This past Saturday, 1,300 families in Miami County utilized the services of the largest foodbank in the region to access free food for their household. This number represents a 400 percent increase in demand for this monthly service, come to be known as a “pop-up pantry,” as compared to February of this year. Plenty has changed in our community over the last 60 days, but the question we should ask is not, “How did this happen?” but rather, “What does this look like moving forward?” How long will the food lines be post COVID-19?
Social disparity, or the measure of functional limitations faced by sub-populations in society, has always been a reality for residents of Miami County. The disparities in food, shelter, medical care, financial literacy, etc., have created barriers for our neighbors and loved ones for some time, whether we wish to admit it or not. The only difference today is the incredible increase and visibility of the disparity. There are estimates that nearly 40 percent of Ohio residents will wait in the food line at some point before our economy has a chance to recover. Authorities still cannot put a figure on the potential homelessness that residents will face in the next six months and we at Health Partners Free Clinic can predict a minimum 25 percent increase in need for free healthcare. Without having lived through a pandemic, officials do not know what the aftermath looks like nor understand appropriate preparation.
Structural violence, however, is a concept that is rearing its ugly head through this crisis and is something many do not realize has been here all along. In definition, structural violence is the imposition of unequal risk for disease, injury, and death by social, political, institutional, and economic configurations and policies on identifiable population groups. Simply put, it is the violent policies imposed on impoverished populations without the realization of the rest of society. There are everyday examples of this violence right under our nose. Think of the sub-prime high interest rate car loans that individuals with poor credit utilize because they must get into reliable transportation in order to maintain employment. Or the decision to utilize a stimulus check to purchase food or clothing while not realizing the fact that a landlord will still come looking for rent after being kind enough to let a tenant default payment for a month. Maybe it is just simply assuming that everyone around you grew up in a supportive home where they received a positive financial education. Some of this should just be “common sense” right? Perhaps that sense isn’t as common as we all think.
So, what do social disparity and structural violence have to do with a world post pandemic? These concepts and the magnitude in which they exist in our community may well set the stage for the length of time it will take us to recover. Structural violence builds the foundation that social disparity lives on. Many may experience social disparity soon simply because they skated right above it until now. In a 2019 Forbes Magazine article, it was reported that 78 percent of Americans live paycheck-to-paycheck. The article, based on a 2017 survey performed by CareerBuilder.com, went on to state that 25 percent of workers do not save money at all, 75 percent are in debt, 50 percent of minimum wage workers have to work more than one job, and only a third of those surveyed use a budget at all.
If social disparity is a precursor to poverty, then structural violence is the predatory policies and industries that take advantage of those in poverty. This concept births the high interest loans utilized by industries like buy-here-pay-here used car lots. Or the merchant cash-advance industry that promises fast and easy loans today for a pound of flesh tomorrow. Structural violence is all around us while completely invisible to many at the same time. Those who will succumb to social disparity in the coming months may get to see structural violence for the first time in their lives. It may be scary, but we will all be in new territory.
Miami County is a generous community where there resides many caring individuals, agencies, and foundations. Citizens truly care for each other and we have felt that love at the Clinic for sure. This is a time for us to take a moment as a community to recognize how close to the brink folks live. Many at no fault of their own. We should take the time to analyze our political and economic structures while wearing someone else’s shoes.
Justin Coby, PharmD, has been affiliated with Health Partners Free Clinic as a volunteer pharmacist since 2007, and was appointed executive director in 2012.