HEALTH
A Pandemic of Health Care Inequities “The familiar dictum that ‘prevention is the best medicine’ needs to be the focus when treating patients of color” BY SHAZIYA BARKAT
T
rayvon Martin. George Floyd. Breonna Taylor. Ahmed Arbery. These are just a few of the names that have ignited Black Lives Matter (BLM), an activist movement that promotes public consciousness about police killings of unarmed African Americans. While BLM has sparked nationwide protests calling for the end of race-based discrimination, its concurrent nature with the Covid-19 pandemic has sparked conversations about barriers that prevent racial minorities from accessing optimal health care services. Thousands have joined the #WhiteCoatsForBlackLives movement, which calls for action to eliminate these inequities. Health care inequities may be defined as avoidable and unjust inequalities that lead to worse health for disadvantaged social groups such as the poor, the disabled, women, and racial and ethnic minorities. Latinx, Native Americans and Asian Americans have predominantly been classified as underserved populations within our country’s health care system, with African Americans being at the top of the list. The existing gaps have been amplified even more during this pandemic. According to the Covid-19 Tracking Project (https:// covidtracking.com/), infection rates are 2.5 times higher and deaths are 1.7 times higher among people of color than they are for Whites. Blacks, who make up about 13%
of the population, account for at least 22% of all Covid-19 deaths where the deceased’s race is known. The Washington Post poll published on June 26, 2020, stated that nearly onethird of African Americans report that they personally know someone who has died of Covid-19. In addition, more than half of all Blacks state that they know someone who has either had or died from Covid-19; less than 40% of Whites stated the same. While testing is crucial to reducing Covid-19 infection rates, Black patients are currently six times more likely to receive less testing than White patients. Unfortunately, such realities are nothing new. Consider the following facts: On average, Blacks live six years less than Whites. Racial minorities account for more chronic medical conditions than others, putting them at higher risk of developing severe illnesses from Covid-19. The Centers for
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Disease Control and Prevention reports that Blacks suffer from chronic health conditions like asthma and diabetes significantly more than Whites do. A Black woman is 22% more likely to die from heart disease than a White woman. Black infant mortality rates are twice the national average, with Black women dying three times more during childbirth than White women. As someone who works with cancer patients, it’s heartbreaking to see that Blacks have the highest mortality rate for all cancers combined when compared to any other racial and ethnic group. Some barriers that contribute to these inequities include the limited access to necessary resources, such as food and housing, as well as a predominant history of systemic racism and unequal treatment of minorities. Even work environments play a part. According to the Bureau of Labor Statistics, more Black than White workers cannot work remotely during the pandemic. Minorities are also more predominant in high-risk environments, such as meatpacking plants, where Covid-19 rates are higher than those in 75% of U.S. counties (https://www.epi.org/ publication/black-workers-covid/). The increased unemployment rates have become a barrier to obtaining proper care as well. A Gallop study said that 1 in 7 individuals in the U.S. reported that they would not seek treatment due to the cost (https:// news.gallup.com/poll/309224/avoid-carelikely-covid-due-cost.aspx, April 28, 2020). According to the U.S. Census Bureau, in 2017 10.6% of Blacks were uninsured, compared to 5.9% of non-Hispanic Whites. An analysis conducted by FAIR Health found that insured patients hospitalized with coronavirus can expect to pay up to $38,000 for their stay, while the uninsured may pay up to $74,000. However, even after controlling for insurance coverage, employment, age, gender, marital status and residence region, African Americans have worse health outcomes in nearly every illness category. Medical education teaches that prevention is the best medicine. This is why the health care professionals’ ultimate responsibility is to fight systemic and individual racism, address the inequalities and close the existing gaps in patient care. Ultimately, this begins in the classroom, long before we even step into the world with our embroidered white coats. Unfortunately, many medical schools’ curriculums lack the context of race in
