FOREWORD

Dr. Jeanine Abrams McLean, President, Fair Count

Dr. Sarah Beth Gehl, 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 the pandemic into an opportunity to build prosperity and progress for all. Data and civic engagement will be critical for this to occur. 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) and Bipartisan Infrastructure Investment and Jobs Act can use these findings to target disparities that ultimately undermine community resilience.

The U.S. has gained over 2.7 million jobs in 2022, and most Americans have resumed pre-pandemic activities. But over 1 million Americans have died of Covid, and an estimated 1.6 million adults can’t work each month because of Long Covid. As more people become infected, the numbers experiencing Long Covid may swell. Many other impacts of the pandemic are just now becoming clear — including an ongoing mental health crisis and increasing threats to our democracy. Our review of 26 indicators related to the Covid crisis and the nation’s civic health revealed:

Covid impacts New variants BA.4 and BA.5 are spreading rapidly, and local officials in many cities are encouraging greater vaccine uptake. Of the more than 1 million Americans who have died of Covid, 1 in 4 could have been saved if 90% of the population had been vaccinated. 5 Southern states (AL, AR, KY, TN, WV) were among those that could have saved the most lives per population size. In addition, 1 in 3 Southerners who survived Covid have suffered from Long Covid.

Economic impacts  Jobs have recovered in record time and could reach pre-pandemic levels this summer. 6 Southern states (AR, GA, FL, NC, SC, TN) have more jobs as of May 2022, than they did at their pre-pandemic peak. Employment rates have increased slightly with the labor force remaining smaller than it was pre-pandemic. In this tight labor market, Black adults experienced the greatest gains with employment rates increasing 2.1 points to 58.6% from December 2021 to June 2022. Inflation and rising interest rates may dampen growth, causing companies to shed jobs in the coming months and an estimated 1 million women may have to leave the workforce this summer for lack of child care while schools are out. Employers will likely continue to struggle to find employers, with Long Covid hobbling a sizable number of workers, and childcare insufficiently available. 

Housing and utilities costs Home prices have increased 20%, and rents have gone up 15% over the last 12 months. Home utility costs are an added concern–especially in the South. Even before the pandemic, low-income households in AL, LA, and MS spent 10% or more of their income on home energy. Fears of foreclosure or eviction are rising such that 43% of Southerners who were late on rent or mortgage in June feared losing their homes. But AL, GA, TN, and WV have distributed only 35% or less of their federal Emergency Rental Assistance dollars. To make matters worse, 95% of the population of AL, AR, FL, LA, MS, and NC live in a county that has had at least one climate disaster since March 2020, and housing prices tend to increase after disasters.

Financial stability The share of Americans with medical debt fell from March 2018 to April 2021 when stimulus bills boosted enrollments in public health insurance plans. As the official health emergency ends, many adults will lose their insurance, and medical debt will likely increase, particularly in Southern states that have not expanded Medicaid (AL, GA, FL, MS, NC, SC, and TN). The Child Tax Credit payments distributed from July through December 2021 stabilized family finances, measurably reduced food insecurity, and lifted children out of poverty – lowering the child poverty rate to 12%. Child poverty — considered the greatest threat to children’s healthy brain development — has now spiked again to 17%.

Mental health Levels of anxiety and depression have tripled since the pandemic hit. 9 of the 11 states with the highest adult rates of anxiety and depression were in the South. Among LGBTQ+ high school-age youth nationwide, 12% of girls and 26% of gay, lesbian, or bisexual youth actually attempted suicide during the pandemic. Firearm suicides (among adults and children) increased from 23,941 in 2019 to 26,316 in 2021. Across Southern states, mental health providers are in short supply and the majority of rural counties have no pediatricians — an important source of mental health care for children.

Democracy 6 southern states have enacted new laws that make it harder to vote, and research reveals that restrictive voting laws are associated with poorer health. AL, AR, LA, MS, and WV have the worst infant mortality rates in the country and restrictive electoral climates. Moreover, AL, GA, FL, LA, MS, and WV lack constitutional protections for fair and equal elections. Meanwhile, local news sources have been rapidly disappearing and 75% of Southern counties now lack this important source of reliable news. 8 of the 10 states with the worst internet access rates are in the South. American Indian people are about 2.5 times more likely to lack internet than white people, and Black people are about 2 times more likely to lack internet.

Inflation is exacerbating the challenges that many Americans have struggled with since the pandemic struck. State and local governments can mitigate some of the harshest effects by expediting the distribution of Emergency Rental Assistance funding and investing ARP dollars in human needs such as utility assistance, food assistance, child care, and mental health programs. As Americans grapple with the rapid changes in our world, threats to our democracy are mounting. Without protections for free and fair elections, states could find their election results undermined. Improving and expanding civic engagement and voting enfranchisement will be essential for improving Americans’ health outcomes and overall well being.