Why Disadvantaged Populations are at Greater Health Risk from COVID-19 – and How Libraries are Helping, Despite Closing

Beth St. Jean - April 2, 2020

Image of medical gloves, mask, sanitizer

The World Health Organization (WHO) Constitution, drafted in 1946 and accepted by the U.S. in 1948, states: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” However, this fundamental concept of health justice (the recognition that every person is morally entitled to a sufficient and equitable capability to be healthy) has not been realized; in fact, health disparities between various populations have only continued to grow over time. The current COVID-19 pandemic has highlighted and intensified disparities in access to information, as well as contributed to the wide array of health injustices that we are seeing in the news every day.

Studies have consistently shown that people who have higher incomes, people who have more education, and people who are white tend to live about 10 to 15 years longer, on average, than people who do not belong to one (or more) of these advantaged populations; they have also shown that these gaps in life expectancy have actually grown over time.

One of the core factors underlying health justice is disparities in the accessibility of health information for various populations. Accessibility encompasses both physical and intellectual accessibility. While physical accessibility refers to whether information is physically obtainable, intellectual accessibility refers to whether information is understandable.

Individuals and communities who experience various forms of social injustice, such as poverty, inadequate education, insufficient health insurance, etc., often have limited access to resources and opportunities, which contributes to the higher rates of illness, injury, and premature death they face. One such resource is accessible, trustworthy health information – without access to trustworthy health information that is understandable, relevant, and actionable, people are unable to make informed decisions that involve not only their own personal health, but also the health of others in their day-to-day lives.

With the current COVID-19 pandemic, the very same populations that have always borne the brunt of health injustices in this country – people who are older; who belong to racial, ethnic, sexual, gender, and other types of minority populations; who have lower incomes; who have less education; who lack health insurance; who are immigrants; who are incarcerated, etc. – are seeing existing disadvantages compounded and their health outlooks and outcomes worsen.

For example, low-wage workers, such as many of the individuals currently out delivering packages or food, are finding themselves having to navigate the virus and risk their own health and that of their families while they continue to serve the public; that is, if they have not lost their jobs (and their incomes) altogether.

Health is not a zero-sum game – one person’s gain should not be another’s loss (and vice-versa). When an individual takes steps to protect or improve their own health at the expense of others, we all lose. For example, some consumers have taken to purchasing a large supply of items, such as toilet paper, hand sanitizer, food, etc., to ensure their (in some cases, quite long-term) future. However, people who live paycheck-to-paycheck and who do not have a living situation that could possibly accommodate this large store of goods find themselves unable to purchase one bottle of hand sanitizer or the one roll of toilet paper that they can afford and need for today and tomorrow.

If some people don’t have access to the basic necessities of life, their health is likely to suffer. However, this suffering is borne not just by the individuals directly affected, but by their neighbors, their loved ones, and all of the people who would have benefitted from the gifts they brought into this life and what they had to offer the world.

Information and information professionals (such as librarians) are instrumental in ensuring that every individual has access to the resources and opportunities that will enable them to optimize their ability to live a long and healthy life. Many different types of information-related factors influence this ability, including an individual’s awareness of, and access to, trustworthy health information; their awareness of, and their ability to articulate, their health-related information needs; their health literacy levels (which encompasses their ability to obtain, understand, and act on health information); and the strategies they use to seek out, evaluate, and benefit from health information.

All of these factors influence the individual’s potential and actual health outcomes. Fortunately, these factors can be influenced by information professionals, who have both an opportunity and a responsibility to help to shape these factors in such a way that they optimize each individual’s capability to be healthy and to flourish in all facets of their lives.

One of the central institutions serving the information needs of all populations – libraries – are facing the need to close in unprecedented numbers due to the risks posed by COVID-19. However, many public, academic, and K-12 school librarians are finding ways for their libraries to continue to serve the public.

Libraries are continuing to offer electronic access to their digital resources, and many are still offering internet access that people (some of whom would otherwise have no internet access) can use from outside the library. Additionally, numerous libraries are collecting and curating collections of COVID-19 resources on their websites.

And some libraries are actively engaged in more directly dealing with the fallout of COVID-19. For example, San Francisco Public Libraries have converted their 28 branches into emergency youth care centers, serving the children of healthcare workers. Two high school librarians created a mini clearinghouse of links to trustworthy information sources focused on COVID-19. University libraries across the country are donating their supplies of N95 masks, safety goggles, and disposable gloves – items they ordinarily use for preserving centuries-old materials or that they have stocked to prepare for a disaster – to their local health care providers.

In 1966, Dr. Martin Luther King, Jr. stated: “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.”

We will emerge from the shadow of COVID-19. Let us do so with a greater awareness of the pervasiveness, unfairness, and destructiveness of the health injustices that many of our fellow humans face (many of whom are currently enabling others to keep themselves safe or to recover from the virus); a commitment to act to improve this situation for the betterment of all of us; and an understanding of the central importance of supporting libraries, as they steadfastly see to the needs (for information and beyond) of all members of their communities.

“The Covid-19 pandemic will change our world forever. Until it is controlled, we will all need to change how we wash our hands, cover our coughs, greet others and how close we come to others. We will rethink the need for meetings and conferences. We will need broadband for all as a public utility like mail or water. We will need to support the vulnerable, even if only because their illness can risk our health.” (Frieden, 2020 March 22)


Dr. Beth St. Jean, Dr. Paul Jaeger, and doctoral students Gagan Jindal and Yuting Liao are editing a volume of the Advances in Librarianship book series entitled: “Roles and Responsibilities of Libraries in Increasing Consumer Health Literacy and Reducing Health Disparities.” This volume focuses on the many ways in which libraries and librarians are helping (and can help) to improve consumer health literacy and decrease health disparities. This volume will be coming out in September. To learn more about research and scholarship at the UMD iSchool, please visit the college’s website, https://ischool.umd.edu/.