By Michael J. Widener
Assistant Professor, Department of Geography & Planning
Incoming Director of Health Studies (July 2021), University College
Canada Research Chair (Tier 2) in Transportation and Health
Unprecedented and tragic. These are two of many words that have justifiably been used to describe the extraordinary situation the world finds itself in as it grapples with COVID-19. Globally, over 200,000 lives have been lost to this virus, with over 3 million confirmed cases as of April 30, 2020. And for communities around the world there is still great uncertainty around how many more will be infected, how much longer distancing measures will be in place, and when some semblance of normalcy will return.
The immediate medical toll of COVID-19 has been felt by those who have fallen ill or lost loved ones. To help those who are ill, researchers at the University of Toronto, across Canada, and around the world have rightfully focused on quick testing, treatment protocols, and vaccine development. Thanks to their work, there is optimism that the virus will be essentially powerless in the not-so-distant future.
However, for many of us, our health will not be directly harmed by the virus. This does not mean we are in the clear. COVID-19 has wreaked havoc on social and economic systems and we are only beginning to see the repercussions of this disruption. In order to fully appreciate the impact of the pandemic on our lives, in the coming months and years we need to proactively monitor changes to our social systems, with a particular focus on existing and emerging inequalities in health, economic, and social outcomes.
In the social sciences, researchers have long examined the links between health and social systems using their respective disciplinary methods, which are often complementary to the valuable work being done by colleagues in medicine and public health. Many of these social science health (SSH) researchers focus on a concept known as the social determinants of health, which include the different social, economic, and geographic factors that contribute to health outcomes and inequalities in populations. SSH researchers will play an important role in understanding the near- and long-term impacts that COVID-19 and extended isolation measures will have on these social determinants, what the implications of these will be for our most vulnerable communities, and how we might be able to move toward a more robust and equitable society in the future.
In the near-term, SSH researchers will need to focus on the most pressing issues related to stemming the spread of COVID-19 and the impact physical distancing has had on physical and mental health, as well as financial stability. This will involve working closely with medical and public health professionals to identify whether certain populations are at increased risk of infection and what social mechanisms might be responsible for these differences. Additionally, there is a great need to understand how physical distancing has affected social relationships. For example, there have been troubling increases in reports of domestic violence and abuse, and for others the stress of remaining at home has negatively affected mental health. What resources and care systems can be mobilized in the current environment? Theories from psychology and sociology are well positioned to provide answers to this through identifying stressors and coping strategies, in addition to connecting people in need with mental health or domestic violence resources.
SSH researchers must also engage in conversations surrounding how to be best address the rapid deceleration of the global economy. Many Canadians have been left without their expected wages and subsequently the ability to pay bills and buy groceries. Many others, who were already suffering from homelessness or food insecurity before the pandemic, are facing challenging situations at shelters and a surge in demand for food banks. How can economic assistance be quickly distributed to those with the most need, and where can additional shelters and food distribution points be set up for easy access? Here, theories from across the social sciences are able to guide government programs aimed at supporting household spending, and approaches developed in geography can help with locating shelters and mobile food banks where they are needed most.
In the longer-term, after the virus has run its course, SSH researchers will be faced with more complex issues, especially if the anticipated global economic downturn materializes. Interdisciplinary teams must begin to rethink the structure of long-term care for our communities’ older adults to ensure future outbreaks will not leave this population isolated and vulnerable. More generally, older adults have been hit particularly hard by COVID-19 and social scientists have the toolkit to both pinpoint which aspects of their lives were disrupted and identify social and healthcare policy priorities that might shield this population from similar outcomes during future pandemics.
We have also seen the laudable efforts of essential workers at grocery stores and in delivery trucks. They perform their tasks for little pay while risking their own health and safety. What policies might improve their working conditions and ensure their health going forward, and what protections do we as a society owe to our neighbours in these roles? There are serious ethical questions we must grapple with as so many of us rely on the essential work of those in what are commonly considered precarious jobs.
On the home front, many of us have also been made painfully aware of the limits of our own residences and the urban environments in which they are situated. Housing affordability is a major issue in Canada, and housing quality is linked to a range of health outcomes from respiratory infections to mental health. After spending so much time indoors, will people begin to consider trading in their smaller urban homes for something more affordable and spacious in the suburbs in the name of maintaining health? And for those who live in community housing units, are public institutions investing enough in these homes to ensure that residents will not be subjected to further negative health impacts? Anthropologists, urban planners, and historians can help guide us through these questions by looking into our past, understanding our relationship to housing and shelter, and anticipating what might be needed going forward.
For those of us who have been able to leave our homes, have we been impacted by the lack of public space that would enable safe and physically distanced outdoor activities? Do we continue to build our cities in a way that emphasizes the automobile, or will this moment inspire people-oriented urban design? For many, months of being confined to relatively small geographies may have a profound impact on how we think about our physical, social, and urban environments. What are the mental health implications, and could this be an opportunity to engage in more equitable and healthier city building? Researchers in urban planning, geography, and political science should be front and centre when discussions about urban infrastructure stimulus and future public space inevitably arise.
Finally, and perhaps most importantly, SSH researchers must closely monitor the longer-term impact a post-COVID-19 financial downturn has on economic inequalities. Increases in negative health outcomes amongst those who are already in vulnerable financial situations are unacceptable. SSH researchers across many disciplines are in an ideal position to collect data on health and economic inequalities, through techniques that range from interviews and walkalongs to GPS tracking and large-scale surveys, to understand the struggles of our most at risk communities and produce policy recommendations that address key economic and social drivers of these hardships.
Ultimately, the next few years will present a moment where the links between public health and the social sciences have never been more relevant. Researchers in this space will have a great deal to contribute as the immediate medical crisis subsides and the social and economic repercussions of the pandemic become more apparent. Beyond this, these researchers will be key in educating the next generation of social scientists who will require broad training in many disciplines to tackle both the expected and unanticipated challenges that come after the pandemic. Units like University College’s Health Studies Program are ideally situated to provide this important training.
With a toolkit that engages directly with communities and policy makers, social science researchers have the theories and methods to ensure that the pandemic recovery happens quickly and equitably. And, perhaps, this moment will provide a once in a generation opportunity for social scientists to work with community members, healthcare professionals, and politicians to reconsider how many components of our social systems work--making them fairer and more robust to any future health and economic shocks.
This article is the first in a three-part series on COVID-19 by Health Studies researchers at University College.