In this paper, we leverage newly available rich administrative data to study the heterogeneous evolution of fertility and newborn health during the pandemic. We focus on Tuscany, a representative region of Italy, which was one of the first countries to experience the severe impact of the COVID-19 outbreak in early 2020. Our findings indicate a decline in the number of births relative to the pre-pandemic trend in late 2020 and early 2021, roughly nine to twelve months after the pandemic onset. However, starting in March 2021, birth numbers consistently exceeded the pre-pandemic trend, resulting in a cumulative “baby bump” compared to the counterfactual scenario. This aggregate increase conceals significant heterogeneity across sociodemographic groups, with positive deviations entirely driven by native, educated, and employed parents. During the same period, newborn health indicators showed no signs of deterioration and, if anything, slightly improved.

This paper draws upon the theoretical literature on migration policy and health, and empirical data on three European states with differing welfare models – Sweden (social democrat), France (conservative), and the United Kingdom (liberal) – during Covid-19, to highlight the often hidden and contradictory politics through which refugees, asylum seekers, and undocumented migrants were forced to navigate during the most uncertain period of the pandemic. Although migrants’ treatment during Covid-19 was generally better in Sweden with a social democrat welfare tradition, we see migration management priorities greatly undermining the extent to which welfare systems function overall for the benefit of population health. Furthermore, Sweden’s recent political shift to the right exacerbates those negative tendencies. As the paper shows, there was considerable effort by civil society and local government to fill the gap where national governments failed to protect this group, stepping in to provide health information, and support.

This essay explores central aspects of the relationship between money and national health policy from the passage of Medicare in 1965 to the present, including the two most sweeping attempts at system reinvention during that period: the Patient Protection and Affordable Care Act of 2010 (ACA), and the failed Health Security Act of the early 1990s. Its point is not that ethical professionalism has prevailed, though it survives on the skill and dedication of nurses, physicians, and other health care workers. Rather, its point is that one should not criticize the morality of change without interrogating the morality of the status quo. In the 1990s, Jerome Kassirer wrote that “a system in which there is no equity is, in fact, already unethical.” The same can be said for a system that overfunds medical care and underfunds other essential social investments, including education. A system that, moreover, cannot be justified by the limited morality of competition in the marketplace because it does not — and could not absent radical change — perform as a functioning market would. In terms of robust market competition with its winners and losers, U.S. health care has been, at worst, a sheep in wolf’s clothing.

The papers in this special themed section reflect on, explore, and analyse national and local government policy responses to the recent pandemic between 2020 and 2022, and the short- and longer-term impacts on human security for different groups of people and places, with a particular focus on the UK and Korea. Drawing on an integrated critical human security and state capacity approach and qualitative methodology, they contribute to and further develop debates on the social policy responses to the pandemic and their scarring effects. They also highlight the key role that a state capacity for human security approach can play in promoting inclusive risk governance, recognising and addressing constellations of vulnerability, risk and insecurity, and highlighting the rapid and uneven distribution of the benefits of digital technologies and its potential from compromising as well as enhancing human security.

There remain important questions about how personality shapes risk perceptions, willingness to engage in protective behaviors, and policy preferences during a changing pandemic. Focusing on the Big-5 and COVID-19 attitudes, we find associations between risk perceptions and negative emotionality and agreeableness, as well as between each Big-5 trait and protective behaviors and support for government restrictions. These associations are mostly stable over time, with instability pronounced for lockdown policy support, where agreeableness and conscientiousness diminish in importance as pandemic conditions improve. Negative emotionality, conscientiousness, and agreeableness reduce differences between the political left and right and between those who do and do not trust experts. We highlight the heterogeneous interplay between personality and political ideology to understand pandemic policy support, attitudes, and behaviors.

Will voters punish incumbents for psychological distress associated with public policy during external shocks? This study examines this question in the empirical context of the first wave of the COVID-19 pandemic in India, utilizing three novel cross-sectional surveys conducted in the first three weeks of June 2020, immediately after the national lockdown policy was officially revoked. We find that propensity to vote for the nationally incumbent Bharatiya Janata Party (if hypothetical elections were held on the day of the survey) was negatively correlated with mental stress from routine disruptions in mobility (Week 1); worsening mental health (Week 2); and emotion-focused coping (Week 3). We show that these effects are strongest in BJP-ruled states. We argue that psychological distress shaped political attitudes in the midst of the pandemic and this effect was conditional on the source of distress and moderated by governmental clarity of responsibility.

This article considers how the COVID-19 pandemic triggered a remarkable social experiment in the market for migrant ‘au pair’ labour in Australia. As has been illustrated in broader accounts of the pandemic’s ‘care crisis’, the global health emergency cracked open underlying fault lines, as capacities for social reproduction were stretched to breaking point. At the same time, the pandemic deepened the precarity of temporary migrants as they lost jobs and incomes, experienced housing insecurity, and were excluded from state emergency relief measures. Building on interdisciplinary feminist literatures on gender, work, migration, and social reproduction, this article adds to emerging scholarship on the growing phenomenon of au pairing in Australia to examine drivers of demand, migrant mobilities in and out of au pair labour, and the impact of the COVID-19 pandemic upon the market. While au pairing emerged during the pandemic as a form of survival work where migrants had little negotiating power, the market ultimately shifted when emergency childcare measures were withdrawn, migrant labour became scarce, and visa restrictions on working hours were relaxed. In addition to providing new empirical insights into au pairing in Australia, the findings underscore the constitutive role of law and policy settings in shaping the distributions and divisions of reproductive labour, which can both consolidate and also challenge broader gendered care norms and distributions and the social reproduction bargain.

We examine the impact of decentralisation on COVID-19 mortality and various health outcomes. Specifically, we investigate whether decentralised health systems, which facilitated greater regional participation and information sharing, were more effective in saving lives. Our analysis makes three contributions. First, we draw on evidence from several European countries to assess whether the decentralisation of health systems influenced COVID-19 mortality rates. Second, we explore the regional disparities in one of the most decentralised health systems, Spain, to untangle some of the determinants shaping health outcomes. Third, we estimate the regional loss of Quality Adjusted Life Years (QALYs) due to COVID-19 mortality, broken down by the wave of the pandemic. Our findings suggest that coordinated decentralisation played a critical role in saving lives throughout the COVID-19 pandemic.