Racial and ethnic minorities have experienced health inequities for decades in the United States. Research demonstrates that minorities are more likely to come down with illnesses, and die across a variety of health conditions.
When looking at chronic health conditions, such as diabetes, obesity, and heart disease, minorities experience an increased rate of morbidity and mortality when compared to their white counterparts.
Moreover, minorities on average have a lower predicted life expectancy than white Americans.
Although great strides have been made to close the gap in health outcomes, there is still a lot of work to be done. We are far from finished when addressing and eliminating inequities, as demonstrated by the COVID-19 pandemic.
The coronavirus pandemic has been a profound example of how just being a minority can predict poorer health outcomes.
This article will explore this phenomenon and how it affects COVID-19 exposure, illness, and death in minority groups.
What is “health equity”?
Health equity refers to the opportunity for everyone to have access to the same services and opportunities to better their health. When health equity is at play, everyone has equal access to healthcare resources.
Unfortunately, health equity is not a reality for minorities in present day. The hope is that policies and programs can be implemented to prevent existing inequities and promote better health outcomes for everyone.
What are social determinants of health?
Social determinants of health are important to understanding how an individual’s racial and ethnic background can affect how they receive care and support from society, specifically in the COVID-19 pandemic.
There are five main pillars of these social determinants, which are explained in detail below:
Environment: Minority groups are unequally affected in terms of accessing affordable and quality housing.
These groups often must turn to less ideal living spaces that are overpopulated, removed from reliable transport, and far from healthcare services.
Additionally, nutritious and healthy food may be limited, and environmental pollution levels may be higher.
The lack of resources and quality living conditions contributes to increased illness, disease, and injury, leading to poorer health outcomes.
Healthcare: Minority groups are historically affected by disproportionate access to proper healthcare and healthcare insurance.
There may be physical distance between an individual and healthcare resources or social barriers to accessing care.
Oftentimes there are cultural or linguistic differences between providers and minorities that are not properly addressed by services, causing many to remain undertreated or not treated at all.
Occupation: Many minority groups are unequally represented in essential work settings. These workplaces include healthcare facilities, factories, retail, and public transit.
Individuals in these roles are more susceptible to developing illness because of close public contact. Additionally, they may not have access to benefits to take time off or sick days when needed.
Wealth: Minorities typically have lower incomes and have barriers to obtaining wealth. Thus, managing bills and expenses can prove to be difficult, specifically when it comes to medical bills.
Individuals may not take advantage of healthcare services in an effort to avoid additional expenses.
Education: Minorities don’t always have the same access to education, resulting in low health literacy and numeracy.
Additionally, minorities demonstrate lower rates of high school and college completion. This can result in lower paying and low stability jobs that can further health disparities as mentioned above1.
What about COVID-19?
The coronavirus pandemic has been a stark example of the aforementioned health disparities. Minorities have been more likely to get sick, develop severe illness, and die from coronavirus.
This section will discuss how these inequities came about in relation to the social determinants listed above.
Exposure: Individuals who live in crowded areas are more likely to contract COVID-19, as the disease has high transmission rates.
Additionally, minorities are more likely to work in jobs where public interaction is high, such as in healthcare, grocery stores, and public transport.
Minorities may also have increased travel times to COVID-19 testing sites in addition to lacking health insurance, the ability to take time off of work, or the funds to access testing. This can result in unknown and uncontrolled spread of the virus.
Risk of Severe Illness and Death: A few studies exist evaluating how social factors can elevate one’s risk for developing severe COVID-19 disease.
These analyses elucidate that racial and ethnic minorities are at an increased risk of severe illness or death from COVID-19. This is largely in part by limited access to healthcare resources.
Access can be limited due to an individual’s lack of childcare or transportation, inability to take off work, language barriers, and discrimination within the healthcare systems.
Additionally, minority groups are more likely to have underlying medical conditions. These conditions, such as obesity, increase an individual’s likelihood of developing severe disease.
Impact of Mitigation Strategies: Racial and ethnic minority groups had increased job losses throughout the pandemic.
This has led to financial insecurity and potentially the loss of health insurance, and along with access to healthcare resources comes the lack of access to preventative vaccination.
Non-Hispanic Black, Hispanic or Latino and non-Hispanic Asian people had historically lower vaccination rates before the pandemic, and the concern remains with COVID-19 vaccination.
Children: Minority children are less likely to have been vaccinated, paralleling the stark racial disparities amongst the general population.
This makes them more susceptible to disease and increases the likelihood of them spreading it to their families.
Moreover, minorities already demonstrate disproportionate access to education and with the closing of schools because of the pandemic, there have been consequences.
Minority children have been reported to be falling behind academically. These inequities will continue to affect minority children, specifically when they return to in-person school2.
Conclusion
To build a healthier nation and end this pandemic, we must break down the barriers that have led to racial and ethnic health inequities. Healthcare must be accessible to all, including minorities, to stop the spread of coronavirus.
There is much to be done to address these disparities, including the implementation of policies and procedures to increase access to healthcare services.
Written by: Emmanuel J. Osemota
References
- CDC. (2020, February 11). Community, work, and school. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/index.html
- 2021. (2021, September 16). Racial disparities in covid-19 impacts and vaccinations for children. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-covid-19-impacts-and-vaccinations-for-children/
