Alex Klek Problem Statement As COVID-19 spread internationally, the World Health Organization announced the virus as a global pandemic. The United States implemented a wide variety of strategies to help combat the spread of the virus; including social distancing. Although it has been scientifically proven through research that public health interventions limited the spread of Covid, but the economic disruption due to the interventions were lopsided. The problem in question was the relationship between the safety of public health and social safety net protection in the United States. Background Section Non-pharmaceutical interventions (NPIs) and public health interventions were positively associated with limiting the spread of Covid. The United States reported 34 million confirmed COVID infections and 600,000 deaths (Ahlers, 2021). Many strategies were implemented to combat Covid; including the public mask mandate, closing of non-essential businesses, indoor gathering bans, and stay at home orders. Although NPI’s forced behavioral adjustments, several of the interventions were proven to decrease the number of COVID cases. The most effective NPI for limiting infection rates was the stay-at-home order, the p-value was 0.0284, which proves strongly that the order was very effective. Secondly, the public mask mandate incurred a p-value of .0001, proving the significance of the mandated order (Ahlers, 2021). When considering mortality rates, the stay-at-home order was the only NPI shown to decrease COVID19 mortality. No significant associations between mortality and the other NPI’s were found through the research. State polices and COVID-19 infection rates within the state were directly correlated. The unemployment rate forced some states to discontinue the lock down orders and reopen earlier than they should have. South Carolina reopened just 13 days after the stay-at-home order was put into place and they saw a dramatic increase in daily new cases of Covid (Zhang, 2020). States were in control of which NPI’s they would like to choose, allowing comparative data between states and their correlating COVID infections. States that held strict and consistent NPI’s through the entire year had much smaller peak rates during the fall/winter months compared to states with lenient or nonexistent NPI’s (Avery, 2021). Safety nets allowed states to enforce stay at home orders sooner and lift the policy later due to the resources available. The combination of both public health orders and safety nets affect the general well-being of society. States that allocated safety nets were able to keep their communities less at risk for contracting Covid- 19 (Mildred, 2021). Racial and ethnic minorities were affected the most by the public health interventions implemented in the United States. This group is more likely to be low-income as well as having pre-existing medical conditions such as obesity and diabetes (Mildred, 2021). People of color were 2.4-2.7 times more likely to acquire Covid compared to white individuals (Zhang, 2020). Ethnic minorities who were working during the pandemic has had more reports of unsafe conditions and negative experiences compared to their white counterparts. People from ethnic backgrounds were less likely to receive precautionary measure to limit the chance of becoming infected at their work environment, including face masks and eye protection. They are also more likely to have a household with several generations of families or multiple occupations which increases their rate of infection and mortality (Zhang, 2020). The lack of social safety nets when implementing NPIs negatively impacted the social determinants of health for the population in the United States. As public schools began to close due to the dangerous nature of Covid; many students relied on the Universal School Meals Program. Students if applicable received a free or reduced lunch during school hours. Being deprived of this right increased food insecurity specifically to students living in poverty. Students living in poverty were the most impacted due to the high rate of participation of the free lunch program, compared to students not enrolled in the lunch program. Food insecurity can lead to malnutrition which poses risks to the child’s physical and mental health. Children were not the only ones facing food insecurity. Households struggling with food insecurity prior to the pandemic were more prone to deal with this issue; households that had no prior experience with food insecurity encountered it. A survey collected at the height of the pandemic recorded 20 million adults did not have enough food to eat in the last seven days (CBPP, 2022). Low-income families also would utilize food banks, but during the pandemic 40% of emergency food services shut their doors due to high infection rates. In addition, 73% of food bank closures were recorded in neighborhoods that were considered “high need” (Russo, 2021). The United States Federal and State governments began to introduce NPI’s which was followed with the closing of nonessential business. This in turn caused a substantial increase in unemployment and economic burden on individuals. While financial hardships increased, the ability to pay rent fell; 1 in 6 renters were behind in rent, (CBPP, 2022). As families faced hardships relating to their rent, they were forced to cut funds from other areas. Grocery shopping and purchasing food was the first cost allocated for families which foreshadows a loss of nutritional healthy food. Covid-19 negatively impacted individuals psychologically status due to an increase in stress and fear. Predominantly in older adults, the stay-at-home orders increased levels of loneliness, anxiety, depression, and poor sleep quality. Individuals were forced to adapt to the changing mandates of social distancing causing a change in social connections between families and friends. Platforms such as Zoom and Facetime began to become very popular to people who had access to the resources to conduct this method of interaction. Individuals from an ethnic background or low-income area are less likely to have access to technology to connect with relatives. In turn giving rising to an increase level of loneliness and social isolation for this group of individuals (Russo, 2021). As State governments began to roll out NPI’s, the healthcare system began to change how individuals will complete their doctor visits. Dependent on the individual’s health status, appointments were made though telehealth services as non-emergent appointments were not authorized to be completed in-person. Individuals who are undocumented, uninsured, and lowincome faced challenging barriers relating to accessibility of healthcare services prior to Covid. Accessibility for these services decreased even more causing individuals to self-medicate or prolong the prognosis of a health issue causing even more harm to the individual. Primary care visits between April and June were much lower compared to recorded visits in past years (Russo, 2021). Screenings for breast, colon, and cervical cancer dropped by 94% between January 20, 2020 and April 21, 2020 (Cancino, 2020). Screenings are the most crucial step to identify cancer in the very early stages as the chance of a successful treatment is much higher the earlier the problem is identified. Considering this is a nationwide issue with negative impacts across all people, a policy intervention is required. All communities can benefit from financial and mental support provided by the federal or state government. Although Covid has been declining, there is a risk of another dangerous virus in the near future. NPI’s were effective in limiting the spread of Covid, but the social determinants of health were negatively impacted. The combination of both public health orders and safety nets must be investigated to find balance between limiting infection rates without negatively impacting the publics social determinants of health. Policy Section The CDC issued a temporary policy called the eviction moratorium. The NPI of closing all nonessential businesses was the main factor the policy was implemented. As renters lost their jobs and fell into economic hardships, millions of households were at risk of being evicted. The eviction moratorium allowed tenants not to be evicted even if they were behind on rent if the community resided in a high-level transmission zone (NLIHC, 2023). The policy temporarily solved the issue during the height of the pandemic as tenants were able to stay protected and isolate at home. The eviction moratorium has never been documented that it was used in the past in the United States. In response to the pandemic, the CDC had the power to subject this national moratorium with an expiration date of December 31st, 2020. President Biden extended the moratorium until the month of July 2021, as well has providing $46.5 billion for emergency rental assistance. The moratorium estimated to insure 90% of renters their home to stay protected from Covid-19. The CDC than implemented a limited evection moratorium between the months of August and October due to the rising transmission rates. During that period over 6.5 million renter households that were behind on rent were again relieved off being evicted until the end of October (NLIHC, 2021). Landlords were still able to evict tenants if there was criminal activity reported on the premises, tenants damaging property, and threatening the safety and health of other residents. (Velez, 2021). Landlords were not allowed to evict tenants due to the absence of rent fees or late fee’s which alleviated the pressure of being evicted during the Covid outbreak. Policy Section (2) The U.S. Department of Health implemented a public health emergency which created the Coronavirus Aid, Relief, and Economic Security Act (CARES). A proposed solution to the overcrowded and high prevalence of Covid in hospitals was the Telehealth policy. Telehealth services allowed patience to conduct appointments with their doctors from a safe distance using smartphones and computers. As non-emergent doctor visits were completed online, healthcare facilities were experiencing less overload. The patients also had zero risk of contracting Covid19 when completing appointments online as they did not need to enter a hospital and have physical human interaction. As Covid-19 was becoming an apparent issue in January 2020, only 24% of US Healthcare facilities had a definite telehealth program. The term Telemedicine was established in the 1970’s and defined as, healing from a distance. The World Health Organization in 2007 standardized a definition as it was becoming a popular way for patients to meet with their specialists. Telehealth refers to services across all health care professions, in comparison to telemedicine which specifically is a service provided by physicians only. (Doraiswamy, 2020). The Telehealth program is steadily evolving and changing to combat health disparities. The program has become more popular due to the outbreak of Covid and continues being funded to this day. Policy Analysis Public Health Impact The Telehealth Program provided an option for patients to continue to self-isolate while also appearing for their doctor appointments virtually. Preventing, diagnosing, and treating disease while also combating the widespread COVID-19 virus was possible due to the Telehealth Program. Telehealth technology can benefit nonemergent and routine care services that do not require a direct physical physician to patient relationship. Limiting the number of patients entering the hospital will dramatically decrease the risk of covid exposure for healthcare professionals and their patients. b. The Telehealth program will benefit patients and health care workers alike as there is no risk of contracting Covid through a smartphone or laptop. The program can reach any individual in the United States that has the required technology and Wi-Fi. The benefits of this program decrease the risk factor of contracting Covid, quality of care is equal to in-person care, and individuals’ morbidity and mortality rates will decrease when this policy is implemented. The burden would be on individuals who do not have access to the technology needed to utilize this program. Minorities and individuals with ethnic backgrounds will have an increased risk factor for contracting Covid due to the in-person appointments. c. Individuals who are enrolled in government funded programs such as Medicaid and Medicare will highly benefit from this program. 29.3% of all Telehealth users are enrolled in Medicaid and 27.4% off individuals utilizing the program are enrolled in Medicare. Only 9.3% of participants were uninsured (ASPE, 2021). Individuals who are privately insured have a high chance their service provider will cover costs relating this program. Non-Hispanic white adults were the highest recorded participants to utilize this program, 39.2%. Non-Hispanic Blacks and Asians were recorded at levels of 33% (CDC, 2022). Individuals with financial earnings higher than the Federal Poverty Level were recorded to have a higher level of engagement in the program, in comparison to their counterparts; families residing near the federal poverty level were identified to use the program less. When relating to education level, adults with less than a high school diploma or GED recorded at a level of 28.7%. In comparison to adults with a college degree or higher, 43.2% (CDC, 2022). In the short period the Telehealth program has been introduced, predominantly white and financial stable individuals are recorded to be benefiting from this program. Individuals who are supported through government programs such as Medicaid and Medicare as well as individuals with insurance will benefit from Telehealth. d. Individuals who require specialized care or has a complex medical condition will not be able to use this program. As the program is online some patients with specialized diseases or illnesses must physically enter the doctor’s office to complete the care they need (Watson, 2020). These individuals may not be able to use this program for their specific needs, but they unfortunately will not be able to utilize the program. Individuals who require to pay out of pocket for this service due to their insurance will not benefit from this program. e. Telehealth resources and easy to use tool will help promote health equity among vulnerable populations. The Telehealth program has made accessibility easier and safer for individuals to receive the care they need from their healthcare professional. By leveling the playing field for low-income communities and minorities it has helped them utilize this resource and receive quality care. Without these resources individuals would need to enter hospitals to see their healthcare professional and risk the chance of contracting Covid. Although every household does not have the technology available to use Telehealth, it still increased access to healthcare for many others. This population now has access to program and resources that were not available to them in the past (Shah, 2022). Impact on Social Determinants of Health The Telehealth program improves multiple aspects of the social determinants of health for patients. Telehealth directly impacts the healthcare system and how patients will be completing their appointments. Telehealth also drives for an impact relating to an individual’s neighborhood and physical environment. The program also impacts an individual’s community and social context and helps alters one’s health outcomes. i. The Health Care System will be more easily accessible through an online program. Individuals who reside in a rural area with limited access to a hospital will have the opportunity to quickly speak to a health care professional. During COVID as individuals were self-isolating, the telehealth program allowed safe access to a medical environment without the risk for transmission. Physicians also agree that the quality of care is equal, if not better than in-person care. (AMA, 2022). Considering Telehealth is an online-based program many individuals do not need to worry about transportation to the health care facility. Barriers to transportation before Telehealth lead to patients with late arrivals, missed appointments, and delayed medication use. Issues pertaining to transportation ultimately leads and contributes to poorer health outcomes (Oluyede, 2022). In the comfort of the patients home they can directly contact a healthcare professional. Community and social context were improved by the telehealth program as stress relating to Covid declined. Individuals were nervous to leave their house and enter a medical facility as the probability of Covid being present is very high. The introduction of this program alleviates the stress of Covid while still receiving quality care from a health professional. ii. This policy would only negatively impact the social determinants of health for a vulnerable population. Individuals who require specialized care can still make an in-person appointment and go to the healthcare facility. The quality of care from telehealth is equal to the care one would receive if entering or seeing their personal doctor. Social determinants of health for the majority of the population will be positively impacted and provide medical advice from a safe distance. Impact on Vulnerable Populations Underserved populations such as individuals of color and ethnic backgrounds are less likely to have the technology needed to utilize this program. Low-income communities and individuals without a high school degree are also a vulnerable population who will not be utilizing the program in numbers Telehealth has expected. Populations of ethnic backgrounds with limited English proficiency (LEP) can be handicapped from using the service (Karimi, 2022). These populations are vulnerable due to this policy as they may not have the resources or cultural background for Telehealth. i. Telehealth provides an option for individuals who don’t have internet access to utilize their landline. The Telehealth platform also identifies places in the individual’s local area that offers free internet hot spots; this includes community centers, libraries, and parks. Patients with LEP can utilize the platforms language services such as written translation and oral interpretation. Providers accompanying the patient will also receive resources on how to be aware of certain cultural needs that can affect the patients care (Telehealth HHS, 2022). By providing this population with more options and resources it allows them to utilize and benefit from this program. The program also educates healthcare providers relating to cultural areas to better the quality of care for racial and ethnic minorities. ii. Racial and ethnic backgrounds are statistically known for having a low level of education and financial instability. The need for technology to utilize this program affects this vulnerable community as they may not have access to the resources needed to utilize this evolving program. Obtaining a device and internet connection can be a very difficult or impossible feat for an individual. Individuals of an ethnic background may linguistically be vulnerable as English may not be their native language. Individuals with LEP will experience challenges to receive the quality of care they demand. As hospitals began shifting to telehealth programs, this vulnerable population still experienced immense amounts of stress when entering a medical facility due to COVID. SDOH Impact The social determinants of health for the vulnerable population had a positive impact due to the Telehealth program. Access to the HealthCare system dramatically increased as these individuals are given resources to utilize Telehealth. Their overall well-being and health should increase due to the option to speak to a healthcare professional relatively quickly and at the comfort of their choosing. Due to the appointment online, the neighborhood and physical environment of the individual as a positive impact as they do not need to worry about transportation to the Healthcare facility. The individual’s community and social context will be positively impacted as the populations stress levels will lower as they have less worry of transportation and the risk of contracting Covid at the hospital. Budget Impact The CARES act in total was approved for $2.2 trillion in funding. The CARES act specifically provided $200 million in funding for the Telehealth program. (ED, 2023). The benefit of this policy is mitigating the spread of Covid by utilizing the online platform Telehealth. By decreasing the number of patients entering Hospitals and other medical facilities, the prevalence of Covid will decrease. The cost of funding this program creates a safe environment for patients to receive quality health care. Individuals benefit from the program by being protected from Covid while still acquiring the care they need. Economic Impact The cost of Telehealth is covered by the majority of insurance providers and individuals will be spending the same amount money for appointments. Allowing online access to doctor appointments allowed a saving in cost for transportation. Individuals do not need to pay or worry about the responsibility of getting to their appointments if they have internet access. Individuals also would need to communicate with their place of employment to take time off to complete the visit with their doctor, which incurs a loss of wages. An individual is quickly able to go to their online appointment, then quickly clock back into work. A study including 11,600 participants recorded $1.2 million in savings for drive time and $467,000 in savings for lost income for the visit (Winstead, 2023). The accessibility allows individuals to save time, money, and other benefits positively impacting the patient financially. Policy Analysis (2) Public Health Impact The Centers for Disease Control and Prevention implemented the evection moratorium as a preventative strategy to prevent the transmission of Covid. The household must reside in a community experiencing high levels of Covid to take advantage of this policy. The CDC has laid out the framework and guidelines for the public to combat the spread of Covid. Practices of selfisolation and quarantine is the most important preventive measure an individual can take to stop the transmission of Covid. Eviction which can than lead to homelessness increases the chances of individuals contracting covid due to congregate settings with limited preventative resources such as masks and hand sanitizer. Homeless shelters do not have the necessary space to house individuals during a pandemic such as Covid. The eviction moratorium would provide a support system for households in need; as well as protect the same households from the transmission of Covid. b. Considering this policy was in effect and ultimately expired, there is data between states and their relationship of moratorium expiration. Mortality rate ratios rapidly increased five weeks after the state abandoned their relative moratoriums. Research shows that 16 weeks after states lifted their respected moratorium, states recorded 2.1 times higher incidence rate and 5.4 times higher mortality rate compared to their counterparts who maintained the moratorium (Leifheit, 2021). The eviction moratorium is a preventative strategy that will help limit the spread of Covid. In addition to limiting the spread, the quality of life for individuals receiving assistance from this program will increase. c. Households who are struggling to afford rent during the pandemic will benefit from this policy. To receive the benefits from the eviction moratorium, the tenants must be unable to pay rent due to income loss and must receive less than $99,000 per year (NLIHC, 2022). The tenants must sign a declaration that will be given to their landlord stating they are eligible for the program and telling the truth. The tenants will have their rent covered until the eviction moratorium has expired, a break in lease leading to an immediate eviction, or the Covid rate in the community has dropped below the threshold. d. Communities not residing in a high-level zone but may also still be falling behind on rent will not receive assistance from this program. The NPI stay at home order is still in place; landlords will evict nonpaying tenants forcing the individuals into overcrowded homeless shelters where transmission rates of Covid are high. Individuals in communities such as this one will not receive any assistance from the eviction moratorium. Landlords may rely on their rental property as their main source of income. Renters failing to pay rent for multiple months can negatively impact the landlord. The amount of past due rent must be paid in full once the community has been lifted from the high transmission zone or the eviction moratorium has expired. The eviction moratorium added financial stress to landlords who are used to their routinely monthly payments from tenants. e. The policy will temporarily positively impact the health equity of females encountering fears of eviction. The gendered health implications due to eviction include, physical and sexual assault, mental illness, and reoccurring housing instability in the future. The eviction moratorium impacts females’ health disparities that are caused by the process of eviction. Females who experience an eviction during pregnancy are more likely for their unborn child to be preterm or posses a low-birth weight compared to females not evicted (Pollack, 2020). By providing females with the resources to stay in their household, these health implications will begin to diminish Although the policy doesn’t specifically help females only, they will be able to take advantage of the benefits and limit the health disparities they may experience. Impact on Social Determinants of Health The eviction moratorium impacts an individual’s social determinants of health through economic stability, neighborhood and physical environment, and social and community context. Households threatened with eviction experience an increase in stress and anxiety. Postponing the worry of falling behind on rent alleviates some of the stress these households are facing. Providing a financial crutch for households allows a support system to help battle through the hardships and become financially comfortable. The moratorium secures housing which is a important factor that positively impacts the social determinants of health. Housing instability can lead to an increase in stress levels and other detrimental mental health symptoms. Tenants are able stay in their community which is a very familiar space with support systems around them. Although they will be isolated, social integration and community engagement will still be available within their community (Rolfe, 2020). The process of moving into a new community during a pandemic can be a stressful endeavor. Allowing tenants to remain in a comfortable and safe area with their local support systems will decrease levels of stress. The eviction moratorium positively impacts the social determinants of health of individuals struggling to pay rent due to Covid. Impact on Vulnerable Populations Race, ethnic minorities, and low-income communities are a vulnerable population when discussing housing displacement. This community has experienced decades of discrimination through federal and state policies which has negatively impacted their chances of obtaining homeownership. Research reports Black and Hispanic households were more than twice as likely to have reported being behind on rent compared to white households (CFPB, 2021). The vulnerable population will benefit the most from this policy as they are the most financially unstable group. They are most at risk to lose their place of residence which will increase their chances of contracting Covid along with the negative impacts relating to their social determinants of health. These communities statistically are the ones who are in dire need of this financial support system to get through the pandemic in a manner requested by the CDC. i. Funding is also allocated towards counseling and other resources relating to eviction records. Vulnerable households dealing financial issues can speak to an informative counselor who can guide them through the process of the moratorium. These professionals can also provide support to help expunge past eviction records to help the individual find a new home quicker and easier. Landlords have the option to decline an individual with a past eviction on their record (NLIHC, 2022). Unjust and discriminatory factors may have led to that eviction; the counselor works with the household to help alleviate and prepare them for their future goals in housing. ii. When the eviction moratorium was in effect, the vulnerable population would receive many benefits from this policy. As the moratorium expired households were obligated to pay the landlords the rent that was overdue causing a surge of evictions and Covid cases. Racial and ethnic minorities lost their benefits once the evection moratorium expired. Four months after the eviction moratorium expired, the United States recorded the number of deaths attributable to the disease increased fivefold and Covid cases doubled (Smith, 2021). The vulnerable group were the ones being evicted forced to into dangerous congregated settings where Covid is present. How Does it Impact SDOH As the eviction moratorium expired, it began to negatively impact racial, ethnic, and lowincome communities. The vulnerable populations economic stability, neighborhood and physical environment, food, community, and social context were negatively impacted. The moratorium provided them with financial support which allowed them to keep their house for the time being. As that financial crutch was removed the population could not receive any more support for their rent causing stress and anxiety. As they lose their home, they will lose access to necessities such as running water and electricity. Their neighborhood and physical environment will be adjusted and be negatively impacted as they are forced to find shelter. The vulnerable population will lose access to kitchen equipment such as microwaves, stove tops, and ovens. Their nutrition will begin to decline as they don’t have access to resources to make a healthy meal. The population will also lose the support of their community and the support systems in place. (Rolfe, 2020). Racial, ethnic, and low-income communities will be negatively impacted from this policy when it expires. Budget Impact The resources and benefits from the eviction moratorium stem from the Emergency Rental Assistance Program (ERA). The ERA has received over $46 billion in funding approved by the federal government (USDT, 2023). The funding is being used for the payrolls of the counselors as well as assistance payments to renters facing eviction. The benefit of this policy is mitigating the spread of Covid by financially stabling households falling behind on rent. Increasing the number of people isolating at home decreases their chances of contracting Covid. Tenants and landlords economically benefit from this policy as evictions can be an expensive process. Landlords will accrue fees during the process of evicting tenants such lawyer fees, loss of rent for a month if not longer and damages to units. Tenants also benefit as they save costs from securing new accommodations and moving fees (Batko, 2021). Economic Impact Healthcare is expensive in the United States, an individual who tests positive for Covid may need to be hospitalized due to implications. People over the age of 65 and younger adults with disabilities are much more likely to become seriously ill if they contract Covid. 60 million of these individuals are covered by Medicare and will be provided support for medical bills (Cubanski, 2022). By decreasing the number of hospital visits for individuals covered by Medicare, the government will have less of a financial load surrounding medical bills. Tenants will save costs on the process of moving out and finding a new accommodation and landlords also be able to save costs from the process of evicting tenants. An estimation of 4.2 million households reported being at risk for eviction over a two-month period in midst Covid. If all these households were evicted each unit would lose on average $2,700. Landlords on average spend between 2,542-$12,998 per unit to evict tenant (Batko, 2021). For both tenants and landlords, the benefits far out way the costs as they both can benefit from an unfortunate situation. Recommendation Section The eviction moratorium was a great preventive strategy that ultimately positively impacted the social determinants of health for the population. Research shows that 16 weeks after states lifted their respected moratorium, states recorded 2.1 times higher incidence rate and 5.4 times higher mortality rate compared to their counterparts who maintained the moratorium (Leifheit, 2021). The government needs to extend the eviction moratorium as this strategy was very successful to mitigate Covid. Once the moratorium expired, Covid began to increase exponentially in a matter of weeks. Counseling professionals can educate and answer lowincome households’ questions or issues relating to renting. This counseling initiative should become permanent and always be a resource for struggling households. As the vulnerable population experiences underlying cultural and health factors such as limited English proficiency or possessing a medical disability; access to resources like this one will improve their social determinants of health. The eviction moratorium policy relating towards the landlords and their delayed payment of rent should be adjusted. The landlord should not struggle financially and should be compensated 30% of the rent by either the tenant or government until the debt is paid in full. The landlord is the owner of the property and in no circumstance should be struggling due to the eviction moratoriums laws. Providing protection for the landlords will help alleviate the financial stress they are experiencing. Most food banks were forced to close during the pandemic due to reports of high infection rates. Transitioning and researching a new method to operate the service such as contact-less hand offs will help limit the spread and keep the operation open. An increase in funding will allow locations to open in vulnerable communities and provide healthier food. Food insecurity was an issue repeating in many of the articles relating to my topic discussing the prevalence and who was impacted the most by the health disparity. The combination of both public health orders and safety nets must be investigated to find balance between limiting infection rates without negatively impacting the publics social determinants of health. Racial, ethnic, and low-income communities were disproportionally impacted relating to policies implemented and ramifications of Covid. Analyzing data from the past to shape and revolutionize our nation today is an important step towards health equity. Bibliography Abrams, E. M., & Szefler, S. J. (2020). COVID-19 and the impact of social determinants of health. The Lancet. Respiratory medicine, 8(7), 659–661. https://doi.org/10.1016/S22132600(20)30234Ahlers, M. J., Aralis, H. J., Tang, W. L., Sussman, J. B., Fonarow, G. C., & Ziaeian, B. (2021). 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BioMed Central. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09224-0 Russo, R. G., Li, Y., Ðoàn, L. N., Ali, S. H., Siscovick, D., Kwon, S. C., & Yi, S. S. (2021). Covid‐19, Social Determinants of health, and opportunities for preventing cardiovascular disease: A conceptual framework. Journal of the American Heart Association, 10(24). https://doi.org/10.1161/jaha.121.022721 Shah, D. A., Sall, D., Peng, W., Sharer, R., Essary, A. C., & Radhakrishnan, P. (2022). Exploring the role of telehealth in providing equitable healthcare to the vulnerable patient population during COVID-19. Journal of telemedicine and telecare. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283958/ Smith, B. (2021, July 30). Research suggests ending eviction moratoriums led to spikes in Covid cases and deaths. UCLA. https://newsroom.ucla.edu/releases/ending-evictionmoratoriums-increased-covid-cases Telehealth HHS. (2022). Improving access to telehealth. Improving access to telehealth | Telehealth.HHS.gov. https://telehealth.hhs.gov/providers/health-equity-intelehealth/improving-access-to-telehealth USDT. (2023). Emergency rental assistance program. U.S. Department of the Treasury. https://home.treasury.gov/policy-issues/coronavirus/assistance-for-state-local-and-tribalgovernments/emergency-rental-assistance-program Velez, E. (2021). What the eviction moratorium means for landlords. Housing Solutions Tulsa. https://www.housingsolutionstulsa.org/what-the-eviction-moratorium-means-forlandlords Watson, S. (2020). Telehealth: The advantages and disadvantages. Harvard Health. https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-anddisadvantages Winstead, E. (2023). Telehealth can save people with cancer time and money. National Cancer Institute. https://www.cancer.gov/news-events/cancer-currents-blog/2023/telehealthcancer-care-saves-timemoney#:~:text=According%20to%20the%20cost%20models,11%2C600%20participants %20in%20the%20study. Zhang, X., & Warner, M. E. (2020). COVID-19 Policy Differences across US States: Shutdowns, Reopening, and Mask Mandates. International journal of environmental research and public health, 17(24), 9520. https://doi.org/10.3390/ijerph17249520 I apologize for the tardiness of my research paper. I spent much more time reframing my policy analysis section, I sub headed as you requested to make it easier to understand what topic and question I am answering. (Did you want the subheadings such a. b. c. etc, as I did? or is this unnecessary and you only want the main headings). I added more evidence and clarified many of my paragraphs in the policy analysis section and I truly do hope you enjoy my work. I have become much more knowledgeable on this topic and can utilize the information I learned in the future if I commit to a public health career field. Thank you, I enjoyed your class this semester and I hope you have a great summer Professor Lombardi!