As part of the new $900 billion federal stimulus package, the moratorium on evictions for renters will be extended by one month, through the end of January. The help could not come soon enough, said an expert on social and economic development at the Brown School at Washington University in St. Louis.
However, without more intentional, long-term solutions and investments, this aid will only postpone an inevitable housing crisis, a new survey shows.
“Data from our recent survey indicates that the impact of COVID-19 on homeowners not only still exists, but it has significantly worsened, especially among Black and Hispanic households and young adults,” said Michal Grinstein-Weiss, the Shanti K. Khinduka Distinguished Professor and director of the university’s Social Policy Institute.
Grinstein-Weiss is the principal investigator for the institute’s Socioeconomic Impacts of COVID-19 Survey. The survey was administered in late April and early May (Wave 1) and late August (Wave 2) to over 5,000 nationally representative U.S. households each time.
“We found that the eviction/foreclosure rate of Black and Hispanic respondents increased by 7% as compared to only 2% among white respondents,” Grinstein-Weiss said. “Additionally, Black respondents were almost twice as likely to be forced to move as non-Hispanic white respondents in Wave 2 (late August), despite being least likely to be forced to move during Wave 1 (early May). While the jump in eviction risk among Black households is certainly alarming, Hispanic respondents maintain the highest vulnerability to eviction among the three groups both in Wave 1 and Wave 2.”
In addition to severe disparities in housing hardships based on race and ethnicity, the survey indicated a significant increase in hardship over time among young adults.
“In both survey waves, young adults (18-39 years old) were the most vulnerable to housing-related hardships, followed by middle-aged adults (40-54 years old), then older adults (55+ years old), and Wave 2 further widens the gap,” Grinstein-Weiss said.
Nearly twice as many young adults reported both eviction/foreclosure and mortgage/rent delinquency, or payment delay, in August as compared to May.
“This is compounding the financial situation of young adults who have had a shorter amount of time to accumulate protective financial assets, making it harder to weather the shock of the pandemic,” she said.
“Every member of society is impacted by this housing situation. Stable shelter is an essential tool to combat the spread of the coronavirus.”
For more from Grinstein-Weiss and co-author Yung Chun about their findings related to housing hardships, visit the Brookings Institution blog. Other research from the Socioeconomic Impacts of COID-19 Survey in the U.S. and Israel are available at the Social Policy Institute’s website.
Researchers at the Brown School are conducting discussion groups with parents and staff in the Special School District of St. Louis County (SSD) to develop communication tools surrounding COVID-19 testing and vaccination. The research is funded by a two-year, $5 million grant from the National Institutes of Health to the Washington University School of Medicine to offer 50,000 saliva tests to students, teachers and staff in the six special education schools operated by the district.
The grant will serve about 750 families in the district who have children in kindergarten through the 12th grade. The saliva tests will be voluntary and offered weekly to teachers, staff and students over the next year.
The pandemic has disproportionately impacted students with special needs, especially those with intellectual and developmental disabilities, in part because they rely on daily structure and in-person support for learning and social growth. Due to underlying medical conditions experienced by many such students, this student population is at a higher risk for developing COVID-19 and severe complications of the virus.
“The widespread closure of schools has particularly impacted the well-being of these children,” said Jason Newland, MD, co-principal investigator of the project and a professor of pediatrics in the Division of Pediatric Infectious Diseases at the School of Medicine. He has advised multiple school districts in Missouri on plans for reopening schools. “It is a major priority to get children with disabilities back into the schools while providing a safe environment for the students and staff, and a key component of achieving this goal is ample testing that can rapidly detect COVID-19 infections within the school community.”
The Brown School’s role will be to assess the perspectives of parents and school staff to develop messaging that can encourage participation in regular testing and overcome barriers to it.
“Our discussion groups are underway and have already provided valuable insights to inform communication with parents, teachers and staff. This information is also helping to shape the testing process being implemented in the schools by our medical school colleagues,” said Nancy Mueller, director of the Brown School Evaluation Center and an assistant dean who is leading that part of the research. “We hope that our findings can be useful not only for COVID testing but also for vaccinations to provide protection from the virus in the future.” Participating Brown School faculty include Charlene Caburnay, research assistant professor and co-director of the Health Communication Research Laboratory; Virginia McKay, research assistant professor; and Byron Powell, assistant professor.
The funding stems from $500 million awarded by the NIH National Institutes of Health as part of the agency’s Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) initiative to provide underserved communities with rapid testing for COVID-19. The money was part of the CARES Act passed by Congress to respond to the pandemic.
The saliva test provides easy and fast testing with same-day results, ideal for screening large communities. It was developed by the School of Medicine’s Department of Genetics and the McDonnell Genome Institute, in collaboration with a biotechnology company.
“The Special School District is eager to partner with Washington University to improve the lives of students with disabilities, especially during this time of COVID,” said Elizabeth Keenan, Ph.D., SSD’s superintendent.
SSD’s special education schools serve students from all school districts in St. Louis County, including those residing in socioeconomically stressed neighborhoods, where many families have heightened exposure to COVID-19, as well as disproportionate vulnerability to its most serious consequences. SSD’s students returned part-time to in-person learning in November.
The Brown School’s Health Communication Research Laboratory (HCRL) has received two grants totaling $1.57 million from the National Institutes of Health (NIH) to understand and address Covid-19 health disparities. The first study will examine how low-income workers have been affected by the pandemic, while the second will develop and test communication strategies to increase Covid-19 testing and vaccination in underserved populations.
The studies will be led by Matthew Kreuter, Kahn Family Professor of Public Health at the Brown School and Senior Scientist at the HCRL. Both studies include cross-disciplinary teams from the School of Medicine (Kia Davis and Amy McQueen), the Brown School (Charlene Caburnay, Niko Verdecias and Jennifer Wolff) and the Department of Psychology (Tom Rodebaugh). “The impact of COVID-19 on the lives and health of low-income Americans and racial and ethnic minorities has been especially severe,” Kreuter said. “These studies will help assure that public health responses meet their needs.”
The communication study, which also involves 2-1-1 helplines in CT, NC, NE, and WA, is part of NIH’s national initiative, Rapid Acceleration of Diagnostics for Underserved Populations, or RADx-UP, which aims to increase access to COVID-19 testing in vulnerable populations. Both studies are 2-year projects. Funding came from the $1.1 billion CARES Act, which Congress passed to accelerate the development of technologies to address the pandemic, primarily through testing and education. The HCRL proposed a series of rapid-cycle studies to inform the messaging of underserved populations about testing and vaccination.
“The goal is to make sure underserved Americans can easily get tested and vaccinated, and we need strategies that will work. Our team will be collaborating with other researchers and community partners around the country to develop effective approaches through science,” Kreuter said. “It is exciting to be part of the solution, helping bring this pandemic to an end.”
A 10-year-old girl was living in a small village in southeastern Sierra Leone during the country’s decade-long civil war when the rebels arrived. “They said they were going to take the girls and boys,” she said. “I was the first person picked. They picked 20 girls and 20 boys. They took us to another town, and I was there one week. I was raped and couldn’t walk, so they left me there.”
This is just one of countless narratives of gender-based violence that adolescent girls face in humanitarian settings.
While some interventions exist, more needs to be done to ensure that global efforts to end gender-based violence include a focus on adolescent girls, finds a new study from the Brown School at Washington University in St. Louis published Nov. 20 in the journal The Lancet Child & Adolescent Health.
“Despite the fact that we know that violence against adolescent girls increases in humanitarian settings, this remains an under-researched and underfunded area of intervention,” said Lindsay Stark, associate professor and an expert on the protection and well-being of women and children in situations of extreme adversity.
“Such focused attention is essential to meeting international commitments such as the Sustainable Development Goals.”
Stark is co-author of the paper, “Gender-based violence against adolescent girls in humanitarian settings: a review of the evidence.” The study presents a novel framework for gender-based violence risks facing adolescent girls in emergencies, synthesizes the limited evidence for relevant prevention and response, and identifies barriers to effective and ethical measurement and evaluation.
“We have few evidence-based models for how to keep girls safe,” Stark said. “This reality not only has relevance for many of the global settings in which I work, but also communities closer to home who are currently being hit hard by the COVID pandemic.”
Sexual violence against girls and women is common in humanitarian settings, mainly due to their combined vulnerabilities related to age, gender and factors associated with conflict or disaster.
Among the limited studies that do exist, the majority come from sub-Saharan Africa and suggest that approximately 40% of female adolescents in emergency settings have experienced some form of intimate partner violence, Stark said.
In some humanitarian contexts, as many as 26.5% of adolescent girls have experienced nonpartner sexual violence, she said. Within the context of ongoing war, studies suggest that 29% to 44% of former female child soldiers experience rape during conflict.
Due to a lack of clear division of labor between gender-based violence and child protection sectors, adolescent girls are often neglected by both groups, and violence against this subpopulation too often goes unaddressed, the paper’s authors wrote.
The study included work in conflict-affected communities with refugees, both in camps and in urban settings; internally displaced people; and communities affected by natural disasters.
“While some early evidence highlights promising interventions for transforming girls’ attitudes around violence and gender inequity and improving mental well-being, limited evidence supports the ability of existing approaches to reduce the incidence of violence,” Stark said. “More explicit focus on adolescent girls is needed when designing and evaluating interventions to ensure global efforts to end gender-based violence are inclusive of this population.”
While many violence prevention programs focus exclusively on women or younger children, adolescent girls often fall through the cracks and lack the access and capital to advocate for their needs, she said.
“Efforts to measure experiences of gender-based violence for this often-neglected population, in particular, are critical for ensuring adolescent girls are not missed in programming,” the authors wrote in the paper. “Further, the upheaval that accompanies humanitarian crises also comes with an opening for structural and social change led by those affected; engaging and supporting adolescent girls in the process of designing, implementing and evaluating interventions and response services can help to ensure this population is not left behind in the global effort to end gender-based violence.”
Covid-19 has adversely affected millions of Americans who needed help the most even before the pandemic, an impact that has been especially noticeable in the holiday season, according to a Brown School expert who has been tracking calls to 2-1-1 helplines around the nation.
“The normal seasonal spikes in calls for help with holiday meals from low-income families are much lower this year,” said Matthew Kreuter, the Kahn Family Professor of Public Health. “Part of that is that there aren’t as many providers who are offering meals. One of the sad realities behind these numbers is that there may be a lot fewer people able to have a Thanksgiving meal.”
2-1-1 is a free and confidential service that helps people find the local resources they need 24 hours a day, seven days a week, in most communities. A team led by Kreuter, the senior scientist at the Brown School’s Health Communication Research Laboratory, and Rachel Garg, a doctoral student in Public Health Sciences, has been tracking millions of 2-1-1 calls. To do that, they are using 2-1-1 Counts, a unique, daily tracking system that analyzes calls to helplines in 35 states and is updated daily with location-specific data.
When Covid-19 was declared a pandemic in March, the team began analyzing the impact on calls and created Focus-19, a website featuring reports on its findings. The team recently completed its 100th report on trends in calls for needs like food, utility payments, and housing from around the U.S. With a grant from Washington University’s Institute for Public Health, a new site, Focus-19 St. Louis, was created to report on regional trends in line with Washington University’s emphasis on research that benefits its local community. The team has been approached by three other states to produce similar reports for them.
At the end of each month, the team looks back and examines the biggest areas of growth in calls from the prior month. In September, requests for internet service jumped dramatically as schools reopened. “There was a lot of demand, particularly among low-income families,” Kreuter said. “The places where we see the largest increases in social needs requests are the counties that have the most Covid cases, or the highest rates of Covid. There’s a pretty clear connection to how Covid is affecting the social and economic situation of families. Housing, food and utilities continue to dominate the list.”
Kreuter said there has been a four-fold increase in the use of 2-1-1 Counts dashboards around the nation since the pandemic. “That is very encouraging,” he said. “It’s very clear that people are discovering this data source.” Local policies and conditions influence or reveal the demand for certain services, he said. “So when eviction bans start and stop, it really influences people’s requests for assistance.” In North Carolina, some of the first outbreaks were at meat-processing plants and 2-1-1 calls from the counties where those plants were located saw much greater increases in requests for help. That news from Focus-19 was the subject of a newspaper report and soon thereafter a local organization reached out to provide aid to the meatpacking workers.
“Calling attention to these issues is part of our aim, so resources can be allocated more efficiently to help,” Kreuter said. But limited funding has meant that most of the team’s effort is geared to analysis, with less effort at media outreach and follow-up to magnify the impact of the data. “All of our resources are going to generating the reports,” he said. “For full impact, they need to be seen by more people in more places.”
The Focus-19 work is made possible by the 2-1-1 Counts surveillance system. “That puts us in a position to observe these Covid-related changes,” Kreuter said. “But we’re using data that these 2-1-1s work so hard to collect. They are the real heroes here.”
Dozens of Brown School students, staff and faculty volunteered at polls across the St. Louis region on November 3, helping voters to cast their ballots in what would turn out to be the largest vote total in U.S. history and the highest turnout rate since 1900. Heavy voting before Election Day meant the polls weren’t as crowded as had been feared, but volunteers played a key role in keeping lines moving and answering voter questions, a job that proved especially rewarding for many first-time poll workers.
“Oh my gosh, it was the best volunteer experience I’ve ever had,” said Sarah Mosby, MSW ’22, who served as an election monitor to help speed the lines of voters at an elementary school in St. Louis. “I met great people throughout the experience, including a man in his 80s who was voting for the first time.
“It was extraordinarily moving – our community in action,” added Mosby, who was recently admitted to the Graduate Policy Scholar program.
The Inclusive Voting: Key to Democracy Project was headed by Gena McClendon, director of the Center for Social Development’s Voter Access and Engagement Initiative, and Cynthia D. Williams, assistant dean of the Office of Community Partnerships. The St. Louis Area Voting Initiative and the St. Louis Area Election Protection Coalition partnered with CSD for election protection training and volunteer recruitment as poll workers, election monitors.
“For the most part, things went well,” said McClendon, who praised the Brown School and Dean Mary McKay for backing the effort.
McClendon said one purpose of the initiative was to engage social work and public health students with other organizations in protecting the right to vote.“We’re introducing them to the idea that they’re making history, so they will continue to do this,” she said. “They’ll use this exercise as part of their professional development and part of their profession.”
Many students, she said, are so focused on their clinical work that they don’t understand the connection between their work and voting. McClendon will make that connection clear to students next semester in a class she’ll be teaching: Voting, Racism and the Promise of Democracy.
The relevance of voting to social work was brought home years ago to Trish Kohl, an associate professor at the Brown School who volunteered as a poll monitor at a community center in Florissant. “I wasn’t personally civically engaged early in my career working for a non-profit, mental health agency. But a few years into it, I began seeing the impact of policies on families, recognizing the systemic changes that need to happen.”
“It is probably my years of work as a social worker that made it so important to me to work at the polls this year,” she said. “I believe it is critically important for social workers to engage in voting rights and ensuring people have the opportunity to vote.”
For Sicong (Summer) Sun, a PhD student from China, working as a poll monitor at a St. Louis elementary school was her first in-person experience inside the American voting process. “I was glad to see great voter turnout, especially young people and communities of color,” she said.“They showed up and made their voices heard.” She said her focus on the social determinants of health and financial capability as a research associate at CSD will be strengthened by the experience.
Like Sun, Annie LaFleur’s polling experience was a new one. LaFleur, MSW ’21, came to the Brown School from Oregon, where she had only voted by mail. Her experience at the Better Family Life Center in St. Louis was an eye-opener. “I had never been to a polling place before,” she said. “I wanted the experience to see what it would be like. I’m so glad I did it. I felt I was part of something bigger,” said LaFleur, whose concentration is mental health.
The experience gave many first-time volunteers a new appreciation for poll workers. Kevin Brown, MSW ’21, worked a 14-hour shift at an elementary school in St. Louis. “It’s exhausting and consumes the whole day,” he said. “But I would do it again. Ultimately it felt like I was serving a useful function. It was inspiring to see that many voters exercising their right to vote.”
Several students said the high-pressure, divisive nature of the 2020 elections encouraged them to volunteer, as did the pandemic.
“This year is different,” said Madelyn Brandt, MSW ’22, who worked as a monitor at a community center in Florissant. “Older poll workers were not able to be there due to the pandemic. I wanted to get involved. It was really cool volunteering with election protection. I think our presence across the nation helped people feel more comfortable. A lot of people were fearful.”
The potential danger for poll workers was brought home to Brandt in August, when she volunteered during the primary election at a polling place in her home community of St. Charles County. She became alarmed when poll workers were not required to wear masks and alerted a local TV station after receiving an e-mail from county election officials asking poll workers to “act surprised” if voters asked them to wear a mask. Outrage over the ensuing TV story, which featured Brandt, caused authorities to reverse their policy and require masking. But on Nov. 3, a poll worker who had been diagnosed with covid-19 reported to work in the county for a full-shift anyway and died later that day.
“I’m hoping that the new masking policy kept this person from spreading their Covid, or limited the spread,” Brandt said.
Brandt, who didn’t vote until 2016, said she began to get more engaged in part due to her concentration in domestic social and economic development, with a specialty in policy. She thinks greater civic engagement is a trend in the field. “A lot of social workers are becoming more active in their communities,” she said.
One reason for that activity is its relative lack of stress compared to that which many social workers face daily, said Ryan Lindsay, an associate professor of practice and assistant dean for social work at the Brown School who volunteered after running into McClendon at a Sam’s Club. “It’s a function of how exhausted and burned out social workers are in general,” he said. “They’re working trying to fix problems they cannot solve but which create significant pain for people. They don’t have a lot left to give, but this is something they can give. They just have to show up and say, ‘Tell me what to do.’”
Lindsay said his experience at a St. Louis middle school was “super rewarding,” especially a conversation with a 93-year-old survivor of the bombings of London during World War II. “I’m definitely going to sign up for this again. This gave me an opportunity to exercise my social-justice muscle,” he said. An added benefit, he said, was the opportunity to interact with people in person.
“I haven’t been in any place I’ve seen so many humans since the pandemic started,” he said. “It was invigorating.”