Are Health Disparities Magnified by Coronavirus (COVID-19)?

Some may say that the infection known as coronavirus or COVID-19 does not appear to discriminate. From heads of state, star athletes and famous actors to those of us lacking fame and fortune, it is has crossed international borders, oceans, and seas. In fact, it seems inevitable that the pandemic will reach into the inner circles of our families, friends, and social networks. Today, changing the status quo and our daily way of living holds promise as the most effective means for slowing down this pandemic in the absence of an available vaccine. 

And while there is still much that we don’t know about COVID-19, what we have learned from our global neighbors and new data here in the United States should raise particular concern for our communities of color.

Health officials in Chicago announced Monday that while 30 percent of the population is African-American - 52 percent of COVID-19 cases are African-Americans. Even more frightening – African-Americans also make up 72 percent of the city’s deaths from COVID-19.

WHY AFRICAN-AMERICANS ARE BEING HIT HARD

Reports from around the world have identified individuals with chronic health conditions like high blood pressure, heart disease, diabetes, and COPD as being more likely to have complications from COVID-19 infection and at higher risk for death. We know that the African American community has long endured higher rates of many of these chronic medical problems than the general US population. These long-standing health disparities are the result of structural barriers in access to fresh food, quality housing, employment, education, safe spaces to play and exercise, and quality health care. A legacy of mistrust of the health care system persists given our documented history of racial disparities in health care delivery. Prior to the pandemic, too many communities of color have been burdened with the weight of multiple, intertwined disadvantages leading to sustained shorter life expectancies. Now we can apparently add coronavirus to the list.

Many state and local leaders have taken action to protect their citizens. Yet, nearly 13 million of America’s 41.6 million African Americans live in states where “shelter in place” orders were not implemented until April 1st, or are still not in place. 

Too many people have been lulled by misinformation into believing that the unimaginable scenes televised from hospitals in Italy or New York could not become part of their future. They were told that COVID-19 was just like the flu and it is not.  A delay in accepting the advice of public health officials and medical experts has resulted in much more avoidable illness and death visiting communities with the least resilience.

Communities living on the margin of financial security are amongst the first to feel the personal impact of job loss due to shuttered stores, cancelled conventions, empty hotel rooms, and quiet barbershops and beauty salons. Social distancing will be part of our lives for the foreseeable future and is even harder to accomplish as family or friends share housing as rent becomes past due.  One infected individual can infect the household and as more people in vulnerable communities live together, the risk of infection can grow higher.  As we look out beyond the storm clouds of today, the social and economic recovery will not be easy or fast. 

WHY IT SHOULD MATTER TO EVERYONE

The perils of the status quo, our nation’s acceptance of social inequity and health disparities, have reminded us of what Dr. Martin Luther King, Jr. described as the “inescapable network of mutuality,” noting that we are “tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.” 

As the pandemic has accelerated in vulnerable communities, our physicians, nurses, respiratory therapists, and other health care workers have been exposed to COVID-19 by patients who were ill, as well as patients who had no symptoms but were contagious. Some of our health care workers have recovered from their illnesses, others are fighting for their lives, and already too many have died. It should not be lost on us that at the point of care, the repercussions of long-standing health disparities are clandestinely jumping socioeconomic and sociodemographic boundaries.

Times of crisis expose the torn seams of our society. Whether it is Hurricane Katrina in New Orleans in 2005 or the 1995 Chicago Heat Wave, we have seen the trailer of this movie before. Our efforts to change the status quo must accelerate across areas of action. We must mobilize personal protective and critical care equipment to the front lines to support our health care workers and patients. Our elected officials must be accountable for leading; mandatory social distancing and stay at home orders must include all communities as recommended by experts. And as we try to see beyond the pandemic and current economic turmoil, we also must address injustices in the social determinants of health, so that all our citizens can be resilient and achieve their best possible health. After all, we are all part of the fabric of this nation and have a shared destiny.

(Views expressed are my own and not of my employer or other organizations with which I am affiliated)