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Table of Contents

PandemicToProsperity.org

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Pandemic to Prosperity: South

PandemicToProsperity.org

This project provides a timely and comprehensive overview of Covid-related impacts on Southerners’ lives and livelihoods, governments, civic institutions, and overall well-being. State and local governments prioritizing projects for the American Rescue Plan and the Infrastructure Investment and Jobs Act can use these findings to target disparities that ultimately undermine community resilience.

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In this report, the South is defined as the 12 states of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia.

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Indicators PandemicToProsperity.org

Pandemic…

to Prosperity

How are lives and livelihoods faring during Covid-19?

Responsive and

accountable governments

Fair and effective

civic institutions

Opportunity to be gainfully employed, healthy, and connected

  • Excess deaths
  • Drug overdose deaths, by race/ethnicity
  • Long Covid estimates, by state
  • Total jobs, by month
  • Jobs change, by state
  • Quits rate, by industry
  • Disaster declarations, by county

  • 2020 Census net coverage error, by race/ethnicity
  • 2020 Census estimated undercounts, by state
  • American Community Survey response rates, by state
  • Emergency Rental Assistance distribution, by state
  • New voting laws, by state
  • Legislative efforts that weaken state courts, by state
  • News deserts, by county
  • Internet access, by county
  • Child care disruptions
  • Health insurance coverage, by county
  • Mental health providers, by state
  • Pediatricians, by county

  • Student loan debt, by race
  • Renters with severe housing cost burden, by county
  • Medical debt, by county
  • Employment rate, by race/ethnicity
  • Employment rate, by gender
  • Difficulty paying expenses
  • Food insecurity, by state
  • Likelihood of eviction or foreclosure, by state
  • Symptoms of anxiety or depression, by state
  • LGBT well-being

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From March 2020 through Jan 2022, Covid directly caused 923,000 deaths and contributed to an additional 338,000 excess deaths beyond expected levels.

Source: CDC

Excess deaths, Covid and non-Covid, U.S.

Deaths above expected levels by week, Feb 29, 2020 - Jan 29, 2022

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Drug overdose deaths spiked in 2020 and 2021. Overdose death rates are highest for American Indian/Alaska Native, Black, and White individuals.

Source: CDC/ Wonder Mortality Data. Notes: Race groups are non-Hispanic. Total number of drug overdose deaths are for the 12-month period ending October of each year. Light gray sections of bars represent provisional data.

Drug overdose death rates and total number of drug overdose deaths, U.S.

Rates are age-adjusted per 100,000 population, by race/ethnicity

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Experts estimate between 7.9 and 23.8 million Americans may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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The U.S. added 1.7 million jobs in Q1 2022, with 1.6 million jobs still to go to reach the Feb 2020 pre-pandemic peak.

Total jobs by month, U.S.

Jan 2000 - Mar 2022

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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Among Southern states, 5 now have more jobs than they did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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The rate at which workers are quitting jobs is at all-time highs. Since January 2021, 56 million workers have quit jobs.

Quits rate by industry

Dec 2000 - Feb 2022

Source: Bureau of Labor Statistics. Notes: The quits rate is the number of quits during the entire month as a percent of total employment. Quits include employees who left voluntarily except retirements or transfers to other locations. Data is seasonally adjusted. Feb 2022 data is preliminary.

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70% of Southerners live in counties that have experienced disasters in the last two years, compared to 57% of non-Southerners.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Though the 2020 Census count was better than anticipated, undercount problems persisted or grew worse for Black, Hispanic, and other race groups.

Net coverage error by race and ethnicity, U.S.

Percent of under- and overcounts, 2010 and 2020 Census PES data

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Many states with high census undercounts will not receive their fair share of Medicaid funding. But states can still inform federal funding distribution by engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

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Response rates for the American Community Survey declined 25 percentage points (from 96% to 71%) between 2015 and 2020. Response rates declined the most in Georgia, New Mexico, and Texas.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 49% of Emergency Rental Assistance funds have been distributed to Southerners who rent, compared to 59% in non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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Despite gains made in voter turnout in 2020, 19 states passed laws restricting voter access in 2021.

Voting laws passed

Jan 1 - Dec 7, 2021

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In 2021, legislators in 35 states introduced bills that would weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent.

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31% of Southern counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Child care disruptions have declined since the Omicron surge but 28% of adults with young children still reported a disruption last month.

Child care disruptions, March 2 - 14, 2022

Percent of households where children < 5 years were unable to attend child care in last 4 weeks

Source: Census Bureau’s Household Pulse Survey. Note: Universe is adults in households with children under 5 years of age.

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States refusing Medicaid expansion contributed to a 15% uninsured rate for working-age Southerners compared to 11% outside the South.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Alabama has only 106 providers per 100,000 people and West Virginia has only 138 – well below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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The South faces a shortage of pediatricians with only 101 per 100,000 children, compared to 112 per 100,000 in the rest of the nation.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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Before Covid hit, 1 in 5 U.S. families were saddled with student loan debt. Black households were most likely to have student loan debt at 30% – up from 12% in 1989.

Education installment loans, 1989 - 2019

Percent of households holding education loans by race/ethnicity

Source: Survey of Consumer Finances

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1 in 4 Americans who rent pay half of household income on housing costs.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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One in five Southerners holds medical debt in default, reaching up to 40-50% of residents in some Southern counties.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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The March 2022 employment rate of 60.1% is 1.1 percentage points below Feb 2020. Disparate access to jobs has narrowed recently.

Source: Bureau of Labor Statistics. Note: The employment rate is officially known as the “employment-population ratio.” Here it is calculated for the population 16 years and older. Data is seasonally adjusted.

Employment rate by race/ethnicity, U.S.

Jan 2008 - Mar 2022

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The March 2022 employment rates for both men and women are 1.2 percentage points below February 2020 levels.

Employment rate by gender, U.S.

Jan 2008 - Mar 2022

Source: Bureau of Labor Statistics. Note: The employment rate is officially known as the “employment-population ratio.” Here it is calculated for the population 20 years and older. Data is seasonally adjusted.

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With the end of monthly advances of the child tax credit and rising inflation, 34% of Americans had difficulty paying household expenses in March 2022.

Percent of adults having difficulty paying for usual household expenses

Adults in households where it has been somewhat or very difficult to pay for usual household expenses in the last 7 days

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In the South, 12% of adults reported their households went hungry in March. Four Southern states — MS, LA, AR, and FL — reported the highest rates of hunger in the U.S., topping out at 18% in MS.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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As recently as March 2022, 35% of Southerners who are late on rent or mortgage payments were fearful of losing their homes

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. Southern states have the largest share of adults reporting symptoms, at 39% in AR and 38% in OK, LA, and MS.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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LGBT adults are more likely to experience lost income and anxiety than non-LGBT adults, and are more likely to be vaccinated.

Source: Census Bureau’s Household Pulse Survey. Notes: Loss of employment income is % reporting a loss of employment income in the last 4 weeks for self or household member. Food insecurity is % of persons reporting "sometimes not enough to eat" or "often not enough to eat” in the last 7 days. Anxiety is % reporting frequency of symptoms is "more than half the days" or "nearly every day” in the last 2 weeks.

Indicators of well-being for adult LGBT population, South

Mar 2 - Mar 14, 2022

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State-by-State Highlights

�PandemicToProsperity.org

This resource provides a state-by-state snapshot of the South, highlighting key indicators where we have state or county-level data. Data on every indicator and a downloadable spreadsheet can be found at the link below:�

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ALABAMA

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Experts estimate that 255,000 Alabamians may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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Alabama still has 1% fewer jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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While 60% of Americans live in counties that have had a disaster in the last two year, 100% of Alabamians have experienced one or more disasters in that time.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Alabama had an estimated census undercount of 0.7% and will not receive its fair share of Medicaid funding. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 25 percentage points (from 96% to 71%) between 2015 and 2020 in Alabama.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 27% of Alabama’s Emergency Rental Assistance funds have been distributed, compared to 59% across non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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Despite gains made in voter turnout during the pandemic, in 2021, Alabama passed legislation that will make voting more difficult.

Voting laws passed

Jan 1 - Dec 7, 2021

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In 2021, legislators in Alabama introduced bills that would weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 22 Alabama counties are news deserts.

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32% of Alabama counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Alabama has refused Medicaid expansion contributing to a 15% uninsured rate for working-age Alabamians, compared to the 12% national average.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Alabama has only 106 providers per 100,000 people – well below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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Alabama faces a shortage of pediatricians with only 88 per 100,000 children, compared to the national average of 109 per 100,000 children.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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1 in 4 Alabamians who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, 1 in 5 Alabamians held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In Alabama, 10% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 34% of Alabamians who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In Alabama, 34% of adults reporting symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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ARKANSAS

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Experts estimate that 159,000 Arkansans may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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Arkansas’ economy has recovered from the shock of the pandemic and the state now has 0.9% more jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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While 60% of Americans live in counties that have had a disaster in the last two year, 100% of Arkansans have experienced one or more disasters in that time.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Arkansas had an estimated census undercount of 0.8% and will not receive its fair share of Medicaid funding. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 23 percentage points (from 96% to 73%) between 2015 and 2020 in Arkansas.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 35% of Arkansas’ Emergency Rental Assistance funds have been distributed, compared to 59% across non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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Despite gains made in voter turnout during the pandemic, in 2021, Arkansas passed legislation that will make voting more difficult.

Voting laws passed

Jan 1 - Dec 7, 2021

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In 2021, legislators in Arkansas passed legislation that will weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 43 counties in Arkansas are news deserts.

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49% of Arkansas counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Arkansas accepted Medicaid expansion contributing to a 12% uninsured rate for working-age Arkansans– lower than the Southern average of 15%.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Arkansas has only 237 providers per 100,000 people – below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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Arkansas faces a shortage of pediatricians with only 80 per 100,000 children, compared to the national average of 109 per 100,000 children.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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1 in 5 Arkansans who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, 1 in 5 Arkansans held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In Arkansas, 15% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 31% of Arkansans who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In Arkansas, 39% of adults reporting symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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FLORIDA

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Experts estimate that 1,166,000 Floridians may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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Florida’s economy has recovered from the shock of the pandemic and the state now has 1.7% more jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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While 60% of Americans live in counties that have had a disaster in the last two year, 96% of Floridians have experienced one or more disasters in that time.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Florida had an estimated census undercount of 1.0% and will not receive its fair share of Medicaid funding. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 26 percentage points (from 96% to 70%) between 2015 and 2020 in Florida.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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60% of Florida’s Emergency Rental Assistance funds have been distributed.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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Despite gains made in voter turnout during the pandemic, in 2021 Florida passed legislation that will make voting more difficult.

Voting laws passed

Jan 1 - Dec 7, 2021

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In 2021, legislators in Florida introduced bills that would weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 25 counties in Florida are news deserts.

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18% of Florida counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Florida has refused Medicaid expansion contributing to a 19% uninsured rate for working-age Floridians compared to the 12% national average.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Florida has only 169 providers per 100,000 people – well below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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Florida faces a shortage of pediatricians with only 99 per 100,000 children, compared to the national average of 109 pediatricians per 100,000 children.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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More than 1 in 4 Floridians who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, nearly 1 in 5 Floridians held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In Florida, 15% of adults reported their households went hungry in March.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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As recently as March 2022, 33% of Floridians who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In Florida, 29% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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GEORGIA

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Experts estimate that 475,000 Georgians may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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Georgia’s economy has recovered from the shock of the pandemic and the state now has 1.6% more jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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16% of Georgians live in counties that have experienced at least one disaster in the last two years – compounding the misery of the Covid pandemic.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Georgia had an estimated census undercount of 1.2% and will not receive its fair share of Medicaid funding. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 31 percentage points (from 94% to 63%) between 2015 and 2020 in Georgia.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 25% of Georgia’s Emergency Rental Assistance funds have been distributed, compared to 59% across non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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Despite gains made in voter turnout during the pandemic, in 2021, Georgia passed legislation that will make voting more difficult.

Voting laws passed

Jan 1 - Dec 7, 2021

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In 2021, legislators in Georgia passed legislation that will weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 133 counties in Georgia are news deserts.

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35% of Georgia counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Georgia has refused Medicaid expansion contributing to a 18% uninsured rate for working-age Georgians compared to the 12% national average.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Georgia has only 143 providers per 100,000 people – well below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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Georgia faces a shortage of pediatricians with only 93 per 100,000 children, compared to the national average of 109 pediatricians per 100,000 children.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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About 1 in 4 Georgians who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, nearly 1 in 5 Georgians held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In Georgia, 12% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 34% of Georgians who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In Georgia, 30% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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KENTUCKY

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Experts estimate that 260,000 Kentuckians may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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Kentucky still has 1.1% fewer jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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59% of Kentuckians live in counties that have experienced one or more disasters in the last two years – compounding the misery of the Covid pandemic.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Kentucky had an estimated census undercount of 0.03%. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 24 percentage points (from 97% to 73%) between 2015 and 2020 in Kentucky.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 40% of Kentucky’s Emergency Rental Assistance funds have been distributed, compared to 59% across non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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Despite gains made in voter turnout during the pandemic, in 2021, Kentucky passed legislation that will make voting more difficult.

Voting laws passed

Jan 1 - Dec 7, 2021

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In 2021, legislators in Kentucky passed legislation that will weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 90 counties in Kentucky are news deserts.

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36% of Kentucky counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Kentucky has accepted Medicaid expansion contributing to a low 8% uninsured rate among working-age Kentuckians – lower than the 12% national average.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Kentucky has only 238 providers per 100,000 people – below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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Kentucky faces a shortage of pediatricians with only 106 per 100,000 children, compared to the national average of 109 pediatricians per 100,000 children.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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More than 1 in 5 Kentuckians who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, nearly 1 in 5 Kentuckians held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In Kentucky, 11% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 39% of Kentuckians who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In Kentucky, 35% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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LOUISIANA

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Experts estimate that 230,000 Louisianans may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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Louisiana still has 4.4% fewer jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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Every parish in Louisiana has experienced at least 12 disaster in the last 2 years – greatly compounding the misery of the Covid pandemic.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Louisiana had an estimated census undercount of 1.1% and will not receive its fair share of Medicaid funding. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 29 percentage points (from 95% to 66%) between 2015 and 2020 in Louisiana.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 41% of Louisiana’s Emergency Rental Assistance funds have been distributed, compared to 59% across non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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Despite gains made in voter turnout during the pandemic, in 2021, Louisiana passed legislation that will make voting more difficult.

Voting laws passed

Jan 1 - Dec 7, 2021

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In 2021, legislators in Louisiana introduced bills that would weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 35 parishes in Louisiana are news deserts.

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36% of Louisiana parishes have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Louisiana accepted Medicaid expansion rather late (in 2016) contributing to a 13% uninsured rate for working-age Louisianians – lower than the Southern average of 15%.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Louisiana has only 304 mental health providers per 100,000 people.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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Louisiana faces a shortage of pediatricians with only 98 per 100,000 children, compared to the national average of 109 pediatricians per 100,000 children.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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More than 1 in 4 Louisianans who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, more than 1 in 5 Louisianans held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In Louisiana, 17% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 47% of Louisianans who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In Louisiana, 38% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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MISSISSIPPI

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Experts estimate that 157,00 Mississippians may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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Mississippi still has 0.4% fewer jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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Every county in Mississippi has experienced at least 2 disasters in the last 2 years. Some counties have experienced as many as 8 disasters since the pandemic began.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Mississippi had an estimated census undercount of 1.3% and will not receive its fair share of Medicaid funding. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 25 percentage points (from 94% to 69%) between 2015 and 2020 in Mississippi.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 42% of Mississippi’s Emergency Rental Assistance funds have been distributed, compared to 59% across non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 61 counties in Mississippi are news deserts.

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59% of Mississippi counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Mississippi has refused Medicaid expansion contributing to a 18% uninsured rate for working-age Mississippians compared to the 12% national average.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Mississippi has only 170 providers per 100,000 people – well below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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Mississippi faces a shortage of pediatricians with only 67 per 100,000 children, compared to the national average of 109 pediatricians per 100,000 children.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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1 in 4 Mississippians who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, more than 1 in 5 Mississippians held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In Mississippi, 18% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 24% of Mississippians who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In Mississippi, 38% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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NORTH CAROLINA

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Experts estimate that 522,000 North Carolinians may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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North Carolina’s economy has recovered from the shock of the pandemic and the state now has 2% more jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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While 60% of Americans live in counties that have had a disaster in the last two year, 100% of North Carolinians have experienced one or more disasters in that time.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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North Carolina had an estimated census undercount of 0.8% and will not receive its fair share of Medicaid funding. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 24 percentage points (from 96% to 72%) between 2015 and 2020 in North Carolina.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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84% of North Carolina’s Emergency Rental Assistance funds have been distributed.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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In 2021, legislators in North Carolina introduced bills that would weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 62 counties in North Carolina are news deserts.

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18% of North Carolina counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Mental health providers are in short supply in many Southern states. North Carolina has only 258 providers per 100,000 people.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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In 2021, 18% of North Carolina counties had 0 general pediatricians, forcing many rural parents to travel long distances to get care for their children or simply go without.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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More than 1 in 5 North Carolinians who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, nearly 1 in 4 North Carolinians held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In North Carolina, 12% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

182 of 256

In March, 44% of North Carolinians who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In North Carolina, 30% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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SOUTH CAROLINA

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Experts estimate that 290,000 South Carolinians may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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South Carolina still has 0.3% fewer jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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39% of South Carolinians live in counties that have experienced at least one disaster in the last two years – compounding the misery of the Covid pandemic.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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South Carolina had an estimated census undercount of 0.9% and will not receive its fair share of Medicaid funding. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 26 percentage points (from 97% to 71%) between 2015 and 2020 in South Carolina.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 40% of South Carolina’S Emergency Rental Assistance funds have been distributed, compared to 59% across non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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In 2021, legislators in South Carolina introduced bills that would weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 21 counties in South Carolina are news deserts.

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30% of South Carolina counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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South Carolina has refused Medicaid expansion contributing to a 16% uninsured rate for working-age South Carolinians compared to the 12% national average.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. South Carolina has only 184 providers per 100,000 people – well below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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South Carolina faces a shortage of pediatricians with only 96 per 100,000 children, compared to the national average of 109 pediatricians per 100,000 children.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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1 in 5 South Carolinians who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, 1 in 4 South Carolinians held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In South Carolina, 9% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 56% of South Carolinians who are late on rent or mortgage payments expect to lose their home in the next two months.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In South Carolina, 27% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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TENNESSEE

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Experts estimate that 382,000 Tennesseans may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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Tennessee’s economy has recovered from the shock of the pandemic and the state now has 1.4% more jobs it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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63% of Tennesseans live in counties that have experienced at least one disaster in the last two years – compounding the misery of the Covid pandemic.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Tennessee had an estimated census undercount 0.4%. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 21 percentage points (from 96% to 75%) between 2015 and 2020 in Tennessee.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 25% of Tennessee’s Emergency Rental Assistance funds have been distributed, compared to 59% across non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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In 2021, legislators in Tennessee introduced bills that will weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Small communities across the nation are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 72 counties in Tennessee are news deserts.

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20% of Tennessee counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Tennessee has refused Medicaid expansion contributed to a 14% uninsured rate for working-age Tennesseans compared to the 12% national average.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Tennessee has only 156 providers per 100,000 people – well below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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In 2021, 40% of Tennessee counties had 0 general pediatricians, forcing many rural parents to travel long distances to get care for their children or simply go without.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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More than 1 in 5 Tennesseans who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, 1 in 5 Tennesseans held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In Tennessee, 10% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 30% of Tennesseans who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

219 of 256

32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In Tennessee, 30% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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VIRGINIA

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Experts estimate that 330,000 Virginians may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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Virginia still has 1.8% fewer jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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23% of Virginians live in counties that have experienced at least one disaster in the last two years – compounding the misery of the pandemic.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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Virginia had an estimated census undercount of 0.1%. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 20 percentage points (from 95% to 75%) between 2015 and 2020 in Virginia.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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71% of Virginia’s Emergency Rental Assistance funds have been distributed.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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In 2021, legislators in Virginia introduced bills that would weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Source: UNC Hussman School of Journalism and Media, inspired by Brookings research

Southern counties are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 72 counties in Virginia are news deserts.

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22% of Virginia counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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Virginia has accepted Medicaid expansion contributing to an 11% uninsured rate for working-age Virginians compared to the 12% national average.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. Virginia has only 186 providers per 100,000 people – well below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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In 2021, 27% of Virginia counties had 0 general pediatricians, forcing many rural parents to travel long distances to get care for their children or simply go without.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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More than 1 in 5 Virginians who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, roughly 1 in 5 Virginians held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In Virginia, 7% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 17% of Arkansans who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

237 of 256

32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In Virginia, 30% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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WEST VIRGINIA

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Experts estimate that 98,000 West Virginians may be suffering from long Covid.

Source: AAPM&R Dashboard, Census Bureau: Population Estimates. Notes: This map uses Post-Acute Sequelae of Sars-Cov-2 (PASC, or “long Covid”) estimates at 20% of the surviving Covid-19 cases (confirmed cases less deaths).

Estimates of long Covid cases per 100,000 population

Cumulative, February 1, 2020 - April 10, 2022

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West Virginia still has 3.4% fewer jobs than it did in February 2020 before the pandemic hit.

Change in jobs by state

March 2022 compared to February 2020

Source: Bureau of Labor Statistics. Note: Seasonally adjusted. Data for Feb 2022 and Mar 2022 are preliminary.

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28% of West Virginians live in counties that have experienced at least one disaster in the last two years – compounding the misery of the Covid pandemic.

Number of FEMA disaster declarations by county

Mar 1, 2020 - Mar 31, 2022

Source: FEMA. Notes: Excludes COVID declarations and statewide declarations.

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West Virginia had an estimated census undercount of 0.5%. But states can still inform federal funding distribution by actively engaging in new census review programs.

Estimated miscounts in total population by state, 2020 Census

States losing out on rightful share of Medicaid funding over the next decade

Source: Urban Institute Center on Labor, Human Services, and Population

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Response rates for the American Community Survey declined 22 percentage points (from 95% to 73%) between 2015 and 2020 in West Virginia.

Declines in American Community Survey response rates by state

Percentage point change, 2015 to 2020 (housing units)

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Only 19% of West Virginia’s Emergency Rental Assistance funds have been distributed, compared to 59% across non-Southern states.

Source: U.S. Department of the Treasury. Notes: Assistance to households is the total dollar amount of ERA1 and ERA2 award funds paid to or for households, including payments for rent, rental arrears, utility/home energy costs, utility/home energy arrears, and other eligible expenses. This does not include funds paid for Housing Stability Services. "Percent distributed" is calculated as the sum of assistance to households divided by 90% of the ERA1 and ERA2 allocation amount.

Percent of Emergency Rental Assistance funds distributed

Jan 1 - Feb 28, 2022

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In 2021, legislators in West Virginia introduced bills that would weaken the power and independence of state courts.

Legislative efforts to weaken state courts

Jan 1 - Dec 10, 2021

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Counties with no or only one newspaper (“news deserts”)

News deserts as of 2020

Source: UNC Hussman School of Journalism and Media, inspired by Brookings research

Southern counties are most likely to be news deserts, with 1 or no local newspaper, meaning a critical vehicle for trusted information is absent. 43 counties in West Virginia are news deserts.

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18% of West Virginia counties have poor internet access (defined as one-quarter of households without internet) compared to only 9% of counties outside the South.

Lack of internet access by county, 2016-20

Percent of households without internet access

Source: Census Bureau’s American Community Survey 2016-20. Note: Internet access is defined as any form of internet subscription, including cellular data plans only, as well as having internet access with no subscription.

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West Virginia has accepted Medicaid expansion contributing to a 9% uninsured rate for working-age West Virginians compared to the 12% national average.

Lack of health insurance coverage by county, 2016-20

Population age 19-64

Source: Census Bureau’s 2020 ACS 1-Year Experimental Data. Note: WI has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level.

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Mental health providers are in short supply in many Southern states. West Virginia has only 138 providers per 100,000 people – well below the national average of 259.

Mental health providers per 100,000 population, 2020

Registered mental health providers

Source: County Health Rankings & Roadmaps and Census Bureau Vintage 2020 PEP. Notes: Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care, as well as those treating alcohol and other drug abuse.

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West Virginia faces a shortage of pediatricians with only 90 per 100,000 children, compared to the national average of 109 pediatricians per 100,000 children.

General pediatricians per 100,000 children age 0-14, 2021

General pediatricians ever certified, age 70 and under

Source: The American Board of Pediatrics and Census Bureau Vintage 2020 PEP. Notes: Includes all general pediatricians age 70 and younger who have become board certified at some time in their career. Pediatric subspecialists are excluded. For more notes, see the Pediatric Physicians Workforce Data Book at link provided.

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Nearly 1 in 4 West Virginians who rent spend the majority of their household income on housing.

Severe housing cost burdens by county, 2016-20

Percent of renter households paying half or more of household income on housing costs

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Even before Covid, more than 1 in 3 West Virginians held medical debt in default. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.

Share of individuals with medical debt in collections

December 2020

Source: Urban Institute, Kaiser Family Foundation. Note: Universe is people with a credit bureau record. Debt in collections includes past-due credit lines that have been closed and charged-off on the creditor’s books as well as unpaid bills reported to the credit bureaus that the creditor is attempting to collect.

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In West Virginia, 12% of adults reported their households went hungry as recently as March 2022.

Food insecurity, Mar 2-14, 2022

Percent of adults who report their household sometimes or often went hungry in last 7 days

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In March, 32% of West Virginians who are late on rent or mortgage payments were fearful of losing their homes.

Likelihood of eviction or foreclosure, Mar 2-14, 2022

Percent of adults living in households not current on rent or mortgage where eviction or foreclosure in the next two months is “very likely” or “somewhat likely”

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32% of adults nationwide report symptoms of anxiety or depression, up from 11% in 2019. In West Virginia, 34% of adults reported symptoms in March.

Symptoms of anxiety or depression, Mar 2-14, 2022

Percent of adults who experienced symptoms of anxiety or depression in the last two weeks

Source: CDC and Census Bureau’s Household Pulse Survey. Notes: This indicator is based on self-report of the frequency of anxiety and depression symptoms, derived from responses to the first two questions of the eight-item Patient Health Questionnaire (PHQ-2) and the seven-item Generalized Anxiety Disorder (GAD-2) scale.

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