Economic Stress

Los Angeles County has been a national leader in providing access to healthcare for all residents, regardless of socioeconomic status. Serving an incredibly diverse population experiencing inequality, the Department of Health Services and the Department of Public Health—along with many private and non-profit service providers—strive to serve all Angelenos without regard to documentation status, income, race or ethnicity, language, or health status. However, COVID-19 and the effects of the global pandemic threaten this progress. Both the virus and the related shutdowns run the risk of entrenching inequities resulting from the social determinants of health, creating challenges and undoing the gains made by expansive public policy in recent years.
Overall, in the California service sector about half of workers still earn less than $15 per hour, which due to the high-cost living in the state is substantially below a living wage.
Report Authors

Economic Stress from Impacts of COVID-19 in Los Angeles County

California has been particularly hard hit by COVID-19, with an estimated $1.5 billion in lost revenue, around 21,000 lost community health center jobs, and nearly 7 million lost patient visits. This loss made it harder to provide healthcare, increased the likelihood of negative health outcomes in patients, and, barring intervention, could result in the closure of community health centers. While health outcomes were racialized prior to the onset of COVID-19, the pandemic exacerbated health inequities in Los Angeles County. The death count for Native Americans is about 1.5 times that of whites, while it is two times as high for African Americans, 2.7 times for Latinos, and over 3 times for Pacific Islanders. Though some primary care providers have been able to pivot rather seamlessly to telehealth visits, prohibitive Medicare and Medicaid reimbursement rules, combined with the difficulty of navigating prescribing laws and regulations at the federal and state levels, created burdens for the FQHCs that provide healthcare to lower-income communities in Los Angeles. Chronic non-communicable diseases such as cardiovascular disease, diabetes, and sickle cell disease all increase the risk of severe illness from COVID-19.

While cardiovascular disease is the leading cause of death for Black, Native American, Latino and white men, other comorbidities tend to disproportionately impact communities of color. For example, approximately 9.7 percent of Black and Latino adults in California have Type 2 diabetes, compared to 6.8 percent of white Californians. According to the American Diabetes Association and the Centers for Disease Control and Prevention, diabetics face a higher chance of serious complications from COVID-19. Current evidence suggests that individuals living with HIV/AIDs who are on an effective treatment regimen are no more susceptible to COVID-19 than individuals who do not have HIV/AIDS. However, among the many knock-on effects of COVID-19 is the disruption in healthcare and social service provision.

We must prevent the pandemic from worsening health disparities and ensure access to critical services for communities with serious comorbidities.

The death count for Native Americans is about 1.5 times that of whites, while it is two times as high for African Americans, 2.7 times for Latinos, and over 3 times for Pacific Islanders (Los Angeles County Department of Public Health 2020).

  • 7.1% 7.1%

%

Approximately 9.7 percent of Black and Latino adults in California have Type 2 diabetes, compared to 6.8 percent of white Californians (Chronic Disease Control Branch 2019).

  • 9.7% 9.7%

California has been particularly hard hit by COVID-19, with an estimated $1.5 billion in lost revenue, around 21,000 lost community health center jobs, and nearly 7 million lost patient visits (National Association of Community Health Centers 2020).

  • 30% 30%

10 Policy Recommendations To Help With Economic Stress

The report puts forward 10 recommendations for policy and practical action.

Mitigate impact of lost revenue for FQHCs and FQHC-look-alikes.

Ensure adequate supply of personal protective equipment (PPE) and other tools essential to fighting COVID-19 and other infectious diseases.

Provide interest-free loans to private service providers and clinics hard hit by COVID-19 shutdowns, like substance use treatment facilities

At the county level: ensure that the Department of Health Services’ outpatient clinic facilities, including both primary and specialty care, are able to maximize patient care and compensation through telephone and video visits.

At community health centers (FQHCs and FQHClook-alikes): promote the adoption of video services to maximize Medicare and private insurer compensation

Promote the adoption of video services for providers that serve patients with substance use, such as buprenorphine prescribers and therapists.

Enable organizations like Alcoholics Anonymous, Narcotics Anonymous, and other support services to provide virtual care by investing in technology for both the organization and the patients they serve

Dramatically improve testing capacity and access to testing

Provide temporary isolated housing for all people with COVID-19 who do not live alone. In addition, childcare and eldercare resources should be offered as well, to reduce the likelihood of transmission to vulnerable Angelenos

When it is safe to do so, fund outreach efforts to bring patients back to their healthcare providers for preventative care, especially cancer screening, HIV and STD testing, diabetes screening and care, and nutrition counseling.

Our Streets Our Stories

Thank God that we have our health, but work has been very slow. It’s kind of like when the recession came, you could go and find a job, but now, you can’t even get close to someone because in the first place there isn’t any work, and second, you’re probably going to get fired.

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