COVID-19 socioeconomic and racial health disparities

Nurse practitioner shaking hands with African American man to stand against racial health disparities

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COVID-19 has brought to light prevalent socioeconomic and racial health disparities in the United States. Here we’ll explore what lessons can be learned from the pandemic.  How can we harvest this knowledge to impact change in our practice and communities? 

Evidence points to higher rates of COVID-19 hospitalization and death for people of color. Ethnic minorities are more often working front line jobs. They may experience higher risks of contracting the virus due to their interaction with the public.  For example, these jobs include delivery truck drivers, postal men and women, sanitation, retail, and food services.  Ethnic minorities are more often socioeconomically disadvantaged and prone to live in multi-generational households and densely populated areas. This makes transmission easier among individuals.  As healthcare providers and servants of our community, let’s take steps to better the health of our patients.

COVID-19 hospital rates by race and ethnicity

  • Non-Hispanic Native Americans or Alaska Native persons have a rate of hospitalization approximately 5 times that of non-Hispanic white persons
  • Non-Hispanic black persons have a rate approximately 5 times of non-Hispanic white persons
  • Hispanic or Latino persons have a rate approximately 4 times that of non-Hispanic white persons. 

(Source: CDC)

How can we improve socioeconomic and racial health disparities?

1. Educate ourselves on the social determinants of health affecting our communities

Housing, access to indoor plumbing and water, access to healthcare, access to quality schools, and access to transportation all impact an individual’s ability to sustain optimal health. For instance, the nearest doctor’s office is an hour or 2 away for a family of 5 with no car or reliable transportation. We can’t really blame the family for not being able to keep a regular primary care checkup schedule.  Instead connect them with social resources to assist with access to vital necessities. Improve their living conditions. Become a public advocate and educate ourselves on the legislative issues affecting vulnerable and higher risk populations.  If there’s a water access proposal that the city council is introducing, write our city representatives and advocate for passing the proposal.

2. Acknowledge that ethnic and social health disparities exist

People don’t decide which zip code they’re born into or which preschool they were zoned to attend.  Where we live impacts our health and success.  Many communities are impoverished.  Not due to any fault of their own, but their ethnicity has led to their circumstances. Native Americans have been confined to reservations where there is little to no access to quality healthcare.

Yes, systemic racism exists. We also have our own biases to contend with when providing culturally competent care. Acknowledge your biases. What has influenced your thinking? Acknowledge that there is no place for cultural biases in the healthcare setting. Then make the decision to see things from another’s point of view.  We are all held to the principles of “duty to do no harm”. We have “a duty to do good” as well. All patients deserve to be treated with respect and dignity.

3.  Implement strategies to promote health equity

The CDC has published reports on reducing health disparities and evidence based strategies promoting health equity for nearly a decade. Top strategies include health promotion, access to high-quality health care, food and drug safety, and prevention and control of infectious disease. Initiatives are aimed at improved prevention, detection, and treatment of disease.  The CDC states that one of the goals of the Healthy People 2020 initiative was to achieve health equity, eliminate health disparities, and improve the health of all US ethnic groups. 

Small steps you can take to improve your practice today

  • Educate yourself about the demographic composition of your patient population and community.
  • Advocate for a cultural awareness and/or social determinants of health workshop or training session at your hospital or clinic.
  • Make sure there are translators available during your visit. This can be via telephone, smart device, or in person.
  • Recognize your own cultural biases and why they’re not OK to carry into the exam room.
  • Schedule a meeting with your unit or clinic social worker. Ask them what are common socioeconomic concerns and access issues among your patient population. Ask for resources that you may be able to provide during the course of your visit.
  • Listen to your patients and ask them what are their highest priorities regarding their health. What barriers exist to them achieving optimal health?                
  • Find out what local legislation is on the docket affecting vulnerable and higher risk populations in your community.  Advocate at the local level for topics you feel passionate about changing.

This blog post has been about the socioeconomic and racial health disparities that COVID-19 has brought to light and how healthcare professionals can improve community health and equity.

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