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How the COVID-19 Outbreak Is Exposing Health Disparities in the US

COVID-19 hasn’t affected all Americans equally. How has the spread of the virus highlighted already existing health disparities in the U.S.?

COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, has wreaked havoc on the United States. As of May 9, 2020, according to the Centers for Disease Control and Prevention (CDC), nearly 1.3 million Americans had tested positive for COVID-19 and over 77,000 Americans had died.

Yet while the pandemic has upended life across the country, its impact hasn’t been equally shared. We’ll discuss COVID-19’s disproportionate impact on minority communities and outline some possible solutions to lessen health disparities in the U.S. in the future.

COVID-19 and Health Disparities

Early in the pandemic, the CDC didn’t release racial or ethnic data about confirmed cases of COVID-19. Even now, the data is incomplete; in fact, as of May 9, information on race and ethnicity was available in only 47% and 42.6% of confirmed cases, respectively. The available data, however, has revealed COVID-19’s disproportionate impacts on communities of color. Despite comprising 13.4% of the U.S. population, African Americans make up 27.6% of confirmed cases of COVID-19 in the U.S. A similar pattern can be seen with Americans of Hispanic/Latino ethnicity: Despite comprising 18.3% of the U.S. population, they make up 27.3% of confirmed cases of COVID-19.

Communities of color have also experienced higher mortality rates during the outbreak. According to APM Research Lab, per 100,000 Americans, 40.9 African Americans, 17.9 Asian Americans, 17.9 Latino Americans and 15.8 white Americans have died during the outbreak as of May 7, 2020. In other words, the mortality rate has been roughly 2.6 times higher for African Americans and 1.1 times higher for Asian and Latino Americans as compared to white Americans. These topline figures obscure wide variations across the country. In Kansas, for example, African Americans are seven times as likely to die from COVID-19 as white Americans, APM notes. In New York City, the epicenter of the outbreak in the United States, African Americans and Latino Americans have been hospitalized and have died at far higher rates than white and Asian Americans.

Incomplete data limits a full assessment of the disparate impacts of COVID-19 among all racial and ethnic groups. As the Kaiser Family Foundation notes, “Data remain largely unavailable for smaller groups, including people who are American Indian or Alaska Native (AIAN) and Native Hawaiian or Other Pacific Islander (NHOPI), limiting the ability to identify impacts for them.”

What Explains This Disproportionate Impact?

According to the CDC, multiple factors are responsible for the disparities in health outcomes seen during the COVID-19 outbreak in the U.S. For example, members of racial and ethnic minority groups are more likely to reside in densely populated neighborhoods that are far from grocery stores and healthcare facilities. Living in these areas makes it more difficult to effectively social distance, obtain necessary healthcare and acquire essential supplies. These individuals are more likely to work in essential industries — like agriculture, transportation and healthcare — that require continued work even as the virus spreads. These jobs are also less likely to offer paid sick leave, which makes it harder to miss work while sick.

Additionally, members of racial and ethnic minority groups are less likely to have health insurance, hindering their access to adequate medical care. These Americans are also more likely to suffer from many of the comorbidities that increase the risk of severe disease in those who have been diagnosed with COVID-19.

Long-Term Solutions for Health Disparities in the U.S.

Reducing and mitigating the impact of health disparities in the United States during the COVID-19 pandemic requires a complex set of solutions. Some will be relatively easy to implement, while others will prove far more challenging, both politically and administratively.

In a recent article in JAMA Health Forum, Drs. Utibe R. Essien and Atheendar Venkataramani propose three broad sets of policies to address these inequities:

  1. First, they propose that leaders in medical organizations and government prioritize the release of “racial and ethnic demographic data on COVID-19 infection and mortality” to better inform resource allocation policies in the future.
  2. Second, they recommend increasing access to Medicaid and removing barriers to accessing the social safety net to support Americans who have lost their jobs or work hours during the pandemic.
  3. Lastly, they argue for more investments in “community-based care and the social safety net” to “improve access to high-quality education and address ongoing discrimination in labor markets, housing, and the justice system.”

The COVID-19 outbreak has illuminated and worsened health disparities in America. Urgent action is needed to reduce the risk of further harm to these communities across the United States.

Want to learn more about health disparities in the U.S.? Read:

Kunal Sindhu

Kunal Sindhu

I am a resident physician who is interested in the intersection of politics, economics, and health care. My work has appeared in Huffpost, Vice, Education Week, The New York Daily News, BMJ Opinion, Medscape, STAT, Undark, and JAMA Oncology, among others.

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