Racial Inequity of COVID-19 in Mississippi: A Q&A with Dr. Thomas Dobbs by Nick Judin
M
April 29 - May 12, 2020 • jfp.ms
NJ: MSDH has steadily provided more data portraying the racial health disparities of COVID19. What does Mississippi’s racial disparity in COVID-19 look like, and how do we compare it to other states in this regard? TD: Well, clearly we have a disparity in deaths and in cases. If you look at our info, the latest information, you know, based on available data, 51.3% at least of our cases are African American. You know black folks only make up about 37% of the population. So there’s a lot more—but then you can look at the deaths. It’s about 64% of the deaths. So that’s really, really just unacceptably high. As far as how we compare to other parts of the country as a proportion, we’re pretty much in line, unfortunately, with other states around the country. This is obviously not just a Mississippi issue, but because we have the largest percent population (about 38%) of African Americans in the (country), obviously the disparity is going to be a lot more obvious.
14
NJ: Underlying health conditions such as heart disease, lung disease and diabetes exacerbate the threat of this virus. Based on what I’m reading, it seems that virtually all of Mississippi’s deaths have been from these at-risk populations. How much do those comorbidities explain the discrepancy in outcomes, but also the reports of infections in general? TD: Yeah. So you know, clearly we do have health disparities underlying chronic illnesses. That is a part of the problem. We’re trying to be careful not to state that that’s the only issue, because we want to make sure that that black population is getting tested adequately. That’s a possibility, also—access to care issues.
Are there other factors that play into the disproportionate number of infections and the disproportionate number of deaths? So, you know, that’s going to take more investigation. Clearly the chronic disease burden is part of the equation, but we need to make sure that we investigate into other etiologies, other causes. Because, you know, certainly if it’s a testing access issue, that’s something that we can fix in the short term versus these, you know, decades and decades of health disparities
ally understand, perhaps, where our weaknesses are in messaging or in access to care to the black community. NJ: Is there anything that you’ve found that you can share with us so far? Weaknesses that are trying to be addressed right now? What’s the progress? TD: We’re still collecting surveys. But, you know, I’m hoping to have some preliminary data at least by the first part of next week. But we have thousands of them, and courtesy State of Mississippi
ississippi State Health Officer Dr. Thomas Dobbs is leading the public-health response to the COVID-19 crisis, directing the State Department of Health and serving as Gov. Tate Reeves’ chief health adviser on the virus and the state government’s attempts to stem its spread. But the burden of COVID-19 is not equally shared among all Mississippians. Black Mississippians are acquiring the virus at a disproportionate rate, and their health outcomes paint an even harsher picture of health inequity. MSDH data on April 28 shows 52% of cases and 59% of deaths occurred in the Mississippi’s black population, a severe disparity with the state’s demographics: Only 37% of Mississippians are black or African American. MSDH reached out to the Jackson Free Press to schedule the Wednesday, April 22, interview on the subject of black health disparities in the coronavirus crisis, and MSDH’s plans to address these burdens moving forward. The interview has been lightly edited for clarity. A portion of cross-talk regarding available data on deaths according to gender was excised.
State Health Office Dr. Thomas Dobbs called the disproportionate COVID-19 cases and fatalities in Mississippi “unacceptably high,” while acknowledging that they are the norm in the United States.
and social inequality. That’s not something that we’re going to be able to resolve within a couple of weeks. NJ: So, you raise a good point there where it comes to racial disparities and health-care access, clinic access. Does it follow these disparities extend to COVID-19 testing? What I’m asking is, what metrics or numbers will give us confidence that there’s not a racial testing gap hiding an even wider racial health impact? TD: We have identified a way to … that data point is not something that’s readily available, but we’ve identified a way that we could survey the negative case reports so that we’d get a proportionality of testing based on race and ethnicity. So that’s something that we’re working on and hope to be able to report out soon. The other thing is we’re doing a statewide survey of people, with a focus on African Americans, (to) understand what are the concepts within the black community, especially around COVID, attitudes toward social distancing, you know, attitudes towards risk, to make sure that we re-
would like to get more if possible. And that’s a project we’re doing in collaboration with Jackson State (University). So we want to credit their work. NJ: So speaking of that, what is MSDH’s plan for viral surveillance and prevention, specifically in minority communities? Then following that, as we start to see a decline, what’s the plan for preventing a resurgence in those exact same communities? TD: Well, you know, certainly we’re trying to target our resources into the most affected communities. And so it obviously makes sense that we’re going to spend a lot of our testing and investigation efforts within the black community. Even from the beginning—although maybe not intentional, but because we recognize these are communities that are affected—we started doing targeted testing in the Delta, in locations (like) Lauderdale County, in places where the black community is really badly affected. So increasing access to testing is going to be very, very
