Racial disparity and COVID-19 Local factors, seen across the country

. July 2, 2020.

A recent Center for Disease Control and Prevention (CDC) study found that COVID-19 hospitalizations and fatalities had a disproportionate impact on African-American and Latino populations. The April report revealed that in New York City, the hardest hit area of the country, the death rate for black people was 92.3 fatalities per 100,000 people and the Hispanic/Latino rate was 74.3, substantially higher than that of white people (45.2) or Asians (34.5). In Ohio, where African-Americans comprise 14-percent of the state’s population, 1-in-4 coronavirus cases and nearly 1-in-5 deaths are attributed to black people, according to the Ohio Department of Health.

Anthony Armstrong, MD, MPH, a Toledo physician and president of the Ohio State Medical Association, the state’s largest physician led-organization, shared his insights on the racial and ethnic disparity of COVID-19 infection locally.

Disproportionate impact

Current information from across the country shows the COVID-19 fatality rate is disproportionately impacting the African-American community as well as Latino and other people of color.
“Given the racial disparities this virus has had on minority populations it is extremely important that our local and state health departments, with the support of the federal government, gathers meaningful data that includes race, ethnicity, gender, and overall health status to have a better scientific understanding of how this virus spreads,” said Dr. Armstrong. “This is essential to developing effective strategies not just to mitigate the spread of the disease but also to form meaningful public health policy and legislation specifically aimed to improve the health and wellbeing of the impoverished.”

Dr. Armstrong, who also serves on Ohio Gov. Mike DeWine’s Minority Health Strike Force, continued, “Dating back many generations in our country, many African-Americans have always held a general distrust of the medical system and a distrust that medical professionals had their best interest and best health in mind. That mentality is rooted in our country’s prior history of racial inequality, not just for African-Americans, but other people of color. To that point African-Americans have higher rates of diabetes, asthma, high blood pressure and other public health ailments and statistically we are less likely to regularly see or be under the care of a physician. African-Americans live with these public health conditions for a longer period before getting medical care, which could exacerbate our overall care.”

Several factors

Dr. Armstrong said a number of factors could be driving the higher virus rates within minority communities.
“What we know about COVID-19 is that if your body is already weakened by other severe medical concerns then this virus is likely to have a more devastating impact on you. Access to medical care, medical providers and PPE (personal protection equipment) currently plague lower income populations,” he said. “There may be other underlying mitigating factors that predispose lower income populations to be more susceptible to not just getting the virus but spreading the virus amongst themselves. Through Governor DeWine’s task force we are gathering meaningful demographic information and scientific data to better understand the relationship with the COVID-19 virus and why it seems that lower income neighborhood “hotspots” have a higher prevalence of illness.”
Dr. Armstrong said more complete data is needed to more fully understand how the virus is impacting segments of our community.

“We need this data to better understand how the virus spreads and to develop more effective strategies to prevent the spread of the virus while we continue to develop effective ways to treat it for those who are already sick or will become sick,” he said. “It’s clear we’ve seen significant spikes in cities with higher concentrations of African-Americans – New York, Detroit, New Orleans, Chicago. Ohio also has large American cities with higher concentrations of African-Americans that could warrant our attention.”

New health care technology

New health care technology is helping physicians provide the supportive care COVID-19 patients need.
“One thing we are learning to use more where I work and I know this is true for healthcare providers across Ohio is to use Telehealth. This allows us to consult with our patients face-to-face via computer, laptops or smartphones,” said Dr. Armstrong. “And if you do not have video capabilities, then you need to know that we can still provide effective care via a telephone call. What are your symptoms? How are you feeling? What is your prior medical history? Do you need to be tested and where can you go to be tested? Do you have or know where to get PPE? These are all questions that can be answered via telehealth and help us as healthcare providers provide some level of care as opposed to no care at all.”

But physicians also have a major role to play in reversing this trend, Dr. Armstrong said, by assuring that medical care is available to everyone – especially those in minority communities who may not have a relationship with a doctor.

“I believe that we in the medical profession can do more to be sure that we make our services more accessible and inviting. We have to look for ways to make healthcare more accessible to everyone, especially those who are the most vulnerable among us,” he said. “We know that early intervention of care can significantly lower the chances of necessary chronic medical care later. We all need to be dedicated to assuring that health care is fully inclusive and attainable so that everyone has access to necessary medical services regardless of race, ethnicity, sexual orientation, or any other defining characteristic.”

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