Health inequities—defined by the World Health Organization as systematic differences in the health status of different population groups—have been in the national spotlight for years, which isn’t surprising given that the U.S. ranks last on measures of health equity compared to other industrialized countries.
Vast racial health disparities are not accidental and can be fixed, says Dr. Marcella Nunez-Smith, head of Biden’s Covid-19 Health Equity Task Force.
The current crisis underscores why the pursuit of health equity should remain the top priority in global health. But it also lays bare the gap between the equity ambitions of the global health field and healthcare realities. The attention that the pandemic has brought to social and health inequalities may offer an opportunity to address that shortcoming.
Without a focus on racial equity, vaccine allocation will further divide the country and perpetuate health inequalities.
Some already yawning gaps are being pushed farther apart by the virus
Unpicking the causes of gaps in health outcomes requires better data than most countries currently collect.
While people in the wealthy West have had preferred access to multiple rounds of vaccines, vast numbers of people, especially in Africa and on the Indian subcontinent, haven’t received a single dose. This has permitted the virus to thrive and accelerated the process of mutation, adding months and perhaps years to the pandemic.
Glaring absences in US data despite disproportionate effect on Black, Latino and Native American communities.
Women’s unemployment has risen more than men’s
The COVID-19 is disproportionally affecting the poor, minorities and a broad range of vulnerable populations, due to its inequitable spread in areas of dense population and limited mitigation capacity due to high prevalence of chronic conditions or poor access to high quality public health and medical care. Moreover, the collateral effects of the pandemic due to the global economic downturn, and social isolation and movement restriction measures, are unequally affecting those in the lowest power strata of societies.
Blackstock is an emergency medicine physician by training. She was in academic medicine for 10 years until she left in December to focus on her company, Advancing Health Equity, which partners with health care organizations to make sure that they have the tools needed to provide equitable care.
Her academic and clinical experience have led her to conclude that not only will testing patterns fall along racial and socioeconomic lines, but Black people are going to be disparately affected by COVID-19.
Companies now have an opportunity to lead where public health has historically failed. Vaccine requirements are here; employers can make sure they work for everyone... Every long-term solution must be viewed through the health equity lens, for if they are not, we’ll be setting the stage for our next public health failure."
The global vaccination initiative has faced setbacks. Could a recent surge in doses foretell a better year ahead?
The pandemic has highlighted longstanding inequities, taking a greater toll on Black and Hispanic communities. An editorial in the journal noted that the health care system has a long history of racism. Hospitals only desegregated when they were threatened with the loss of federal funds from the Medicaid and Medicare programs, which were enacted in 1966.
Early on in the pandemic, PIH began working with partners in various U.S. communities, including Newark, N.J., Fulton County, Ga., the Navajo Nation and the state of Massachusetts, to train contact tracers and set up other public health interventions for America's most vulnerable. Low-income communities of color have been disproportionately hard hit throughout the pandemic — and that's made long-standing racial and ethnic health disparities glaringly obvious.
This burgeoning patient-centric model may soon be the norm, helping make care more fruitful and accessible for everyone. Much of IT modernization work has been done or is underway, and approaches to data management and patient models have evolved with lightning speed—and with these foundations in place, it’s time to chart out the next steps towards better equity and outcomes for all.
The US health system’s racial inequities will still be felt after Covid-19 becomes endemic.
If history is a guide, infectious diseases exploit inequities not just within societies but between them.
Recognize the barriers to equitable, quality health care....
Despite significant advances in healthcare innovation and technology, racialized health inequities have persisted and even worsened over the last century. These trends persist due to the expansive reach of systemic racism on Black communities and other communities of color. Healthcare organizations must act now to mitigate the root causes of these inequities.
Creating health equity is a guiding priority and core value of APHA. By health equity, we mean everyone has the opportunity to attain their highest level of health.
Achieving health equity requires valuing everyone equally with focused and ongoing efforts to address avoidable inequities, historical and contemporary injustices, and the elimination of health and healthcare disparities. The population health impact of COVID-19 has exposed longstanding inequities that have systematically undermined the physical, social, economic, and emotional health of racial and ethnic minority populations and other population groups that are bearing a disproportionate burden of COVID-19.