Reports

The 62-page report, “In Sheep’s Clothing: United States’ Poorly Regulated Nonprofit Hospitals Undermine Health Care Access,” describes how the US government’s lack of guidance and oversight allows privately operated tax-exempt hospitals to spend far less on making healthcare services accessible for people without the means to pay than the massive public subsidies they receive. In 2020, for example, nonprofit hospitals collectively received about $28 billion in tax benefits but only spent about $16 billion on free or reduced-price “charity care,” according to the Kaiser Family Foundation.

The 74-page report, “‘Automated Neglect’: How The World Bank’s Push to Allocate Cash Assistance Using Algorithms Threatens Rights,” details how an automated cash transfer program in Jordan known as Takaful (a word similar to solidarity in Arabic) profiles and ranks the income and well-being of Jordanian families to determine who should receive support – an approach known as poverty targeting. This system, which the World Bank has funded in Jordan and seven other countries in the Middle East and North Africa, is depriving many people of their right to social security even as they go hungry, fall behind on rent, and take on crippling debt.

The 127-page report, “‘Cut Off from Life Itself’: Lebanon’s Failure on the Right to Electricity,” argues that electricity is fundamental to nearly every aspect of living and participating in present- day societies, and as such, the internationally protected right to an adequate standard of living includes the right of everyone, without discrimination, to sufficient, reliable, safe, clean, accessible, and affordable electricity. At present, the government provides electricity for only one to three hours a day on average, while people who can afford it supplement that supply with private generators. The public sector and private generator industry rely on polluting climate-intensive fossil fuels. The electricity crisis has exacerbated inequality in the country, severely limited people’s ability to realize their most basic rights, and pushed them further into poverty.

The 147-page report, “‘If I Wasn’t Poor, I Wouldn’t Be Unfit’: The Family Separation Crisis in the US Child Welfare System,” documents how conditions of poverty, such as a family’s struggle to pay rent or maintain housing, are misconstrued as neglect, and interpreted as evidence of an inability and lack of fitness to parent. Human Rights Watch and the ACLU found significant racial and socioeconomic disparities in child welfare involvement. Black children are almost twice as likely to experience investigations as white children and more likely to be separated from their families.

The 63-page report, “‘We Can’t Live Like This’: Spain’s Failure to Protect Rights Amid Rising Pandemic-Linked Poverty,” documents the enduring weaknesses in Spain’s social security system. Efforts by the authorities to supplement a weak safety net have fallen short, leaving people unable to afford essentials. The violations of people’s rights to food, social security, and an adequate standard of living could worsen as global food and fuel costs spiral. This research is the first in a series of investigations in Europe into people’s right to an adequate standard of living in the context of the impact of the Covid-19 pandemic and rapidly increasing living costs across the globe.

The 92-page report, “‘If I’m Out of Insulin, I’m Going to Die:’ United States’ Lack of Regulation Fuels Crisis of Unaffordable Insulin,” describes the human rights impacts of US government policies that make essential life-saving medication like insulin unaffordable for many people. Human Rights Watch found that exorbitant insulin prices and inadequate health insurance coverage can cause people to pay high out-of-pocket costs for insulin, contributing to dangerous and potentially lethal medicine rationing, forcing people to forgo other basic needs, and disproportionately affecting socially and economically marginalized groups.

The 98-page report “The Tenant Never Wins: Private Takeover of Public Housing Puts Rights at Risk in New York City” examines the impact of the New York City Housing Authority (NYCHA) program called Permanent Affordability Commitment Together (PACT), which utilizes a federal program called the Rental Assistance Demonstration (RAD) to permit the privatization of some housing. Under PACT, which began in December 2016, NYCHA leases its public housing developments to private companies for 99 years and privatizes the buildings’ management. Human Rights Watch found that PACT conversions also mean the loss of key protections for residents, and, in two developments, may have contributed to increased evictions.

The 51-page report, “I Want Us to Live Like Humans Again”: Families in Temporary Accommodation in London, UK,” examines how families across London are being placed in poor quality and uninhabitable accommodation, significantly violating their rights. The situation is due to a combination of reduced funding for local authorities, austerity-motivated cuts to the welfare system, and a lack of affordable permanent housing.

The 87-page report, “‘Between Hunger and the Virus,’ The Economic Impact of the Covid-19 Pandemic on People Living in Poverty in Lagos, Nigeria,” documents how a five-week lockdown, rising food prices, and a prolonged economic downturn have had a devastating impact on informal workers, slum dwellers, and other urban poor families in Lagos. The absence of a functioning social security system meant that government assistance, including cash transfers and food handouts, reached only a fraction of people going hungry.

The 66-page report, “‘We Are All Vulnerable Here’: Kenya’s Pandemic Cash Transfer Program Riddled with Irregularities” found that only a small fraction of vulnerable families in Nairobi benefited from the program, which was characterized by lack of transparency, cronyism, nepotism and outright favoritism. Government officials failed to follow the stated selection criteria or to share information that should have enabled more vulnerable families to enroll.

In the 47-page report, “‘We Lost Everything’: Debt Imprisonment in Jordan,” Human Rights Watch documents the harsh treatment of people unable to repay their debts. In the absence of an adequate social security net, tens of thousands of Jordanians feel compelled to take out loans to cover utilities, groceries, school fees, and medical bills. They often use unregulated informal lenders. Jordanian authorities should urgently replace laws that allow for debt imprisonment with effective personal bankruptcy legislation and enact social security protections to support indigent people.

The 99-page report, “‘Kettling’ Protesters in the Bronx: Systemic Police Brutality and Its Costs in the United States,” provides a detailed account of the police response to the June 4 peaceful protest in Mott Haven, a low-income, majority Black and brown community that has long experienced high levels of police brutality and systemic racism. It describes the city’s ineffectual accountability systems that protect abusive police officers, shows the shortcomings of incremental reforms, and makes the case for structural change.

The 68-page report, “Automated Hardship: How the Tech-Driven Overhaul of the UK’s Benefits System Worsens Poverty,” details how a poorly designed algorithm is causing people to go hungry, fall into debt and experience psychological distress. Human Rights Watch has also found that the government is failing to address the socio-economic inequalities which prevent people from being able to apply for and manage their benefit online.