Health inequalities have long been a concern in medicine. A robust evidence base has been growing for decades regarding social determinants — such as poverty, neighborhood proximity to pollution, and education access — that contribute to higher risk of disease and poor health outcomes. However, it wasn’t until the COVID-19 pandemic that these issues took center stage in the public eye.
A JAMA January 2021 article revealed that the hospitalization rate for Black patients with COVID-19 was more than triple that of white people, and Hispanic patients were hospitalized more than four times more often than white patients. Asian patients with COVID-19 had double the hospitalization risk of white patients. Similarly, Black and Hispanic people with COVID-19 were more than twice as likely to die from the disease than white people, and Asian patients were almost twice as likely to die than white patients.
The problem extends beyond morbidity and mortality rates. Multiple articles have addressed how disruptions to usual in-person education have disproportionately affected Black an Hispanic students — who are also less likely to have the resources and opportunities to make up for those learning losses.
The CDC created a section about health inequities related to COVID-19 within racial and ethnic minority communities and the causes of those disparities which include:
- Poverty, causing people to live in crowded housing
- Low-income jobs with greater contact with the public
- Greater need for public transportation use.
The CDC page is also a good starting place for data on this issue. Most of their references provide background and historical information related to systemic racism and discrimination that has continually put Black and Hispanic people at higher risk for disease and poor outcomes. The site also includes studies such as this one, which notes that predominantly Black counties accounted for more than half of all COVID-19 diagnoses even though only one in five counties are predominantly Black.
Health journalists can be a catalyst for change by continuing to shine light on the research that shows the substantial impact of systemic racism and social determinants on people’s health. But journalists must make the effort to seek out this research and report on it.
The American Journal of Public Health’s August issue is a good place to start. Its theme is “Social Justice for Marginalized Communities,” in which they “explore the dual pandemics of COVID-19 and systemic racism, discuss trials and open data processes, share insight into the community-driven health ecosystem and more”.
Here are some of the articles they highlighted from the issue:
- Podcast: “Contact Tracing, School Reopening and Public Health Challenges”
- Social Justice for Marginalized Communities
- Ensuring Progress Toward Ending the HIV Epidemic While Confronting the Dual Pandemics of COVID-19 and Systemic Racism
- Of Mice and Schoolchildren: A Conceptual History of Herd Immunity
- Incorporating Health Equity Into COVID-19 Reopening Plans: Policy Experimentation in California
- Disruptions to Abortion Care in Louisiana During Early Months of the COVID-19 Pandemic
- Disease-Specific Excess Mortality During the COVID-19 Pandemic: An Analysis of Weekly US Death Data for 2020
- Whetting Your Appetite for Food Advocacy
The journal also continues to update its COVID-19 Resource Repository of papers related to the impact of the pandemic on public health not only now but in the future. If you need any articles behind a paywall, the media office can provide them.
Those who have reported on public health for years already know the tremendous impact it has on every aspect of our lives, and that impact has already been growing with the acceleration of climate change effects. Now with the added influence of the pandemic, the public is going to need stronger public health reporting than ever moving forward, even after the pandemic ends. Public health reporting that does not include, address, or at least allude to health disparities runs the risk of perpetuating them by omission.