COVID-19 reinforces racial divide
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An analysis recently published by the Associated Press showed that one-third of deaths from COVID-19 whose race was known were black. The AP also reported that blacks made up about 14% of the population in the areas covered in their analysis.
Experts pointed to long-standing social and genetic factors as the reason.
‘Irony’ of COVID-19
COVID-19 mortality data has done a reversal, according to Scott Frank, MD, an associate professor in the department of population and quantitative health sciences at Case Western Reserve University.
Catherine Troisi, PhD, an infectious disease epidemiologist at The University of Texas Health Science Center at Houston, also noted that insurance coverage rates are lower among blacks.
“It could be that they are not getting adequate treatment,” she said in an interview.
Frank said these disparities extend to other diseases, as well. Blacks are disproportionately affected by CVD and breast cancer mortality and have less access to treatment for certain conditions, findings show.
“The irony is that COVID-19 entered the more homogenous, whiter, richer communities first because of the differential of travel among those populations,” he told Healio Primary Care. “COVID-19 then spread to the minorities in essential occupations or those who can't afford to not work.”
“One might assume that because African Americans are at higher risk for chronic diseases and premature death that they would receive more services. But in fact, African Americans consistently receive fewer services,” he said.
“African Americans also have a higher allostatic load, which represents the physical mechanism that translates chronic toxic, stress into impaired immune function and increased chronic illness,” Frank continued. “That makes blacks both more susceptible to COVID infection and more likely to die when they get it.”
Mistrust of health care
Gary L. LeRoy, MD, FAAFP, president of the American Academy of Family Physicians, told Healio Primary Care that numerous members of the AAFP have reached out to him, describing a sense of fear among minority patients about COVID-19, as well as a lack of information about the disease, an inability to access testing, a lack of personal protective equipment and an inability to effectively adhere to social distancing guidance.
LeRoy added that minority patients who are mistrustful of the health care system may hesitate to receive a COVID-19 vaccine, if and when one becomes available. That mistrust, he said, extends back to the Tuskegee syphilis experiments, which started in the 1930s.
Reversing the trends
Frank said more testing in minority neighborhoods and effective treatment and isolation of patients with COVID-19 are required to close the racial gap that the disease is now exploiting.
Additionally, health officials need to “improve surveillance so that it doesn't only identify those who have easy access to care, and identifies where the problem is and provide the right interventions at the right time to the right people.”
Troisi stressed that experts also need to address misinformation about the disease.
“We need to make sure that we have culturally competent education for minority groups,” she said. – by Janel Miller
References:
Associated Press. Racial toll of virus grows even starker as more data emerges. https://apnews.com/8a3430dd37e7c44290c7621f5af96d6b. Accessed April 20, 2020.
CDC. U.S. Public Health Service Syphilis Study at Tuskegee. https://www.cdc.gov/tuskegee/timeline.htm. Accessed April 21, 2020.
Disclosures: Frank, LeRoy and Troisi report no relevant financial disclosures.