COVID-19: A Disparities Lens
The COVID-19 Pandemic and Racial/Ethnic Disparities
in the United States of America
Underserved populations in the United States suffer from health inequity based on race/ethnicity, gender, sexual orientation, socioeconomic status, and geographic location. The COVID-19 pandemic has not only thrust our nation into unprecedented times, but has highlighted on-going racial and ethnic disparities. Now is the time to help protect our most vulnerable populations and improve the quality of life for these marginalized groups.
As social determinants of health impact all health conditions, understanding these differences in terms of risk factors for COVID-19, disease presentation, treatment, and prognosis must inform our research and clinical decision-making at all levels. This paradigm underscores the need for data disaggregated by race and ethnicity in both clinical and basic science research. The COVID-19 pandemic has demonstrated vast differences in infection rates, illness, and death rates in underserved communities compared to other groups but data are lacking from many states.
The American Medical Women’s Association calls for the following:
- Data collection and dissemination. HHS, CDC, CMS, and other state and federal government organizations should collect and release nationwide racial and ethnic demographic data on COVID-19 testing, confirmed cases, ventilator access, intubation time, and deaths. Data should be collected in a national, standardized, valid, and inclusive manner while promoting autonomy and transparency among participants engaging in data collection.
- Guidance. Immediate and explicit guidance from HHS, CDC, and CMS on mitigating health disparities
- Immediate resource allocation to impacted communities. Federal, state, and city/county governments should provide the following to heavily impacted communities: targeted testing, contact tracing, outreach to residents through community-based organizations, PPE for all essential employees (not limited to healthcare workers), additional healthcare workers, oxygen and ventilators.
- Equitable resource allocation. Medical and public health interventions and allocation of resources and funding must be guided by data. Social and structural determinants of health must be considered as part of the decision-making process about allocation of all resources including but not limited to: healthcare providers, medicines, medical equipment, adequate nutrition, and clean water to ensure that minoritized groups are not denied needed resources that could prevent unnecessary harms.
- Immediate housing support. Local and state governments should work with hotels, uninhabited rental spaces, empty schools, and other organizations to provide safe housing to individuals experiencing homelessness to promote social distancing and self-quarantine. Housing for recently discharged individuals experiencing homelessness should be prioritized.
- Research and analysis of the most affected communities by infectivity and mortality rate. This will guide future healthcare modeling for clinicians. Moreover, such data will serve to guide instruction for the necessary preparation our healthcare system needs in the event of future disaster pandemics.
Furthermore, the focus on resolving pre-existing health disparities and inequities must extend beyond this pandemic, with the goal of eliminating the implicit biases and prejudices that have historically influenced resource allocation. Data collection on health disparities, guidance on mitigating disparities, and improved resource allocation to underserved communities must remain federal and state priorities.
- COVID-19 and African Americans (JAMA)
- Failing Another National Stress Test on Health Disparities (JAMA)
- COVID-19 and Racial Disparities (JAAD)
- Disparities in the Population at Risk of Severe Illness From COVID-19 by Race/Ethnicity and Income (AJPM)
- The COVID-19 Pandemic: A Call to Action to Identify and Address Racial and Ethnic Disparities (J. Racial Ethn. Health Disparities)