The poor in Germany have a higher risk of falling sick from COVID-19

By Elisabeth Zimmermann
30 June 2020

The poorest people in Germany, including the long-term unemployed and recipients of Hartz IV social welfare, have an 84 percent higher risk of becoming seriously ill with COVID-19 and requiring hospitalization. Among recipients of unemployment assistance—that is, those in the first year of unemployment—the risk is 17.5 percent higher than among workers with regular employment.

This is the conclusion drawn in a study conducted by the Institute of Medical Sociology of the University Hospital of Düsseldorf and the health insurance fund (Krankenkasse) AOK Rheinland/Hamburg, which was reported in the ARD-Mittagsmagazin on June 15.

Food bank (Tafel) in Munich

The study analyses data from nearly 1.3 million insured individuals and examines whether the short-term and long-term unemployed require hospital treatment more often than those with employment. The study covers the time period from January 1 to June 4, 2020.

The exploratory analysis is intended to serve as a starting point for further research into the social dimensions of the COVID-19 pandemic, explains the principal author of the study, Professor Nico Dragano of the University Hospital of Düsseldorf. “Should these results be confirmed, this would be further evidence for distinct social differences in disease affliction in Germany,” Dragano says.

Studies from recent years demonstrate that the poor die younger than the rich. The life expectancy for men living in poverty is on average 10 years lower than among the rich. For women living in poverty, the reduction in life expectancy is eight years. Poorer people commonly suffer more seriously from diabetes and illnesses of the heart, among other medical afflictions. Often they cannot afford sufficient or optimal treatment and are under extreme pressure from their circumstances.

The German federal government and the federal health authorities have not commented on the initial findings of the University of Düsseldorf investigation.

As in every country in the world, the COVID-19 pandemic in Germany presents an especially life-threatening danger to the working class, particularly its poorest and most vulnerable layers. The latest and so far largest outbreak of COVID-19 in Germany, at the Tönnies meatpacking plant, where 1,500 workers have thus far been infected, is a particularly egregious example.

The data worldwide demonstrate that the coronavirus pandemic especially affects the working class and the poor. According to the Office of National Statistics (ONS) in Great Britain, the death rate from the virus is more than twice as high in socially disadvantaged parts of the country than in the least socially disadvantaged parts.

The director of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, has addressed this, stating: “A crisis can exacerbate existing inequalities, which is seen in the higher rates of hospitalization and deaths among specific social groups.”

Likewise, the Institute for Employment Research (IAB) of the German Federal Employment Agency published a report on June 10 on individuals in the basic welfare program that makes clear why the crisis hits these people particularly hard. The report points out the cramped living conditions of poorer people, the lack of internet access and the danger of social isolation, since many live alone. The study is based on numbers provided by the Panel Study on the Labour Market and Social Security (PASS) from the years 2017 and 2018.

Living in close quarters, it is difficult or impossible to maintain social distancing protocols, especially when children cannot go to a school, kindergarten or playground. Working from home, children’s participation in school instruction is made difficult by a lack of space or separate rooms. Families with children represent roughly a third of those drawing social welfare. Forty percent of them live in crowded living conditions.

Roughly a fifth of those drawing social welfare are over 60. For them, the danger of a severe case of COVID-19 is greater and the maintenance of social distancing more important. The danger of social isolation is for them especially great.

Almost half of those drawing social welfare live in households without another adult. In households without social welfare, by comparison, only one in four adults lives alone. Whether or not one is socially isolated depends on one’s social network, and thus on one’s access to computers and the internet.

In times of stay-at-home orders and contact bans, computers with internet access and smart phones are more important than ever for information and social interaction. With schools closed, children’s digital participation in classes and programs is dependent on access to the internet.

While 87 percent of people without welfare have access to an internet-capable computer, this is true for only 70 percent of those drawing welfare. In households with school-aged children, the rate is 78 percent. That means that 22 percent of these households have no computer with which to participate in home schooling. Ninety-seven percent of households with children without welfare have access to internet connections.

The Federation of Food Banks (Bundesverband der Tafeln) is registering increased demand from those needing help. Of the 947 food banks in Germany, 120 are still closed and the demand is enormous. Many of the volunteers assisting in food distribution, because of their age or their state of health, are themselves among the highest-risk groups for COVID-19.

The chairman of the Federation of Food Banks, Jochen Brühl, stated: “In recent weeks we have experienced a new form of need.” In particular, younger people have sought help because of existential need, among them many students, including those who normally work while at school in the gastronomy and service sectors. Due to the closing of restaurants and cafes, most have lost their jobs.

At the end of 2019, food banks nationwide had 1.6 million regular users, roughly a third of whom were children and another third older people whose retirement benefits were not sufficient to support them.

Those in low-wage sectors and those who, without sufficient protection, come into contact with many people are at particularly high risk of being infected with COVID-19. This includes nursing staff, cashiers, bus drivers and workers in logistics firms such as the parcel service DPD and at logistics centers such as Amazon. In these areas, there have been repeated breakouts of the disease. The companies are trying to suppress information on the number of infections occurring in their workforces. In this they receive the full support of the unions.

IG Metall and other unions are often the strongest advocates of ramping up production in auto and other industries where closures were implemented during the lockdown. Workers who are concerned for their health and that of their loved ones cannot expect any support from these organizations. They must take the fight for their security and their basic interests and needs into their own hands.

The coronavirus pandemic throws a spotlight on social inequality and exacerbates it. While the federal government throws hundreds of billions of euros into the maw of the banks and corporations, there is no support for those already living in difficult conditions, whose ranks are swelling due to mass redundancies and the destruction of social programs.

With the irresponsible back-to-work campaign, millions of workers are forced to risk their health to generate billions for the rich, the corporations and the banks.

 

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