What Does Structural Inequality Look Like?

The Census Bureau’s 2018 report on income and poverty brought with it good news; at 11.8%, it was the first time that the poverty rate dropped significantly below where it had been pre-recession in 2007. The White House Council of Economic Advisors touted the report, saying that its findings vindicated the Trump administration’s economic agenda, going so far as to issue a statement claiming that over the past year “those who had been forgotten in the past were lifted up the most.”

But their statement made no mention of worrying disparities evident in the data. According to the report, non-Hispanic White households had a median income of $70,642, while Black households’ median income was $41,361. Hispanic households had seen better income growth in recent years, but still lagged behind at $51,450. And with a substantially lower middle income Black and Hispanic workers are disproportionately represented amongst the bottom quartile of incomes, a fact that becomes relevant to the pandemic when one considers that 53% of these workers have access to no paid sick leave whatsoever.

That 53% figure on its own is cause for concern, but at the same time it obscures how unequal the distribution of paid sick leave is both in terms of income and location. Just like how we’ve seen aggregate measures of disease prevalence or mortality mask variance across demographic subgroups, so too do the aggregate numbers for paid sick leave. 73% of American workers had access to paid sick leave in 2019, a significant jump from 62% in 2010. This was spurred by several states passing laws mandating minimum standards during this time, like when California required employers provide a minimum of three sick days a year. Los Angeles County went even further, with workers in the city entitled to at least six days of sick leave annually.

Disparities quickly become evident once the national figure (73%) is broken down. 91% of workers have access to paid sick leave on the west coast, where states passed comprehensive laws with narrower exceptions.

But only 12 states have passed some form of mandatory paid sick leave, with varying degrees of coverage and duration. Contrast this with the 18 states that have passed laws preemptively banning municipalities and counties from requiring that employers provide any paid sick leave whatsoever.

It should be noted that many of the workers left unprotected are the ones who need paid leave the most — overwhelmingly low-income, in hourly wage jobs where close contact with customers or coworkers leave them vulnerable to the coronavirus. Only 60% of American service workers have access to some form of paid sick leave, leaving more than 10 million Americans to make the difficult choice between staying home or getting paid. And in a sector where the average pay in 2018 was $26,938, statistics which suggest that health outcomes are strongly influenced by social factors such as race, income and education take on alarming significance.

The steadfast refusal of many states to protect their working poor will undoubtedly amplify the disproportionate risk they already face. The worst offender is the East South Central census region, comprised of Alabama, Mississippi, Kentucky, and Tennessee— of whose workforce 37.15% earn less than $12/hour, and all of whom explicitly prevent any jurisdiction within their borders from instituting a paid sick leave requirement. It isn’t a coincidence that 38% of workers in these four states could legally lose their job if they were to take a single unpaid sick day. These laws have effectively singled out low-wage workers as somehow undeserving of protection.

Aside from being outright discriminatory, this also flies in the face of sound public health policy. Research from the World Health Organization on H1N1 (the WHO’s latest research shows COVID-19 to be 10x deadlier than H1N1, for reference) indicated that workplace interactions accounted for 7 million infections in the United States alone, while a recent working paper found that adopting paid sick leave paid immediate dividends — American states that followed through saw an 11% average drop in cases of influenza-like-illness within just the first 12 months.

And yet, despite research demonstrating that their higher incidence of chronic illness, limited access to healthcare and close living quarters leave low-income families especially vulnerable, these states (Louisiana amongst them) have been not just derelict in protecting those most vulnerable, but actively complicit in undermining efforts to establish an effective social protection floor.