It's been a year since Governor Charlie Baker first declared a state of emergency in Massachusetts to combat the spread of the coronavirus. The governor's order came just before most people found themselves working and learning from home for what was initially supposed to be just a few weeks. Now, a year later, we're looking at some of the ways the pandemic has collectively changed us. GBH Morning Edition host Joe Mathieu spoke with Innovation Hub's Kara Miller to learn more about the lasting impact this year will have on our society — and especially women. The transcript below has been edited for clarity.

Joe Mathieu: I was talking to our producer, Karen Marshall, who reminded me it's been even longer than a year since we've done this weekly segment in the same room because you were headed out on maternity leave at the beginning of last year.

Kara Miller: That's absolutely true. I had a baby just under the wire before all the masks came on and all the restrictions went in and everything. And yeah, by the time I started covering COVID, we weren't in the same room together anymore. It seems like a lot has changed in a year, which it kind of has.

Mathieu: And so you've been talking with me, I think, in a closet with a towel over your head or something. The lengths that we go to do radio at home, you have no idea. But as you've been following this along with us, now with two young kids, I'm sure there's a lot that sticks out in your mind when we talk about the last year.

Miller: For sure. I think a couple of threads that are interesting to me and that I feel like are maybe not discussed quite enough is that when you make these broad societal decisions, which we had to do in many ways, many dominoes fall. One of those areas where dominoes fell and this, of course, hits close to home is in the lives of women. So back in the summer, I talked to Melissa Kearney. She's an economist who had written a report for the Brookings Institution. And her report was on how the pandemic would impact the number of people having kids.

"There's been a big negative economic shock. And we know from a lot of past economic research, as well as experience in downturns, that when economic conditions are bad, people have fewer babies."
Melissa Kearney

Mathieu: Did that end up being true? People are having fewer babies?

Miller: Yes, they are, actually. So Kearney updated her estimate just in the last few days. It does indeed look like something like 300,000 fewer babies will be born in the U.S. this year. To put that in perspective, that's a very large number. That means something like one in ten kids who would have been born in 2021 will not probably be born. Now, national data is kind of slow to be released, but if you look at California, which is the most populous state, births are down more than 10 percent year over year. And the dominoes of that are huge. This isn't just a baby story. 20 [to] 25 years on, this is a "who's going to be supporting Social Security" story. This is a very, very big story. But I remember once Melissa Kearney saying to me, "Remember, individuals are making choices that make sense for them." Here she is again.

"And really, it's not all that surprising, right? There might be some people for whom childbearing is unintentional and that happens or it doesn't. But again, we're talking about averages and aggregates, and on that, it probably shouldn't surprise us that when it comes to making what are some of the most important decisions in someone's life, they're going to take account of economic conditions and their economic security and income and ability to afford childbearing, et cetera."
Melissa Kearney

Mathieu: And there's less security and less income, right? We've seen reports [that] close to three million women have left the workforce.

Miller: That's right. And that's another piece of this intersection of women and family and money that's been profoundly altered by the pandemic. It's been clear since the beginning, but I think it's gotten worse. So ironically, by the end of 2019 — right before this happened — after about 50 years of big advances, women were pulling equal with men and then they pulled ahead of them on payroll jobs. Here's Betsey Stevenson, who worked in the Labor Department during the Obama administration.

"So those jobs where employers give you a job, you work there, you bring home the paycheck, that's the number we all look for once a month — how many jobs are there in the economy? In December, women held more of them. In January, women held more of them. In February, women held more of them. And then the pandemic hit."
Betsey Stevenson

Miller: And then we saw [that] the overwhelming number of people who voluntarily left the workforce during the pandemic were women. And it's not even close, it's like 80 percent of the people were women. So this is not like men and women are neck and neck here, this is really very lopsided. And I talked to Stevenson over the summer and she could see even then the shadow of school looming in the fall.

"There is a rot that's at the core of women's employment right now and that's child care and elder care, and how women are going to maintain their place in the labor force when we're really having a crisis of care in the country."
Betsey Stevenson

Mathieu: A crisis that, for many, did not get fixed in time.

Miller: That's right. And I think one of the really big questions out there still is: what will women's reentry into the workforce look like? Will they be able to come back into some of the positions that they left? Will this moment set them back, as Betsey Stevenson actually believes it could, forever for many of those women monetarily in terms of hierarchy, like what level can they achieve in those jobs? All of that. And I talked about dominos falling at the beginning. There was this issue that really struck me of women, family and jobs, but I'm going to talk about another thread that also really struck me as I've been covering COVID this year. And that was the issue of poor metabolic health increasing the risk for COVID. Here's Dariush Mozaffarian. He's a cardiologist [and] he's also dean of the Tufts Friedman School of Nutrition Science and Policy. And he's talking about what he started to see as the data emerged from last spring's COVID surge.

"In New York City, the hospital systems there published a very nice study that if someone has moderate obesity — a body mass index of 30 to 40 — they're about four-fold more likely to be hospitalized. And if they have severe obesity with a body mass index over 40, they have a six-fold higher risk of being hospitalized."
Dariush Mozaffarian

Mathieu: So coming out of the pandemic, now that we know this, you think more attention will be paid to metabolic health?

Miller: So heart disease is the number one killer in America. It kills about 600,000 people a year, which is not too different rate from the number of people who've died from COVID in the past year. And I remember so clearly Mozaffarian saying to me that it was like a slow moving pandemic, which is to say poor metabolic health, had collided with a fast moving pandemic, which is to say COVID. The danger actually in the past year is that all this lost employment could lead to more food insecurity [and] to worse metabolic health, so things going in the wrong direction. And Mozaffarian told me for him, the past year has been transformative.

"So to me, the combination of kind of the focus on racial equity and COVID-19 has really brought home and made me more passionate and determined to try to make a difference through a healthier food system because it's all intersected: supply chains, kids out of school unable to have kids get sufficient schooling, parents out of work and not having jobs, unhealthy eating, higher rates of poor metabolic health, more exposure to COVID-19. It's a vicious, negative cycle."
Dariush Mozaffarian

Mathieu: A negative cycle, and we hope we're learning more about and can fix [it].

Miller: Yeah, I think one of the things about this last year has been that there's the big story, but then there's so many really important stories that sit just underneath that big story. And sometimes they get covered up by like, how many vaccines did we get today? How many people are in the hospital? These are very important questions, but there's other super important questions that lie right under them, and I think one of the great things I've been able to do with you is [to] have these conversations. Maybe they're not the conversations everybody's having, but I think they're important.