COVID-19 and Health Care Disparities

A recent Washington Post special report found that people of color continue to die from the coronavirus at much higher rates than Whites. Though COVID-19 infections are surging all over the country, overall mortality rates have significantly decreased since the beginning of the pandemic. However, the death rates have diverged based on race. “Black, Asian, Native American and Hispanic patients still die far more frequently than White patients, even as death rates have plummeted for all races and age groups, according to a Washington Post analysis of records from 5.8 million people who tested positive for the virus from early March through mid-October.”

Similar to conclusions found in other research on the topic, this report listed several factors contributing to these disparities, including shortage of COVID-19 testing in communities of color, incomplete data collection, delays in translations of health information, and limited enforcement of public health steps like mask-wearing in essential workplaces.

Although systemic racism cannot be quickly rooted out, the report found that even small measures that can be quickly implemented have been proven to make a difference and save lives. The Report highlighted successful changes in Michigan that were aimed at addressing these disparities. “Faced with extreme disparities in covid-19 deaths, Michigan officials undertook a series of steps, from boosting testing to connecting people of color with primary care doctors. The state’s rapid progress proves the issues are neither intractable, nor rooted somehow in biology.”

As hope for an end to the nightmare of the pandemic lies in a vaccine that has had promising results in studies, another issue rooted in long standing systemic racism in healthcare arises.  Polling shows that many minority populations are distrustful of the vaccine and express reservations about being vaccinated. 

A recent Washington Post article, Coronavirus Vaccines Face Trust Gap in Black and Latino Communities, highlights results of a study that show vaccine hesitancy in communities of color. “Perhaps its most sobering findings: 14 percent of Black people trust that a vaccine will be safe, and 18 percent trust that it will be effective in shielding them from the coronavirus. Among Latinos, 34 percent trust its safety, and 40 percent trust its effectiveness.”

The New York Times columnist Charles Blow places these vaccine concerns within historical context. He states, “[t]he unfortunate American fact is that Black people in this country have been well-trained, over centuries, to distrust both the government and the medical establishment on the issue of health care,” followed by a catalogue of some of the horrendous exploitation Black men and women endured in the United States in the name of medical research.

Previous research has also demonstrated the lasting damage to Black communities’ trust in government that resulted from the unethical Tuskegee Study. “Black patients consistently express less trust in their physicians and the medical system than white patients, are more likely to believe medical conspiracies, and are much less likely to have common, positive experiences in health-care settings. These have all been connected to misgivings among black patients about Tuskegee and America’s long history of real medical exploitation of black people.”

Conclusion

In order to address the deadly virus and address related health disparities, policy experts must collect data, particularly breaking down data by race and ethnicity, must respond to these disparities, and must understand the magnitude of medical mistrust that exists in communities of color, and the historical context for the concerns.