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While many households suffered negative economic outcomes as a result of the COVID- 19 pandemic and economic recession, households with low incomes were impacted in disproportionate and exceptional ways. From January 2020 to March 2021, low -wage workers experienced job loss at a rate five times higher than middle -wage workers, and high -wage workers actually experienced an increase in job opportunities.109 Because workers in low-income households were more likely to lose their job or experience reductions in pay, those same households were also more likely to experience economic hardships like trouble paying utility bills, affording rent or mortgage payments, purchasing food, and paying for medical expenses.11° The disproportionate negative impacts the pandemic has had on low-income families extend beyond financial insecurity. For example, low-income families have reported higher levels of social isolation, stress, and other negative mental health outcomes during the pandemic. While over half of all U.S. adults report that their mental health was negatively affected by the pandemic, adults with low incomes reported major negative mental health impacts at a rate nearly twice that of adults with high incomes.111 Summary of Interim Final Rule and Final Rule Structure Summary: The interim final rule provided a non -exhaustive list of enumerated eligible uses to respond to the negative economic impacts of the pandemic through assistance to 1°9 R. Chetty, J. Friedman, N. Hendren, M. Stepner, & Team, T. O. I., The Economic Impacts of COVID-19: Evidence from a New Public Database Built Using Private Sector Data (No. w27431; p. w27431) (2020), National Bureau of Economic Research. https://doi.org/10.3386/w27431. 11° M. Despard, Michal Grinstein-Weiss, Yung Chun, and Stephen Roll, COVID-19 job and income loss leading to more hunger and financial hardship, Brookings Institute (July 13, 2020), https://www.brookings.edu/blog/upfront/2020/07/13/covid-19 job -and -income -loss -leading -to -more -hunger -and - financial -hardship/. 111 N. Panchal, R. Kamal, C. Mufiana, & P. Chidambaram, The Implications of COVID-19 for Mental Health and Substance Use, Kaiser Family Foundation (February 10, 2021), https://www.kff.org/coronavirus-covid-19/issue- brief/the-implications-of-covid-19-for-mental-health-and-substance-use/. 77