Covid-19 Magnifies Racial Health Disparities Throughout the U.S.
In April, Dr. Anthony Fauci, the United States’ leading expert on infectious diseases, spoke in a press conference about the impact Covid-19 is having on communities of color, particularly African Americans. “When all this is over — and as we’ve said, it will end — we will get over coronavirus, but there will still be health disparities, which we really do need to address in the African American community,” he said in an April 7 press briefing.
Those “disparities” Fauci mentioned are linked to early numbers that show African Americans are disproportionately dying from Covid-19. In Illinois, black people make up 14% of the population, but account for 32.5% of coronavirus deaths, according to the Illinois Department of Public Health. In Michigan, black people make up 14% of the state’s population, but account for 41% of coronavirus deaths, according to data released by Michigan’s government.
Health Disparities African American or Black Population
In comparison to the White population, African-Americans disproportionately suffer with chronic health conditions, such as obesity, diabetes, and hypertension. Obstacles to better health among Black people include lack of access to care, preventive screenings, and mental health support. The underlying causes of the health disparities have been linked to genetics, lack of economic resources, limited access to health care, delay in treatment, cultural beliefs, low literacy and health literacy rates, and certain environmental factors.
Even beyond the US, CDC global health experts Dr. Barbara Marston and Dr. Nancy Knight discuss the agency’s role in responding to the COVID-19 pandemic globally in this Infectious Diseases Society of America (IDSA) Podcast: “The Global Health Impact of COVID-19” (Sept. 8, 2020)
Health Disparities Hispanic-American Population
Hispanic-Americans have higher rates of obesity than non-Hispanic Whites. There are also disparities among Hispanic subgroups. For instance, while the rate of low birth weight infants is lower for the total Hispanic population in comparison to non-Hispanic whites, Puerto Ricans have a low birth weight rate that is almost twice that of non-Hispanic whites. Puerto Ricans also suffer disproportionately from asthma, HIVAIDS and higher infant mortality rates than non-Hispanic whites. Mexican Americans suffer disproportionately from diabetes.
Richmond, VA: The COVID-19 pandemic is hitting black Americans especially hard. In Richmond, Virginia, for example, three-quarters of the people who have died from the disease are Black. In Virginia as a whole, although African-American and Latin communities make up only 27.5% of the state’s populations African-American and Hispanic communities they account for 64.3% of the state’s coronavirus cases.
Atlanta, GA: In a statement by Atlanta Mayor Keisha Lance Bottoms last month, she said: “Systemic racism and healthcare inequities continue to ravage communities of color in what could be the most devastating public health crisis of our lifetime.” The mayor made those remarks when she issued an Administrative Order to address COVID-19 disparities in communities of color throughout the city. The Order was based on data from the Centers for Disease Control and Prevention, which shows that social and structural factors place Black, Hispanic, Latino, Native Americans and Alaska Natives at an increased risks of contracting COVID-19.
New Orleans, LA: Pre-existing conditions turn COVID-19 into a death sentence for black patients in the city of New Orleans and the state of Louisiana. The state has the highest rate of deaths from COVID-19 in the nation and, according to Gov. John Bel Edwards, more than 70 percent of the people who have died so far were Black.
Why Covid-19 is Hitting Black Seniors Especially Hard
- African Americans ages 65 to 74 died of COVID-19 five times as often as whites, according to an analysis of CDC data.
- Because Black Americans are more likely to have chronic medical conditions, they are at higher risk of dying from COVID-19 than most of the population.
- Many older Black Americans live in multigenerational homes where the new coronavirus can spread more easily.
- Older Black Americans may be more reluctant to get tested or seek treatment because of mistrust of healthcare professionals.
At a U.S. Senate Special Committee on Aging held on July 23, 2020, witnesses identified three urgent priorities in the fight to reduce COVID-19 deaths among seniors of color:
- Enhance data collection
- Investment in research
- Build trust with senior patients and their families can help mitigate the disparate impacts of the COVID-19 pandemic on seniors
ChenMed is Transforming Healthcare for Seniors
ChenMed provides big answers to big problems in health care delivery. ChenMed is a full-risk primary care market leader with an innovative philosophy, unique physician culture and end-to-end customized technology that allows us to provide world-class primary care and coordinated care to the most vulnerable population – moderate-to low-income seniors who have complex chronic diseases.
How Value-Based Care Can Fix Racial Health Disparities of Seniors
“Health disparities based on race in health care are the result of many decades of systematic inequality in the U.S., perpetuated by segregation, economic discrimination, and environmental degradation. Dismantling such structural racism to ensure that underserved populations are better prepared for future public health challenges will require a drastic change in the American health care system,” says Dr. Faisel Syed, National Director of Primary Care for ChenMed.
Essentially, value-based care models revolve around the patient’s treatment and how well healthcare providers can improve their quality of care based on certain metrics, such as reducing hospital readmissions, improving preventative care, and using particular kinds of certified health technology.
Dr. Syed believes that the value-based health care model provides a viable blueprint for that change. “It’s an ethical question, first,” Syed says. “Should everyone feel like it’s their right to contact a doctor they can trust whenever they don’t feel well — and get medication when they need it?” Value-based health care, with its emphasis on prevention and close communication between healthcare provider and patient, can improve access to better health for underserved patients by providing care that is culturally competent.
Culturally Competent Care Reduces Health Disparities Amongst Black Seniors and Others of Color
Cultural competence refers to the ability for healthcare professionals to demonstrate sensitivity toward patients’diverse values, beliefs, and feelings. Whether the focus is African-Americans or Black Americans, Hispanics/Latinos, or American Indian/Alaska Native (AI/AN) populations, developing a culturally competent workforce is essential for providing quality patient and family care and reducing health disparities.
- The research report by Stanford University’s VJ Periyakoil’ entitled Periyakoil, entitled “Building a Culturally Competent Workforce to Care for Diverse Older Adults: Scope of the Problem and Potential Solutions,” outlines patient-related barriers to care. They include limited English proficiency, low health literacy, varying levels of acculturation, biases about Western healthcare and medications, mistrust of clinicians, inability to navigate the complex healthcare system, and cultural beliefs and taboos.
- When I was invited by The American Society for Health Care Human Resources Administration (ASHHRA) to design and deliver an educational webinar on the topic of Developing a Culturally Competent Workforce, I was informed and motivated by Periyakoil’s report. ASHHRA, a division of the American Hospital Association (AHA), is the nation’s only membership organization dedicated to meeting the needs of human resources professionals in health care industry.
The Lessons Learned from the COVID-19 Response According to Dr. Anthony Fauci
Fauci’s lesson regarding addressing existing health care disparities:
“If ever there is going to be a real incentive for us to now make a commitment to address the social determinants of health, it’s got to be now. We’ve seen it with HIV. … We have 13% African Americans and close to 50% of new [Covid-19] infections in the United States are African Americans. We have 13% African Americans and now look at the number of hospitalizations with Covid with African Americans and Latinx. We have got to address that. This has to be a real eye-opener for us to do that.”