Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, United States of America.
PLoS One. 2020 Oct 6;15(10):e0240080. doi: 10.1371/journal.pone.0240080. eCollection 2020.
The global COVID-19 pandemic is causing unprecedented job loss and financial strain. It is unclear how those most directly experiencing economic impacts may seek assistance from disparate safety net programs. To identify self-reported economic hardship and enrollment in major safety net programs before and early in the COVID-19 pandemic, we compared individuals with COVID-19 related employment or earnings reduction with other individuals. We created a set of questions related to COVID-19 economic impact that was added to a cross-sectional, nationally representative online survey of American adults (age ≥18, English-speaking) in the AmeriSpeak panel fielded from April 23-27, 2020. All analyses were weighted to account for survey non-response and known oversampling probabilities. We calculated unadjusted bivariate differences, comparing people with and without COVID-19 employment and earnings reductions with other individuals. Our study looked primarily at awareness and enrollment in seven major safety net programs before and since the pandemic (Medicaid, health insurance marketplaces/exchanges, unemployment insurance, food pantries/free meals, housing/renters assistance, SNAP, and TANF). Overall, 28.1% of all individuals experienced an employment reduction (job loss or reduced earnings). Prior to the pandemic, 39.0% of the sample was enrolled in ≥1 safety net program, and 50.0% of individuals who subsequently experienced COVID-19 employment reduction were enrolled in at least one safety net program. Those who experienced COVID-19 employment reduction versus those who did not were significantly more likely to have applied or enrolled in ≥1 program (45.9% versus 11.7%, p<0.001) and also significantly more likely to specifically have enrolled in unemployment insurance (29.4% versus 5.4%, p < .001) and SNAP (16.8% versus 2.8%, p = 0.028). The economic devastation from COVID-19 increases the importance of a robust safety net.
全球 COVID-19 大流行正在导致前所未有的失业和财政压力。目前尚不清楚那些直接受到经济影响的人如何从不同的安全网计划中寻求帮助。为了在 COVID-19 大流行之前和早期确定自我报告的经济困难和主要安全网计划的参保情况，我们将与 COVID-19 相关的就业或收入减少的个人与其他个人进行了比较。我们创建了一组与 COVID-19 经济影响相关的问题，这些问题被添加到一项针对美国成年人（年龄≥18 岁，讲英语）的横断面、全国代表性在线调查中，该调查是在美国 AmeriSpeak 小组中进行的，时间为 2020 年 4 月 23 日至 27 日。所有分析均经过加权处理，以考虑调查无应答和已知过采样概率。我们计算了未调整的双变量差异，比较了有和没有 COVID-19 就业和收入减少的人与其他个人。我们的研究主要关注在大流行之前和之后七种主要安全网计划（医疗补助、医疗保险市场/交易所、失业保险、食品储藏室/免费餐食、住房/租户援助、SNAP 和 TANF）的知晓率和参保情况。总体而言，所有个人中有 28.1%经历了就业减少（失业或收入减少）。在大流行之前，39.0%的样本参加了≥1 项安全网计划，随后经历 COVID-19 就业减少的个人中有 50.0%参加了至少一项安全网计划。与没有经历 COVID-19 就业减少的个人相比，经历 COVID-19 就业减少的个人更有可能申请或参加了≥1 项计划（45.9%比 11.7%，p<0.001），并且更有可能特别参加了失业保险（29.4%比 5.4%，p<0.001）和 SNAP（16.8%比 2.8%，p=0.028）。COVID-19 造成的经济破坏增加了强大的安全网的重要性。
