The AHURI-HUD International Housing Policy Exchange highlighted the role of social and economic inequality in health outcomes. The participating countries all reported people with inadequate housing who lived in low socio-economic areas were disproportionately affected by the virus. The Sydney lockdown in July 2021 has once again demonstrated a correlation between high rates of transmission and socio-economic vulnerability.
The Policy Exchange examined how housing conditions experienced by low income earners can contribute to the spread of COVID-19. In situations where many people share housing and there is crowding, quarantining individual household members is challenging. When multiple generations live under the same roof it can also be difficult to protect household members with health vulnerabilities.
Quarantining challenges for low-income households
Low-income workers and casual workers are at greater risk of exposure to the virus because their jobs are often in service industries or involve manual labour and cannot be performed from home. Many of these jobs are also in frontline service roles and involve the risk of direct exposure through face to face contact with the general public. Furthermore, insecure and casual workers are likely to feel more compelled to attend work irrespective of symptoms, because they cannot afford the loss of income and may not be eligible for paid sick leave.
Canada reported that there were higher rates of secondary infections in low-income households because workers ‘brought COVID home’ and were less able to effectively quarantine or social distance within their homes. This is particularly challenging in a house with inadequate space for all of its occupants, particularly when there is only one bathroom, and health hardware is in poor condition.
In Melbourne, which had the worst COVID outbreak of all Australian cities in 2020, infection rates were higher for insecure workers living in multi-generational, crowded housing. There was a controversial ‘hard lock down’ of several social housing towers where inadequate facilities, multigenerational living and many people in casual, frontline roles with high risk of exposure resulted in an outbreak.
COVID-19 restrictions have exacerbated precarious income and employment situations, leading to housing stress and other vulnerabilities such as increasing food, energy and fuel poverty in low-income groups.
In Melbourne, which had the worst COVID outbreak of all Australian cities in 2020, infection rates were higher for insecure workers living in multi-generational, crowded housing.
Unsupported populations
Rent and mortgage holidays contributed significantly to more immediate housing ‘rescue’ measures in response to COVID-19, but these measures have not helped some groups (such as international students) who live in informal housing arrangements.
Representatives from Spain referred to the ‘hidden homeless’ which included refugees, temporary migrants (including international students), itinerant populations (such as the Roma population in Ireland) and casual or insecure workers living in crowded or substandard accommodation. Many of these people were unsupported by government welfare policies, and ineligible to access the same supports provided to rough sleepers.
In Melbourne Australia, which has been one of the world’s most popular cities for international students, the federal government did not provide any support to this group during the crisis.
Targeted responses in lower socio-economic areas
The need to provide targeted support to households in low socio-economic areas has been identified as the pandemic has progressed; and there may be opportunities to use housing and accommodation approaches to break the chains of transmission for low income households.
In Spain there were additional restrictions placed on the mobility of residents in lower socio-economic neighbourhoods. These policies were controversial because they were applied unevenly across the city and placed heavy restrictions on low income workers in their personal time, while still permitting them to leave their local areas for essential work. There were also ‘obligatory quarantines’ in neighbourhoods where there were increasing infection numbers.
Recognition of the issues with effectively isolating at home facing workers in aged care and other frontline workplaces led to the Victorian Government providing out-of-home isolation, originally known as ‘hotels for heroes’ in Victoria.