COVID-19’s Impact on Communities of Color Sheds Light on Health Care Disparities, Need for Action
This week has been a turning point in the United States. I want to make sure you see PPI President and Founder Will Marshall’s statement on the killing of George Floyd, and the commitment PPI is taking to come up with new ideas to fight systemic racism in the United States.
The coronavirus pandemic has had a disproportionate impact on communities of color. Essential workers — in direct care, grocery stores and delivery — are disproportionately Black. Essential workers are more likely to get the virus because their jobs don’t lend themselves to social distancing and working from home. Further compounding the damage the virus has caused, people who have lost their jobs are also more likely to be Black, particularly hurt are Black women of whom almost 19 percent lost their job since February.
The virus has also laid bare disparities in health status by race in the United States. Black Americans are 3.5 times as likely to die from Covid-19 than white Americans. This is partly because the virus is more lethal to people with underlying health conditions and people of color are 1.5 to 2 times more likely than white Americans to have chronic diseases, like type 2 diabetes and obesity because of systemic barriers to housing, income and education which all affect health status.
But there are some policy levers that could help.
Make health insurance more affordable. Cost is the main reason people remain uninsured. Even before the Covid-19 pandemic, Black workers were 60 percent more likely than white workers to be uninsured. By focusing on ways to bring down health care costs — such as introducing a price cap on medical care and increasing subsidies for Affordable Care Act health plans — insurance will be more affordable for all Americans.
Address social determinants of health. Insurance coverage is a first step but it will not by itself address racial disparities in health. Health status is a product of more than medical care — things like safety, housing, education, transportation, and nutrition all impact a person’s health. Federal agencies like the departments of education, health, and housing should collaborate to create new programs to ensure that people get not just health care, but also the housing, education, and other things that health outcomes depend on. To have additional funding for these types of programs, it is paramount to lower overall health care spending. States should also have greater flexibility to spend Medicaid dollars on housing and other social determinants that can reduce health care expenditures.
Address bias in medicine. Health care workers need to better understand the ways in which implicit and explicit bias can affect the care they provide in order to counteract centuries of racism. Sen. Kamala Harris’s Maternal CARE Act, and the accompanying House version, would authorize $150 million to programs that seek to help medical professionals identify high-risk pregnancies and establish implicit-bias training curriculum for medical schools. This type of training should be taught across all disciplines.
Make health care workers more reflective of the population. A more diverse workforce can improve outcomes for Black Americans. Using existing programs like the National Health Service Corps, which provides loan forgiveness and scholarships to workers who practice in underserved areas, the federal government could recruit more medical and nursing students from minority communities. Additionally, boosting funding to medical schools at historically black colleges and universities could increase the number of Black physicians and nurses.
Make scientific research more inclusive. In 2009, the NIH changed its grant review process in an effort to make it more racially equitable yet a new study finds that between 2014–2016, only 10 percent of Black applicants got NIH funding, compared to around 19 percent of white applicants. On the flip side, Black Americans are overrepresented in clinical trials that don’t require informed consent and underrepresented in cancer clinical trials. Undoing these racial disparities in scientific research will help improve the practice of medicine.
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