Disparities in Mortality During the COVID-19 Pandemic – Part 3

African Americans may be vulnerable to COVID-19 because many suffer from underlying health conditions, including asthma, diabetes, high blood pressure, obesity. Details of racial disparities came after data revealed the majority of New York’s more than 5,489 deaths due to coronavirus were among men, and 86% of all deaths were among people who had underlying illnesses, such as hypertension and diabetes.

The Crisis Standards of Care, which helps hospitals ration critical resources like ventilators and ICU beds to those who are most likely to benefit from them, recommends that hospitals use frameworks that include the patient’s age, how critically ill the patient is at arrival, and the “comorbidities” — in other words, the underlying illnesses that can put patients who are infected with COVID-19 at a higher risk for worse outcomes. These guidelines aim to treat individual cases fairly, but a system that penalizes on the basis of comorbidities, or underlying health conditions, will undoubtedly and unfairly penalize the populations that are already more vulnerable to those conditions. This will almost certainly mean that racial and ethnic minorities will be placed in the “back of the line” for critical care resources.

Coronavirus cases and related deaths soar in cities with significant black populations, including New Orleans, Detroit, Chicago, and New York. But, only a few states have released the racial information, including Illinois, Louisiana, Michigan, New Jersey and North Carolina. Data from these states shows blacks are dying at a disproportionately higher rate compared with whites. In both Chicago and Louisiana, black patients account for 70% of coronavirus deaths, even though they make up roughly a third of the population.

What Can We Do?

We need to know the facts. We need to divert testing and resources to at-risk and minority communities. Testing may support adequate treatment and next steps. We need to ramp up testing and include demographics in the reporting. The facts will inform policy and programming and what resources are needed and where.

Improve the public health messaging of COVID-19 so that it is culturally sensitive and appropriate.

Faith-based communities have been known to address the health concerns of their parishioners. Public health messaging can be shared during the virtual worship services, church websites, etc.

In the meantime… please follow the advice of the experts. Take care of yourself, shelter-in-place if you are able, physical distance 6 feet apart, wash your hands for 20 seconds, and wear masks or face-coverings.

*For more information on health disparities in general, and to illustrate the impact of health disparities, please watch “Unnatural Causes: Is Inequality Making Us Sick?” https://unnaturalcauses.org. This is a 7-part documentary series that explores racial and social inequalities in health.

The environment in which we live is a major determinant of our health and wellbeing. Clean air, water, soil, plants, food supplies, and even our community environment which includes the Social Determinants of Health, are essential for our personal health. In my blog’s Environmental Health Series, we will continue to talk about the environment and try to answer the question, “What is an unhealthy environment and how does it get under the skin?”The environment’s effect on our health is complicated, but there are ways that we can prevent and reduce toxic exposure.