For disadvantaged communities, the COVID-19 pandemic is far from over
While the COVID-19 pandemic begins to wane due to the recent vaccine rollout, the fight for disadvantaged communities is far from over. Health inequities have been long felt by communities that lack access to adequate health and technology resources. For communities of color and lower socioeconomic status, in particular, these inequities have been brought to new light and exacerbated during the pandemic. For example, American Indian or Alaska Native populations, Black or African American populations, and Hispanic populations are about three times more likely to be hospitalized by COVID-19. Blacks and Latinos also have substantially lower access to mental health and substance-use treatment, both of which are risk factors for COVID-19 (1 (https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/people-who-use-drugs/QA.html),2 (https://www.samhsa.gov/sites/default/files/covid19-behavioral-health-disparities-black-latino-communities.pdf)).
Black or African American populations and Hispanic populations are about three times more likely to be hospitalized by COVID-19.
We met four distinguished experts who study potential contributing factors to these issues, and the new innovative solutions needed to address these inequities.
Technological disparities - Dr. Tollie Elliot
Dr. Tollie Elliott, Chief Medical Officer at Mary’s Center, focuses on inequities such as technological inequities and the resulting barriers to telehealth. Notably, access to factors that contribute to a healthy lifestyle, including nutritious food options and preventative medicine, is crucial to long life expectancy but is not equally available among all localities and populations. While these inequalities have been previously recognized, the lack of these resources throughout the pandemic proved extremely detrimental to many. Specifically, a person’s zip code is the biggest predictor of life expectancy within the United States, which demonstrates the impact of location on overall health and ability to access health resources, especially during a pandemic when travel was encouraged to remain local (3 (https://www.rwjf.org/en/library/interactives/whereyouliveaffectshowlongyoulive.html)). In addition, during the COVID-19 pandemic, telehealth consultations were widely used as a safe alternative to traveling to a doctor’s office and were promoted by federal health agencies as a way to minimize the risk of virus exposure. However, those with limited access to broadband and digital technologies needed to access those services were substantially disadvantaged during the height of the pandemic.
Family mental health - Dr. Anna Gassman-Pines
Dr. Anna Gassman-Pines from the Duke Sanford School of Public Policy has been examining the impact of the pandemic on parental and child stress and socioeconomic functioning. For children and adolescents with mental health needs, quarantine-induced social restrictions and reduction of face-to-face peer support have proven to be an added stressor. These issues were exacerbated by inequities in loss of work compensation, as African American workers who lost their job were less likely to receive unemployment funds (4 (https://link.springer.com/article/10.1007/s12552-021-09319-2)). Those who remained employed, especially in lower-income jobs designated as “essential”, were required to report to work throughout the pandemic and risked exposing their families to the SARS-CoV-2 virus. This was especially true for those of color living in multigenerational households, with elder family members at greater risk of death from viral infection (5 (https://www.nbcnews.com/news/latino/latino-multigenerational-households-risk-covid-states-address-vaccine-rcna511)).
Vaccine hesitancy - Dr. Lillie Williamson
Dr. Lillie Williamson from the University of Wisconsin-Madison has focused her research on the historical context for vaccine hesitancy and solutions to overcome this issue. As COVID-19 vaccines have become widely available, vaccine hesitancy persists among many. Much of this hesitancy stems from misinformation. However, hesitancy among minority populations has historical roots in structural healthcare inequalities and injustice. Examples of unethical experimentation on minority groups have created mistrust for medical professionals among those affected groups (6 (https://www.theguardian.com/society/2021/jan/26/could-understanding-the-history-of-anti-vaccine-sentiment-help-us-to-overcome-it)). For these reasons, vaccination promotion by community members and trusted partners is crucial to addressing vaccine hesitancy and promoting health literacy, including concise and accurate information about vaccine safety and efficacy (7 (https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3315-3)). In addition to vaccine advocacy from community members, a systems approach to addressing health inequalities has shown to be effective and includes public reporting of virus exposure and the creation of multilingual resources (8 (https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0374)).
Long-term social, behavioral, and economic impacts of COVID-19 mitigation efforts- Dr. Theodore Brown
Dr. Theodore Brown from the University of Rochester has long been studying the historical consequences of other public health pandemics and epidemics and associated mitigation strategies across diverse populations. During the COVID-19 pandemic, he has been focusing on the long-term social, behavioral, and economic impacts of COVID-19 mitigation efforts, especially on disenfranchised communities, and potential solutions to address the current pandemic.
The healthcare inequalities experienced by many groups in our society are multifactorial and complex. In order to create long-lasting solutions, approaches must be equally as multifaceted, requiring engagement from the government, healthcare communities, affected community leaders, and health justice advocates. The STPF fellow affinity groups are committed to engaging in discussions about issues influencing healthcare disparities during the COVID-19 pandemic.
If you want to learn more, we invite you to join us to meet these and other experts to discuss potential solutions at the upcoming Science & Technology Policy Fellows (STPF) Affinity Group symposium on ‘Health Inequities Exposed and Exacerbated by the COVID-19 Pandemic Wednesday, June 30th, 2021, from 9:30 AM to 4:00 PM.
To learn more, visit our website (https://sites.google.com/view/sci4covidhealthequity) and register for the FREE event here (https://tinyurl.com/Sci4COVIDTicket).