Covid-19 is temporary. The health ramifications of failing to provide adequate economic relief may last decades

The rollout of a Covid-19 vaccine across the U.S. that began this week suggests that dramatic disruptions to daily life may come to an end within the next year.

Even as Americans anticipate a return to a post-Covid-19 world, it is important to recognize that the nature of these disruptions has been dramatically different for people across the U.S. While some wish to safely dine in restaurants and watch movies in theaters, millions of families are struggling to make rent and car payments and suffering from prolonged unemployment. Many fear imminent eviction and report high levels of food insecurity, especially households with children.

The U.S. is at a critical moment in the pandemic. Without further support, the health effects of homelessness, food insecurity, and extended unemployment will last a lifetime, far overtaking the effects of Covid-19 that we have witnessed during the past year.

Congress can avert long-term harm to health and human capital by passing another economic bill that includes further stimulus checks, contains an eviction moratorium, and renews the expanded pandemic unemployment insurance programs. As it stands now, the stimulus bill being tensely debated in the Capitol falls short of what is needed, likely failing to provide any aid to state and local governments. The economic burden of the moment, falling disproportionately on low-income households, threatens to become a set of health consequences with a long tail.

Since the pandemic began, more than 150,000 evictions have been filed and more than 40% of renters nationally report not being able to pay their rent next month. The damage from eviction is prolonged. When a home is foreclosed on or a family is evicted — which disproportionately happens to families of color — they are at increased risk of contracting Covid-19. Job loss, depression, setbacks to child health and education, and the inability to relocate to housing of choice often ensue as well.

Millions of Americans experienced these outcomes as a result of foreclosure or eviction during and after the Great Recession in the late 2000s, leading to major losses of wealth and elevated suicide rates. The home equity of millions of Black and Latino homeowners deteriorated and never fully recovered, worsening the racial wealth gap.

Twelve percent of all U.S. households report that they have not had enough to eat in the last seven days. Food insecurity is even more common in households with children. This contributes to a host of health problems, especially among children, including asthma, birth defects, cognitive issues, worse general health, and greater susceptibility to chronic diseases. Children who lack access to sufficient and nutritious food can face poor growth and emotional problems. There will be dire, lifelong repercussions for a generation of children.

Unemployment is yet another path to poorer health if not properly addressed. The detrimental effects of sustained periods of unemployment are legion: lower wages in future jobs, deterioration in mental and physical health, elevated crime rates in communities, and the risk of dropping out of the labor force indefinitely. It is today an emergency: Almost twice as many Americans are claiming unemployment insurance benefits during the time of coronavirus than at the height of the Great Recession.

More than 13 million people will exhaust their unemployment benefits by the end of December as federal unemployment programs expire. With their elimination, the U.S. unemployment insurance system will once again stand out among high-income countries as covering a low proportion of people, with a low amount of benefits, and for a short duration of time.

Congress can do much to address these public health crises of food insecurity, evictions, and joblessness with a strong stimulus bill, and it needs to act now.

Expanding unemployment insurance after the 2008 economic collapse pulled millions of people out of poverty and limited the extent of job loss by growing the economy by $2 for every $1 spent on unemployment insurance benefits. Earlier this year, Congress expanded unemployment insurance with the CARES Act, helping stabilize consumer spending and increase household savings. Congress can do that again. People want to get back to work, but there aren’t enough jobs available for everyone out of work. Policy decisions must reflect these grave realities and extend financial protections to ensure Americans remain housed and fed. Economic relief would also avoid further perpetuating racial disparities in Covid-19 mortality.

Some members of Congress, across party lines, have advocated for a stimulus bill that provides direct cash relief to alleviate the burdens on vulnerable Americans. The original stimulus checks and unemployment benefit expansions supplied by the CARES Act were associated with reduced food insecurity and poverty, as well as lower risk for depression and delaying health care. To ensure that everyone in the U.S. is able to afford their basic necessities this winter and beyond, these programs should be renewed and another round of stimulus checks distributed.

Only Congress can prevent catastrophe for millions of Americans; states cannot protect people to the same extent as the federal government. In both the Great Recession and the Covid-19-induced recession, states have found themselves in fragile fiscal situations and, struggling to manage all necessary payments, often cutting jobs and public assistance programs. Both times, the federal government has stepped in to provide monetary support. However, given widespread balanced budget requirements and declining tax revenue, this aid has been inadequate as states have turned to austerity measures. Now is not the time to reduce necessary spending. Congress should support state and local governments with additional funding.

The first wave of Covid-19 vaccine distribution may be the light at the end of the tunnel. But to make sure that everyone reaches the exit, Congress needs to provide additional support to Americans. The renewal of federal pandemic unemployment programs, extending the eviction moratorium, and distributing a second round of stimulus checks are essential to protecting public health.

Failing to do so will cause permanent damage to millions of families and slow our post-pandemic recovery.

Will Raderman is a research fellow at the Boston University School of Public Health. Elizabeth Pancotti is a policy advisor at Employ America. Julia Raifman is an assistant professor of health law, policy, and management at the Boston University School of Public Health and leads the Covid-19 U.S. State Policy Database.