Black ExperienceHealth

COVID-19 Hits Blacks Hardest Due to ‘Legacy of Inequality’

The coronavirus pandemic has exposed long-persisting racial disparities in health and health care.

African-American patients with COVID-19 remain 2.7 times more likely than Non-Hispanic white COVID-19 patients to be hospitalized and with more severe symptoms, per a recent study in the medical journal Health Affairs.

Meanwhile, even those Blacks with health insurance remain less likely to seek coronavirus testing and more likely to wait until it became an emergency to go to the hospital, the study of Northern California patients found. Further, not only are a disproportionate share of African Americans and Hispanics dying of COVID-19 but the hospitals that continue to treat them often have far lower safety ratings, especially when it comes to deadly infections.

“The [Black] community always seems to get the bottom of the list care,” said Thomas Hegens, CEO of Phenom Surgical, a District-based medical staffing company. “It’s one of those things where you walk into a facility where you’re looking for that pristine care and you don’t get it and see it in the waiting room and in the offices where you feel like you are being rushed in and out.”

Thomas Hegens, CEO of the medical staffing agency Phenom Surgical (Courtesy of Jayne O'Donnell)
Thomas Hegens, CEO of the medical staffing agency Phenom Surgical (Courtesy of Jayne O’Donnell)

African Americans and Hispanics are more likely to have one or more of the chronic health conditions that dramatically increase the risk of serious illness or death if they are infected with coronavirus. Obesity serves as a major driver of COVID-19 morbidity and mortality and enhances vulnerability to other chronic conditions and is now considered nearly as bad as smoking when it comes to risk factors for emphysema and cancer.

Anyone who needed a real jolt of motivation to lose weight, should have it now. Given COVID-19’s expected resurgence in the fall, it is quite literally a matter of life and death.

“It will not only help prevent severe COVID-19 disease but will also lessen the severity of the other COVID-19 risk factors such as diabetes, hypertension and heart disease,” said Dr. Kevin Kavanagh, a physician and patient safety expert who heads the nonprofit HealthWatch USA.

The chronic conditions that are more common in the African-American and Latino communities dramatically increase the risk of hospital transmissible infection when patients are undergoing surgery of any type. Infection is also much more likely in a hospital with a poor record of infection control.

Rates of some hospital infections can be found on Hospital Compare and other rating sites including the Leapfrog Group. This makes it even more important for people of color to do their research before choosing a hospital. In Washington D.C., only MedStar Georgetown University and Sibley Memorial hospitals received a B rating by the Leapfrog Group. None received an A. Howard University Hospital received the lowest rating in the nation’s capital with a D.

“There’s no reason to be trapped in bad medicine,” said Dr. Talal Munasifi, a clinical professor at Georgetown University.

Race Matters in Death Rates from COVID-19

Hospitals often blame patients’ socioeconomic conditions for low ratings but patient safety experts say it doesn’t have to be that way. Still, as a recent Georgetown University report shows, a “legacy of inequality is to blame, in part, for Black District residents living fewer years than whites and for a higher rate of African-American deaths linked to COVID-19.

The report, “Health Disparities in the Black Community: An Imperative for Racial Equity in the District of Columbia,” while prepared before the pandemic, indicates that “high rates of chronic diseases, coupled with high-risk socioeconomic conditions,” contribute to the higher rate of coronavirus-related deaths among minorities.

The report reveals that residents in Ward 8, the city’s poorest area which is primarily Black, had a life expectancy of 72 years versus 87 years for those living in Ward 8 which is mostly white.

“Health disparities [such as cancer, diabetes, heart and respiratory diseases and obesity] result from long-standing injustices and make the African-American community much more vulnerable to a highly infectious virus like COVID-19,” said Christopher J. King, chair of Georgetown’s department of health systems administration.

“Only go to the hospital if you need to,” said Kavanagh. “Many ailments can be taken care of through telemedicine or at a doctor’s office, both of which are safer alternatives.”

Because of COVID-19’s disproportionate effect on minority communities, it’s especially important that people of color “develop trust with a health care provider” who also treats them well, said Dr. Georges Benjamin, executive director of the American Public Health Association.

“It’s not surprising African Americans don’t trust health care providers,” said Hegens, who grew up in Southeast. “That mistrust has been built over years of not getting fair treatment at particular venues.”

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