The impact of COVID-19 exemplifies how the existing health system in the United States discriminates against marginalized groups. Data supports that in larger cities, such populations are contracting coronavirus and dying at a disproportionately high rate. For example, in Michigan, African Americans make up about 33 percent of COVID-19 cases and 40 percent of deaths, despite constituting only 14 percent of the population.
But this disparity does not only exist with health care outcomes. Rather, these disparities start early within the chain of medical care: lack of testing for the African American population. This leads to delays in diagnosis and therefore delays in treatment, leading to worse outcomes due to coronavirus’s quick progression. Lack of testing is often due to the fact that lower-income areas of the country and institutions with little funding do not have equal access to testing equipment and personal protective gear.
It’s important to realize that this is not a new issue, but the by-product of a pre-existing system that caters best to the elite class in the U.S. If you’re not financially stable and you’re a person of color, it’s likely that health care services are not readily available to you as health care is a privilege rather than a right. This isn’t a riddle, it’s a reality that lower-income areas of the U.S. lack hospitals and primary care physicians. For example, a special report produced by Journal Sentinel maps a breakdown of primary care physicians in poorer neighborhoods in comparison to large affluent cities. It’s clear that the poorer areas are facing a physician shortage, which means that there are upwards of 3,500 residents per primary care physician in that area. These patient populations are often heavily reliant on student-run clinics and emergency care community centers. This is because single income households cannot afford to pay out-of-pocket costs and premiums. Programs that support marginalized groups include but are not limited to Medicare, Medicaid and the Children’s Health Insurance Program.
A figure in a health report on “Racism, Inequality, and Health Care for African Americans” constructed by The Century Foundation depicts the stark maternal health outcomes between African American and white women. “However, disparities still exist across health conditions when comparing African Americans and whites, including maternal mortality, infant mortality, heart disease, diabetes, cancer, and other health issues.” In addition, underrepresented minority groups suffer from the effects of social factors compounded with medical conditions. Social factors include income inequality, insurance status, inequities in education and lack of access to health care, thus impacting a person’s ability to lead a healthy life. Racism and discrimination are additional examples of social factors that not only take a toll on mental well-being but also impact the level of access to health care. During this pandemic, many of us live with the security that if we do not have underlying health conditions we’re better protected from the worst of it. However, minority communities more frequently fall under the category of at-risk populations as they’re disproportionately impacted by chronic illnesses and underlying health conditions like diabetes and lung disease.
Dr. Sharnell Barber, assistant professor of biostatistics and epidemiology at Drexel University, states that “these communities, structurally, they’re breeding grounds for the transmission of the disease … It’s not biological. It’s really these existing structural inequalities that are going to shape the racial inequalities in this pandemic.” The maintenance of structural inequalities is how the cycle perpetuates.
These inequities in the current health care model are unacceptable. So then the question that arises is: How can hospitals better serve and deliver care to diverse patient populations? To better serve diverse patient populations, the hospitals within this system must embrace a patient-centered focus with consumer-friendly health solutions.
To accomplish this requires an entire paradigm shift in the purpose of the health care system. Currently, the health care system is driven by churning out a high volume of patients rather than focused on producing better health care outcomes. Per the Health System Tracker, in comparison to international prices for health services and prescription drug costs, today the costs of medical procedures in the U.S. are more costly than medical procedures anywhere else. Many may argue this is proportional to the standard of care available in the U.S. such as readily available testing and innovative health care solutions but upon further examination, the demand for lower costs and improved outcomes surpasses the standard of care here.
It’s beautiful to see how in times of true need, so many community members are stepping up to contribute to the efforts. This type of support for at-risk populations needs to operate year-round with or without a pandemic present. Listen to the numbers and listen to the public health experts, they serve as a voice for those who are silenced by the system. Universal health coverage cannot be achieved while racism, biases and other oppressive barriers persist in health care. COVID-19 opened our eyes to the fact that as a nation, we are not prepared to address the public health needs of all people. Providers and hospitals need to invest in closing the gaps in medically underserved communities. While innovative health care solutions that serve all patients equally aren’t easy to come by, we also cannot continue to fail our at-risk patient populations with the current systemic barriers in place. Because health care is a human right.
Varna Kodoth can be reached at email@example.com.