The COVID-19 Pandemic is Worsening Health Disparities. Emergency Physicians Can Help
RACISM AS A PUBLIC HEALTH CRISIS
By William E. Baker MD, David A. Kim MD, PhD, and Leon D. Sanchez MD, MPH on behalf of the SAEM ED Administration and Clinical Operations Committee
20
Though COVID-19 was initially described as a “great equalizer” to which rich and poor, young and old alike were susceptible, the pandemic’s impact on our society has been anything but uniform. COVID-19 mortality is markedly higher in regions with more poverty, crowding, and racial segregation. In Chicago, Black residents account for 30 percent of the population, but 70 percent of COVID-19 deaths. Nationwide, only six percent of white patients who died from COVID-19 were younger than 60, compared to 25 percent among Latinos. Even among front-line providers, risk of COVID-19 is greater among minorities. Though medical comorbidities are more prevalent among minority and low-income patients and are risk factors for severe COVID-19, comorbidities alone do not explain the stark disparities in cases and deaths by race and socioeconomic status. Lower income
“Though COVID-19 was initially described as a “great equalizer” to which rich and poor, young and old alike were susceptible, the pandemic’s impact on our society has been anything but uniform.” and minority patients make up a disproportionate part of the “essential workforce,” with few opportunities for social distancing or remote work. When patients fall ill with COVID-19 and seek care, minority and low-income patients are more likely to receive care in overburdened and under-resourced public and/or safety-net hospitals. At
the height of the outbreak in New York City, COVID-19 mortality was as much as three times higher in the understaffed and overwhelmed public system (which received a preponderance of lowincome patients), compared to wellstaffed private hospitals, which received vanishingly few transfers from the overwhelmed public system.
