Socio-Economic Status as a Risk Factor in Economic and Physical Harm from COVID-19: Evidence from the United States

Abstract

This paper provides an empirical summary of the relationship between social-economic status (SES) and the economic and disease burden of the SARS-CoV2 pandemic. Specifically, we examine how well income, education, race, and ethnicity predict disproportionate risk of layoff, income loss, infection, and death related to COVID-19 in the United States at the individual level and small geographic unit level. To study the disease burden, we rely on large-scale Center for Medicaid and Medicare Services data, Census Household Pulse Survey data, and a zip code database that we constructed from disparate public records to investigate the relationship between COVID-19 infection and death risk. We study economic effects using data from the Bureau of Labor Statistics and Household Pulse data. We find that low socio-economic status is strongly related to higher risk of physical harm (100%-200% greater) and economic harm (30%-100% greater) related to the pandemic. Education and income have similar effect sizes as racial and ethnic disparities, with American Indian, Black, and Hispanic Americans facing consistently worse outcomes. To shed light on potential mechanisms, we use Gallup survey data and other sources to investigate how disease-prevention measures relate to socio-economic status; we demonstrate that disparities across socio-economic status do not appear to be linked to preventive behaviors—such as social distancing and mask use, which are no lower and sometimes higher in lower-socio-economic status individuals—but do appear to be linked to occupation- or industry-related exposure that put lower socio-economic households at higher risk of disease or layoff.