The coronavirus pandemic has elevated and exacerbated deep-seated inequities in communities across the United States. Localities large and small, urban and rural, well resourced and under resourced, are responding to distinct challenges.
The Sentinel Communities project follows the experiences of 29 diverse communities and their efforts to promote health and well-being. Since the onset of the COVID-19 pandemic, researchers have studied nine of these communities—Finney County, Kansas; Harris County, Texas; Milwaukee; Mobile, Ala.; San Juan County, N.M.; Sanilac County, Mich.; Tacoma, Wash.; Tampa, Fla.; and White Plains, N.Y.—in depth to understand impacts on community members and local mitigation efforts.
The Robert Wood Johnson Foundation seeks to understand how the pandemic is affecting Americans by examining evolving social conditions, including access to work, school, social supports, and other critical aspects of health and well-being.
Previous reports summarized the pandemic’s early impacts (released July 2020) and how cross-sector collaboration contributed to recovery efforts (released October 2020).
The latest research finds that the economic, social, and educational impacts of COVID-19 on children and families have been devastating. Communities have struggled to address the acute needs of these families, like ensuring access to healthy food and the internet for school.
As communities look toward recovery, they are trying to determine how to allow the economy to move forward while also prioritizing the well-being of children and families, particularly those with low incomes and from communities of color.
Through our Sentinel Communities research, we highlight how different communities have fared through this crisis and why.
- Finney County, Kansas
- Harris County, Texas
- Milwaukee, Wis.
- Mobile County, Ala.
- San Juan County, N.M.
- Sanilac County, Mich.
- Tacoma, Wash.
- Tampa, Fla.
- White Plains, N.Y.
Finney County, Kansas
Rural Finney County is a diverse and young community where many work in the meatpacking industry—a field that saw some of the earliest COVID-19 outbreaks. The county is nearly two-thirds Latino, has a large immigrant population, and children makeup one-third of the overall population. Despite this diversity, the county has no concrete plans to address persistent health equity gaps.
Collaborative efforts to respond to COVID-19 in Finney County have been largely led by the LiveWell coalition. Nonprofits have also created new connections and the health department has partnered with public school districts. Elected leaders, however, have not made enduring efforts to address the pandemic and its many challenges, particularly for communities of color.
Many families, including those who are essential workers, live just above the poverty line and face food and housing insecurity. Most children in Finney County attend public schools, but one-in-five lack Internet access for online schooling (as of early 2020). There are also severe child-care shortages: for every child-care seat, there were 30 children ready to fill it.
Efforts to support the health and economic response to COVID-19 largely prioritized individual freedom and economic recovery. CARES Act funding and a small amount of philanthropic support went to directly support families as well as the organizations that serve them. This hands-off approach to mitigating the pandemic’s effects so far has resulted in inadequate public health protections.
Harris County, Texas
Harris County, home to Houston and one of the most populous and diverse areas in the nation, offers insight into how the pandemic has affected different populations in different ways—even in a community with good equity practices and deep experience with disaster response.
COVID-19 spurred a highly coordinated response from public health, health care, social services, and nonprofit agencies. Harris County Public Health (HCPH) plays a central role in coordinating early and collaborative efforts to respond to the pandemic. The crisis has also encouraged data alignment and shared data dashboards, motivating a response to housing challenges and encouraging the development of new funding sources. At times, the county has even opted to take a more cautious approach to reopening businesses than the state has recommended.
While equity in housing is a priority for many local leaders, market forces have made housing increasingly less affordable and the county faces an eviction crisis. Though eviction moratoriums weren’t extended, a local organization offered free legal advice to families facing eviction. Local leaders also established a Housing Stability Task Force to find more long-term solutions to the housing crisis.
Similarly, the challenges families face adapting to changes in the public schools while more affluent families secure alternative learning options for their children illustrates equity issues in the county. Significant investments by the CARES Act funds and local philanthropies have helped families meet basic needs, but organizations have struggled to adapt and respond to ongoing challenges in this large and diverse community.
Milwaukee is one of the nation’s most segregated cities where communities of color have experienced wide disparities. But, leaders are committed to addressing equity and systemic racism.When the pandemic began, several established partnerships and cross-sector collaborations expanded their efforts to meet emerging needs in the community. These included creating strategies, coordinating responses by local philanthropies, and organizing volunteers to support systems for local organizations working on the front lines. Collaborations addressed housing insecurity, mental and behavioral health needs, the distribution of personal protective equipment, ensuring access to voting, and more.Given the community’s commitment to equity, many of the policies and investments are aimed at supporting Black and Latino communities.
Milwaukee’s citizens are still suffering many hardships presented by the pandemic. However, there has been movement toward more racially diverse community leadership, recognition of racism as a public health issue, and coordinated efforts to support the health and rights of underserved residents.
Despite these investments, there remain significant concerns about the health, well-being, and economic stability of residents, particularly working women trying to balance work and home responsibilities, as well as children and youth who are trying to navigate virtual schooling when technology, bandwidth, and school resources fall short.
Mobile County, Ala.
In Mobile, where Black residents outnumber whites by seven percentage points, and nearly one in four people experience poverty, equitable pandemic response has been especially challenging. When the pandemic began, Mobile County Health Department spearheaded the COVID-19 response, including ongoing dialogues around the need for response that addresses racial equity.
The few existing public and private collaborations implemented a coordinated response, featuring a joint communication plan and financial support for local business. New collaborations formed to fill critical gaps in health care services and to support the safe reopening of schools.
Mobile was quick to reopen, sparing child and family service organizations from many of the challenges that other communities are facing. However, these policy decisions have not come without a price: COVID-19 cases and deaths have disproportionately affected Black residents, further straining race relations.
Even though schools were relatively quick to open throughout the state, an estimated 5,000 children did not register at any Alabama school this year. This is not only concerning because these children may have disengaged from the school system, but it also could impact school funding for next year. There are broader concerns about children of all ages, particularly children of color, disengaging with the school and social systems and what this might mean for their futures.
San Juan County, N.M.
Much of San Juan County overlaps with the Navajo Nation. Some places in this New Mexico county face deep challenges, like lack of running water or Internet service. Roughly 30 percent of children live below the poverty level and only two-thirds of households have Internet access. These factors impact health, especially during a pandemic.
The county has also experienced uncontrolled spread of COVID-19 for much of the pandemic, particularly among members of the Navajo Nation. An acknowledged but unaddressed disconnect between the Navajo Nation and the rest of San Juan County reveals minimal county-level response to high numbers of cases within the Navajo Nation.
To the dismay of many local business owners, the state has intervened with strict business restrictions. Many families face significant challenges meeting basic needs. Investment of federal CARES Act funds and state money has gone primarily to support small businesses, though some funding has gone directly to residents. Employment challenges have contributed to prevalent food insecurity: over half of households with children receive Supplemental Nutrition Assistance Program (SNAP) benefits.
Although different sectors have mobilized to basic needs and address mental health challenges, the county still lacks a comprehensive response to persistent inequities.
The pandemic’s early days (released July 2020)
- Cross-sector collaborations in recovery efforts (released October 2020)
- Impacts on children and families (released March 2021)
Sanilac County, Mich.
In this small Michigan community with relatively little diversity, health was never a communitywide focus. Sanilac has had far fewer cases of COVID-19 than many communities.
Because summer tourism—an economic mainstay for the community—was severely impacted, many residents experienced higher rates of food insecurity than in prior years. Investments in the region have provided support for basic needs, such as food and housing, and helped to ensure that many of the small businesses in the region remain operational.
Existing partnerships in Sanilac County helped with a coordinated response to COVID-19 through the Emergency Operations Center (EOC) and Community Collaborative, among other efforts. Sectors also worked together in new ways to meet community needs, including a new collaboration between the local schools, hospital, and health department to inform the safe reopening of schools.
Across the county, the impact on children and families appears to have been relatively mild, but many still struggled to meet their basic needs. The lack of internet connectivity in this rural area made it challenging for children and families to connect to schools, jobs, and other necessary services. Most schools opened for in-person learning in the fall, but faced periodic closures due to outbreaks and state-level orders.
In Sanilac County, less emphasis has been placed on equity, although the county does report COVID-19 data by key demographics and continues to support populations that are underserved through emergency assistance funds.
Tacoma is a small city near the first COVID-19 outbreak in the United States. With close state and city coordination, as well as a long-standing commitment to equity and practices in place, it has been weathering the pandemic relatively well.
Different sectors, like health and education, have collaborated. Since the start of the pandemic, new funding streams have enhanced cross-sector collaborations. Despite these efforts, local families still faced many hardships.
While the greater Tacoma economy is doing fairly well, small businesses have been hit particularly hard. A survey of major employers in the area found COVID-19’s impacts to be widespread. Communities of color, particularly immigrant and refugee communities, were most likely to be negatively impacted by small business closures.
As the pandemic continues, families are increasingly unable to meet basic needs. Homelessness has been growing in Tacoma over the past few years, and the pandemic is further exacerbating the issue. Food insecurity has also increased.
The community has taken a cautious approach to reopening, maintaining business restrictions and keeping schools closed to in-person instruction for the first semester of the 2020-2021 school year. Business owners have struggled, particularly those not eligible for or denied federal aid, and families have faced a lack of child care and increased challenges covering housing costs. However, policy provisions and significant investment on the part of political leaders and philanthropy have likely blunted the negative effects.
Tampa has been hit by severe hurricanes in the past and, as a result, sectors are accustomed to working together for emergency response. The pandemic, however, has catalyzed deeper collaborations within and across sectors, including new partnerships to address issues of health and equity.
Tampa-area residents value cross-sector collaboration, with growing acknowledgement that a successful recovery will require a multi-dimensional response. Some local leaders have speculated that these new models of working together may become the “new normal.”
Children and working families in Tampa are feeling the impact of COVID-19 in various ways. While business closures and loss of income immediately impacted many families, Black families have been disproportionately affected. These economic losses, coupled with in-person school and child-care facility closures, have also had cascading impacts on parents’ and guardians’ work performance and on extended family who have taken on additional responsibilities.
There is ample evidence that Tampa prioritizes and values the well-being of children and families in the region. Community response efforts have not only met basic needs
of children and families directly, but also provided training and support to others in the community who can assist and advocate for children and families, including case managers, lawyers taking on eviction cases, child care providers, and kinship care providers.
White Plains, N.Y.
White Plains, a commuter community near New York City, was one of the hardest hit areas in the early days of the pandemic. Its response efforts are closely tied to county and state efforts. Locals, many of whom are immigrant or undocumented, benefitted from cross-sector and neighborly collaborations that were in place well before COVID-19.
While some of these efforts leverage existing coalitions and infrastructure, others started in summer 2020 and are supported by large donations from corporations headquartered in White Plains. The region’s COVID-19 response has also prioritized small business recovery and mitigating the cascading effects of lost income.
Children and families are facing a number of challenges as a result of the pandemic, with immigrant and undocumented families being hit hard. Older youth are taking on more responsibility to care for younger siblings or bring in supplemental income, but this can be detrimental to their own schooling.
The school system has been proactive with the safe reopening of schools. Child-serving agencies, however, are concerned about children’s mental health and the inability to deliver in-person services, like face-to-face counseling.