To Make Matters Worse: Health Disparities and the COVID-19 Pandemic
The COVID-19 pandemic has drastically changed many aspects of everyday life, from socializing with friends and family to the restricting availability and accessibility of healthcare. However, even before the pandemic, equal access to healthcare had long been an issue in the United States, referred to as health disparities.
Per the National Academies of Science, health disparities are “differences that exist among specific population groups in the United States that prevent full attainment of health and can be measured by differences in incidence, prevalence, mortality, the burden of disease, and other adverse health conditions, specifically in the Black/African American, Native American, Asian American, and Latinx populations”1. These gaps in healthcare are evident throughout the entire continuum of healthcare, in the prevalence of chronic and acute illnesses, and across all ages. For example, the infant mortality rate for Black American infants is almost double the rate of White, Non-Hispanic infants, with 11 deaths per 1000 live births compared to 5.8 deaths2.
When it comes to chronic illnesses, such as HIV/AIDS, Black/African Americans accounted for 63% of all new HIV infections in the United States, despite representing only 13% of the U.S. population3. The disproportional disease burden is also seen when examining Diabetes Mellitus (DM) rates, with 17% of the Latinx adults being diagnosed with DM, compared to just 8% of White, Non-Hispanic adults4.
The Impact of the COVID-19 Pandemic
Unfortunately, the COVID-19 pandemic has only exacerbated and amplified the inequality in the U.S. healthcare system. A review and analysis by the Kaiser Family Foundation, which was based on data from the Epic electronic health record system for 47.6 million patients as of July 2020, found that hospitalization rates and death rates per 10,000, respectively, 30.4 and 5.6 for Latinx patients, 15.9 and 4.3 for Asian patients, 24.6 and 5.6 for Black patients, compared to the much lower rates of 7.4 and 2.3 for White patients5. To help address the disproportionate burden of COVID-19 on health disparate populations, it is vital to have strategies that prevent disparities in vaccination rates of these populations. However, recent vaccine data is not promising.
As of May 17, 2021, the CDC reported that 56% of the population were vaccinated with at least one dose, whose race/ethnicity was known – 62% were White, 9% were Black/African American, 13% were Latinx, 6% were Asian American, and 1% were Native American6.
Improvement Strategies and Suggestions
There have been many suggestions and strategies created to address health disparities in the COVID-19 pandemic, as well as overall. In my opinion, ensuring that all people residing in the U.S. can adequately access healthcare services when needed is paramount to ending health disparities. This could be accomplished through various public health measures, including expanding Medicaid eligibility and improving funding to hospitals that act as “safety nets” that care for a high proportion of disparate populations.
Another consideration is increasing the number of primary care and community health clinics to provide greater access. This could help address and prevent many chronic, preventable illnesses that disproportionally affect health disparate communities. In addition, educational resources and outreach efforts should be multilingual, culturally appropriate, and universally accessible to have the greatest chance of reaching previously unreachable populations.
While there is no easy or quick solution for ending disparities in healthcare, the COVID-19 pandemic may have provided an opportunity to develop and test interventions that will not only help end the pandemic but could also be used to improve the overall health of disparate populations.
- National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Community-Based Solutions to Promote Health Equity in the United States; Baciu A, Negussie Y, Geller A, et al., editors. Communities in Action: Pathways to Health Equity. Washington (C.): National Academies Press (U.S.); 2017 January 11th. 2, The State of Health Disparities in the United States. Available from:https://www.ncbi.nlm.nih.gov/books/NBK425844/2. National Center for Health Statistics. (2021). Health of Black or African American non-Hispanic Population. Retrieved from https://www.cdc.gov/nchs/fastats/black-health.htm
- Sullivan, P. S., Satcher Johnson, A., Pembleton, E. S., Stephenson, R., Justice, A. C., Althoff, K. N., … Beyrer, C. (2021, March 20th). Epidemiology of HIV in the USA: epidemic burden, inequities, contexts, and responses.The Lancet. Elsevier B.V. https://doi.org/10.1016/S0140-6736(21)00395-0
- Centers for Disease Control and Prevention. (2021). Hispanic/Latino Americans and Type 2 Diabetes. Retrieved fromhttps://www.cdc.gov/diabetes/library/features/hispanic-diabetes.html
- Rubin-Miller L, Alban C, Artiga S, Sullivan S. COVID-19 racial disparities in testing, infection, hospitalization, and death: analysis of Epic data. Published September 16th, 2020. Accessed October 12th, 2020. https://www.kff.org/coronavirus-covid-19/issue-brief/covid-19-racial-disparities-testing-infection-hospitalization-death-analysis-epic-patient-data/
- Centers for Disease Control and Prevention. Demographic Characteristics of People Receiving COVID-19 Vaccinations in the United States, data as of May 17th, 2021.https://covid.cdc.gov/covid-data-tracker/#vaccination-demographic