Association between pre-pandemic wealth and material hardships during the COVID-19 pandemic

Association between pre-pandemic wealth and material hardships during the COVID-19 pandemic

Alexandra Skinner, Nicole C. McCann, Chanelle J. Howe, Kathryn M. Leifheit, Lorraine T. Dean, Yareliz Diaz, Catherine K. Ettman, Julia Raifman, Paul R

Journal paper

Health Affairs Scholar

2025

Background The COVID-19 pandemic was characterized by large racial and ethnic inequities in acute material hardships. Pre-pandemic economic conditions, including household wealth, may have contributed to these disparities. Methods We used longitudinal data from the Understanding America Study surveys to 1) describe racial and ethnic differences in pre-pandemic household wealth; and to 2) evaluate the association between pre-pandemic household wealth and acute material hardships during the pandemic. Results We found large racial and ethnic inequities in pre-pandemic wealth, with 48.3% of non-Hispanic White households reporting wealth greater than $100,000, compared to 16.4% and 29.8% for non-Hispanic Black and Hispanic/Latino households, respectively. Adjusted Poisson regression models clustered by household revealed that, during the pandemic, households with less than $100,000 in pre-pandemic wealth had 1.7-3.0 times higher prevalence of food insufficiency and 1.4-2.0 times higher prevalence of housing insecurity compared with households with more than $100,000 in pre-pandemic wealth. Implications Wealth inequities, which are racially patterned in the United States, shape vulnerability to material hardships such as food insufficiency and housing insecurity during economic crises.