Since the pandemic began, communities of color have been impacted by COVID-19 at an alarmingly disproportionate rate: upon contracting the disease, Black Americans are twice as likely to die compared to their white counterparts. Pacific Islanders are 2.6 times more likely, Latinx are 2.4 times more likely, and indigenous people are 2.2 times more likely to die of the virus in comparison to the white population.
But what is behind these numbers? Many are now attempting to understand the root cause of racial inequities in access to healthcare, tracing them all the way back to the foundations of the U.S. healthcare system. Increasingly, advocates are helping us understand that it is racism – rather than race – that has been the real cause of why COVID-19 has taken such a devastating toll on communities of color.
“[Communities of color] are looking at a healthcare system that has consistently and persistently demonstrated that their lives are valued less than others, based on the poor outcomes we have seen over and over again and done nothing about.”Dr. Giselle Corbie-Smith
Today, as the United States continues its nation-wide vaccine roll-out, many people are beginning to see a light at the end of the tunnel. For communities of color, however, pervasive inequities in access to vaccines are just the latest in a long history of systematic degradation and racism in the U.S. health system that they have experienced for generations.
As part of Physicians for Human Rights’ webinar series on the health and human rights aspects of COVID-19, PHR hosted a discussion on the impact of structural racism and systemic inequalities on communities of color. The discussion was moderated by Olugbenga Ogedegbe, MD, MPH, director of the Institute for Excellence in Health Equity at NYU Langone Health, professor of medicine, and director of the division of health and behavior in the department of population health at the NYU Grossman School of Medicine. Expert panelists included civil rights activist and hate violence expert Eric Ward; Giselle Corbie-Smith, Kenan Distinguished Professor of Social Medicine at the University of North Carolina; and Monik C. Jiménez, assistant professor of medicine at Harvard Medical School and associate epidemiologist in the department of medicine at Brigham and Women’s Hospital,
Watch the discussion here:
Comorbidities in Communities of Color
In the webinar, the panelists acknowledged that inequities within the U.S. healthcare system was a reality even before the pandemic hit. Early in 2020, in the face of a looming international health crisis, people of color and marginalized groups in the United States failed to receive adequate information in order to protect themselves from the coronavirus.
“The failure in the early days was the failure to understand the role that inequality and racial bias always plays in the case of emergencies,” said civil rights strategist Ward. “I want to situate the coronavirus and the pandemic and the quarantine alongside other natural disasters, whether we [are] talking about hurricane Katrina, whether we are talking about flooding in Florida, or whether we are talking about the deep freeze that hit Texas.”
Marginalized communities were not given adequate access to supplies, such as masks and personal protective equipment, despite the government’s responsibility to do so. Panelists pointed out that the deaths of nearly 600,000 people from the coronavirus in the United States, many of whom were people of color, were a direct consequence of the government’s negligence.
It’s time that government officials as well as the public acknowledge and take responsibility for the major missteps of history and make the changes that so desperately need to be made.
The failure of the U.S. government to effectively communicate the severity of the pandemic also directly impacted the carceral system, a system in which Black, indigenous, and Latinx people are disproportionately incarcerated and detained to begin with. Those in the system are also exposed to extreme levels of overcrowding, unsanitary living conditions, and little access to healthcare, conditions which remained unchanged even as cases of COVID-19 soared. The rate of COVID-19 in the U.S. prison system is five times that in the general population, with mortality rates three times higher.
“There was no question from the beginning that COVID-19 would be devastating for incarcerated and detained people. That was not a surprise,” said Dr. Jiménez of Harvard Medical School. “And inaction early on to center decarceration efforts was quite honestly irresponsible and a complete failure of our systems.”
The panel also emphasized the urgency of addressing vaccine hesitancy among communities of color. Dr. Corbie-Smith pointed out the feelings of uncertainty and mistrust among African American, Indigenous, Asian-American, and Latinx populations of the United States healthcare system.
“[Communities of color] are looking at a healthcare system that has consistently and persistently demonstrated that their lives are valued less than others, based on the poor outcomes that we have seen over and over again, and done nothing about,” she said. With the announcement of the COVID-19 vaccine, these views translated into vaccine hesitancy.
So, what can be done?
Pivotal in improving the health of communities of color, the panelists agreed, is transparency and the reallocation of resources. Elected officials should also expand programs for underserved communities, like the National Institute of Health’s Rapid Acceleration of Diagnostics initiative, in which underserved communities across the nation are given adequate access to testing, vaccinations, and trusted information. As the world continues to understand more about the coronavirus, it is vital that institutionalized systems are put in place to address chronic illness, disease, and disaster, to better prepare at-risk communities for what may come.
Ultimately, equity in all forms begins where inequality ends. As Dr. Corbie-Smith put it, “inequality is not simply a Black and brown problem, this is all a problem for all of us.” After a year in which our health seemed more interconnected than ever, addressing the many existing structural and institutional inequalities in our health systems could not be more urgent. It’s time that government officials as well as the public acknowledge and take responsibility for the major missteps of history and make the changes that so desperately need to be made. Our lives depend on it.