This piece is the second in a three-part series examining the economic and social conditions that impact health outcomes in Southern states, and how these conditions leave communities underprepared to protect front-line workers and communities during the COVID-19 pandemic.

In our earlier post, we described how Southern state lawmakers’ refusal to expand Medicaid, implement paid sick leave policies, allocate sufficient public health resources, and quickly adopt social distancing practices put the health of many workers and families at risk from COVID-19. The coronavirus pandemic is also causing an extraordinary economic crisis that is projected to disproportionately harm Southern states because retail, leisure, and hospitality make up higher-than-average shares of total private-sector employment in almost all Southern states. That’s a key reason why average wages in the South are lower than the rest of the country, and this economic crisis will hit low-wage workers first and hardest.

There are many actions state and local policymakers can take to mitigate economic harm and target responses effectively to provide relief to impacted communities. This includes strengthening unemployment insurance, increasing basic needs assistance, and addressing racial, gender, and additional equity concerns.

Bolster and expand unemployment insurance and adopt work-sharing

Unemployed people need greater state-level protections to maximize federal aid and receive necessary economic relief. However, several states in the South have some of the lowest unemployment insurance recipiency rates in the country, including Alabama, Florida, Georgia, Louisiana, North Carolina, South Carolina, and Tennessee. State policymakers must do more to bolster an already strained unemployment insurance system and expand access by increasing funding for administering unemployment insurance, lowering weekly earning requirements to include all low-wage workers, and eliminating work search requirements and waiting periods. They should also strengthen benefits by increasing the percentage of lost wages replaced and extending the duration of unemployment insurance to at least 26 weeks.

Recently, Georgia’s Department of Labor extended the duration of unemployment insurance from 14 to 26 weeks, while lawmakers in Georgia, Kentucky, Louisiana, North Carolina, Texas, Virginia, and West Virginia have all temporarily waived the waiting period and work search requirements. Only a few Southern states—Arkansas, Florida, and Texas—have work-sharing programs, which help employers avoid layoffs by allowing employees to work reduced hours while collecting partial unemployment benefits to offset their lost hours. In Georgia, the governor and labor commissioner are requiring employers to file for partial unemployment insurance on behalf of their employees, and the Kentucky governor and legislature recently enacted work-sharing in response to the state of emergency. More state policymakers should follow suit.

Help families make ends meet and put food on the table

For families already struggling to pay rent and buy groceries, additional economic relief is even more critical as social distancing guidelines are implemented and schools remain closed. The most recent Census Bureau data before the onset of the coronavirus pandemic showed that poverty rates tend to be higher in Southern states, unaided by low-paying jobs and lower rates of unionization. State and local policymakers must declare moratoriums on foreclosures, evictions, utility shutoffs, and collection of court and medical debt.

State policymakers should also increase aid to social services and increase benefit amounts for direct income support programs, including the Supplemental Nutritional Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and Special Supplemental Nutrition for Women, Infants, and Children (WIC). States can also remove barriers to receiving direct income support such as unnecessary work requirements, approve applications for SNAP and WIC over the phone or online rather than in person, and continue to provide food for children receiving free or reduced-price meals in schools—requesting waivers from the federal government where needed.

Protect front-line workers and communities

Even as shelter-in-place orders are active around the country, many workers and communities remain on the front lines of the crisis and require specific protections. Workers providing “essential services,” including health care workers as well as food service, child care, sanitation, and transportation workers, must have personal protective equipment and medical supplies. Child care or other caregiving supports are also critical for these workers, especially for women and women of color, who tend to shoulder caregiving responsibilities.

For example, food service workers continue to go to work, stocking shelves and working as cashiers at grocery stores. Nationally, food service workers and grocery store workers are paid less than $14 an hour on average, about 42% lower than the typical private-sector worker. Workers at general merchandise stores—a category that includes retailers like Walmart and Target—face a similar pay gap (38% lower than other workers), while couriers and messengers—who deliver groceries and meals—are paid about 21% less than other workers.

On top of their low wages, many of these workers don’t have access to paid sick days unless they test positive for COVID-19. Hazard pay and one-time bonuses are insufficient. These workers need paid sick days and permanent increases in wages and other benefits that aren’t contingent on contracting or being exposed to the coronavirus. Low wages in these occupations make it particularly important that Southern states boost what are currently inadequate levels of public support for child care.

Specific populations in the South are also more at risk of contracting the virus and experience more challenges to receiving adequate medical care even when not faced with a global health emergency. People who are incarcerated in jails, prisons, and detention centers face greater health risks from COVID-19. Incarceration rates are also highest in the South. Black and Latinx people are more likely to be incarcerated than white people nationally, and a growing share of people who are incarcerated are women. Many options are available to state and local policymakers to help reduce the spread of the virus and protect the health and safety of people who are incarcerated, including offering necessary medical care and supplies at no cost and prioritizing people for release.

Rural communities also face higher risks from the coronavirus. These communities have higher proportions of people more vulnerable to the disease, including those who are older and those with disabilities. Workers in rural communities are less likely to have paid sick leave. They are less likely to be able to work remotely, both because of a lack of access to reliable high-speed internet and because the service sector employs the largest number of workers in rural communities.

Rural communities already lack access to adequate and affordable health care, and policymakers’ refusal to expand Medicaid has exacerbated the problem in most Southern states. States that expanded Medicaid have experienced fewer closures during the recent spate of rural hospital closures. But most Southern states have not expanded Medicaid under the Affordable Care Act. This has led to Southern states, which had just 38% of all rural hospitals in 2013, accounting for 77% of rural hospital closures from 2013 to 2017.

While additional federal action is needed, in particular a smarter increase in support to state and local governments, Southern state and local policymakers must do more to combat the coronavirus pandemic and target solutions to meet the needs of front-line workers and communities. Many of the policy solutions described above—good jobs, a strong safety net, and equitable outcomes for women and people of color—point to the need for long-term, permanent reforms for thriving healthy communities in the South and around the country, and not just in times of extreme crises we’re currently facing. In the third piece of this series, we will address what is especially needed in these states to strengthen democracy while also protecting voters’ health.