid has accelerated many pre-existing trends. To name just a few, drug overdoses have skyrocketed, housing insecurity has increased, and the share of Americans with medical debt is mounting.3In this rapidly changing context, leaders must be strategic with their investments. State and local leaders can boost economic recovery by prioritizing investments toward stabilizing middle and low-income families. Southern states that accept Medicaid expansion will increase access to medical services, reduce families’ medical debt, and increase labor force participation.4In addition, flexible ARP funds can support families (and landlords) by providing renters with the resources to stay in their homes. The threat of more workers becoming debilitated by long Covid increases as the new Omicron subvariant BA.2 circulates. Public health officials can protect lives and livelihoods by reinstating protective measures as needed — a small sacrifice in the midst of a not-yet-resolved pandemic.

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