Authored by Nason Maani and Sandro Galea.

The COVID-19 pandemic is at the core of a triple crisis facing the U.S. population. The economic impact, both as a direct consequence of the pandemic and from the cost of accompanying mitigation measures, is the second element of the crisis; it has manifested in lingering high levels of unemployment, with some 26.8 million workers, almost 16 percent of the entire U.S. workforce, either unemployed, otherwise prevented from working by COVID-19, or employed but on reduced pay.

Linked to both are the exacerbating effects of the third element of the crisis: the civil unrest and protests linked to systemic racism. While these emerged last year in response to the killing of Black Americans at the hands of police, long-standing racial inequities have also resulted in the overrepresentation of minoritized groups among those exposed to COVID-19, those experiencing severe infections and deaths, and the ranks of the unemployed.

One of the enduring highlights of working at a school is the regular return of the academic seasons, and, with it, the chance to welcome our community back for a new semester, and to welcome the students who are joining us for the first time this spring. This year, the joy of welcome is tinged with sadness. Last week, the number of COVID-19 deaths in the US exceeded 400,000, a toll of sorrow which adds to the overall weight of sickness and death this disease has brought to the world. Yet even, perhaps especially, in the midst of challenge, we are grateful to be connected, and to pursue the goal of a healthier world. So, welcome to all, and, especially, to our newest students.

We begin our Spring semester at a moment of transition. The inauguration of President Joe Biden and Vice President Kamala Harris represents a political sea change, and, with Vice President Harris and the many firsts her rise reflects, a win for representation in government. Concurrent with this transition, we have also seen a potential turning of the tide in this pandemic. Sadly, ending COVID-19 cannot be accomplished as quickly as a presidential transition. However, the emergence of vaccines, and the new administration’s commitment to their effective distribution, represents what we will hopefully soon be able to say was the beginning of the end of this crisis. So, while the hour remains difficult, we have finally reached a point where we can see the dawn of a better day for health.

Sandro Galea is a contributing author.

The health of Americans is not as good as it could be and is worse than the health of populations of other wealthy nations. America’s lower health status, referred to as the U.S. health disadvantage, inflicts costs on individuals, families, businesses, and society. The coronavirus pandemic of 2020 exposed additional costs as the virus claimed more lives among those with certain underlying conditions—such as obesity and diabetes that are found in greater proportion among Americans than among residents of many other wealthy countries—and disrupted the economy to such a grave extent that access to healthcare coverage was diminished, as millions of individuals lost employer-sponsored health insurance, and preventive services were interrupted. For businesses, the U.S. health disadvantage increases healthcare costs, lowers productivity and competitiveness, and compromises business success and growth. This report strives to convince business leaders of the importance of community health to the bottom lines of businesses and to the health of the economy. The report (a) highlights the U.S. health disadvantage and the importance of strengthening communities and improving the health of residents, and (b) offers recommendations for how businesses can address the U.S. health disadvantage by engaging with and investing in communities, while creating value, lowering business costs, and improving the health of employees and other stakeholders. Given the power of business in American society, efforts to improve community health and recover and then extend economic prosperity will be insufficient without actions by business leaders.

The central story of the Covid-19 pandemic is one of health inequity. Black Americans have experienced higher rates and more severe cases than white Americans, and overall Covid-19 has been more prevalent among people of color. The roots of these inequities are not new; they lie in a long history of marginalization and disenfranchisement dating back centuries. Black Americans in particular live shorter, sicker lives than do white Americans.
While there has been much discussion of Black-white health disparities over recent decades, the solutions that are regularly proposed involve efforts to improve the health care system on its own. But this is not enough. The Biden administration can work toward rectifying fundamental health inequities by moving us toward Black reparations. Reparations can take many forms, ranging from ideas like baby bonds to cash transfers to adults, either of which would at least help to improve the current state of affairs. The Biden administration can, early in its tenure, establish a high-level commission to assess the best approach to implement Black reparations, to conduct return-on-investment analyses and to make the case to the country that we will not, in any foreseeable future, narrow health inequities without some form of Black reparations.