Nationally, employment has taken a huge hit this year because of job losses connected to the COVID-19 pandemic and its wide-ranging impacts. As of September, the U.S. unemployment rate was 7.9%, according to the Bureau of Labor Statistics. Though this number is down from 12% at the end of April, for many Americans, losing a job has also meant a loss of health insurance, which can cause long-term financial difficulties in addition to negative impacts on health.

Polls conducted by NPR, the Harvard T.H. Chan School of Public Health, and the Robert Wood Johnson Foundation have found that 43% of households in rural regions of the United States had members who had lost jobs, been furloughed, or had wages reduced since the start of the pandemic. Two-thirds of those households (66%) reported serious financial problems resulting from these experiences. For individuals who have lost their employer-based health insurance, options vary by state. In North Carolina, where Medicaid eligibility has not been expanded, opportunities for assistance are fairly limited.

Despite federal and state-level efforts, one in five households in the United States (20%) reported household members were unable to get care for serious medical problems since the start of the pandemic. Among those unable to get care, 57% report negative health impacts. In North Carolina, as well as in many other states, older residents and people with serious illness have been disproportionately affected.

Unsurprisingly, this burden is disproportionately heavy in historically marginalized communities. At least 40% of Latinx, Black, and Native American households reported using all or most of their household savings during 2020 because of job loss or other financial issues related to the pandemic. More than 1 in 3 households that include someone with a disability said they had trouble buying food and paying for utilities.

And when it comes to families with children, much of the anecdotal evidence of struggle is borne out in these polls. Thirty-four percent do not have high-speed internet or serious issues with their connection, leading kids to miss school and adults to miss work. Thirty-six percent of households with children had trouble keeping up with kids’ school work, and 18% said they had serious issues accessing child care. In North Carolina, many child care centers and schools have reopened, but the balance of in-person and virtual learning varies by district.

NPR, the Harvard T.H. Chan School of Public Health, and RWJF polled 3,454 adults over the age of 18 in the United States between July and August 2020. The polls included: The Impact of Coronavirus on Households in Major U.S. Cities; The Impact of Coronavirus on Households, by Race/Ethnicity; The Impact of Coronavirus on Households Across America (national); The Impact of Coronavirus on Households with Children; and The Impact of Coronavirus on Households in Rural America.