Addressing inequities in COVID-19 morbidity and mortality: research and policy recommendations

Abstract

The COVID-19 pandemic is the greatest global public health crisis since the 1918 influenza outbreak. As of early June, the novel coronavirus has infected more than 6.3 million people worldwide and more than 1.9 million in the United States (US). The total number of recorded deaths due to COVID-19 are growing at an alarming rate globally (³383,000) and nationally (³109,000) Evidence is mounting regarding the heavier burden of COVID-19 infection, morbidity, and mortality on the underserved populations in the US. This commentary focuses on this global health pandemic and how mitigation of the virus relies heavily on health behavior change to slow its spread, highlighting how the pandemic specifically affects the most socially and economically disadvantaged populations in the US. The commentary also offers short, intermediate and long-term research and policy focused recommendations. Both the research and policy recommendations included in this commentary emphasize equity-driven: (1) research practices, including applying a social determinants and health equity lens on monitoring, evaluation, and clinical trials activities on COVID-19; and (2) policy actions, such as dedicating resources to prioritize high-risk communities for testing, treatment, and prevention approaches and implementing organizational, institutional, and legislative policies that address the social and economic barriers to overall well-being that these populations face during a pandemic. It is our hope that these recommendations will generate momentum in delivering timely, effective, and lifesaving changes.

Genetic Hypothesis and Pharmacogenetics Side of Renin-Angiotensin-System in COVID-19

“…In addition, multiple viral infections and the involvement of associated immuno-virological factors or potential coronavirus resistance gene mutations occurring among East Asians as a result of long-term co-evolution of the virus and host cannot be excluded [ 65 ]. Finally, the existence of health inequities among minority populations unmasked how the pandemic greatly affects the most socially and economically disadvantaged people/gender but paradoxically, also countries with universal health coverage are not able to completely protect its inhabitants against high CFR due to COVID-19 pandemic [ 2 , 110 , 112 , 113 , 114 ].…”

Development, Implementation, and Results from a COVID-19 Messaging Campaign to Promote Health Care Seeking Behaviors Among Community Clinic Patients

“…The overarching goal was to engage patients attributed to Atrium Health’s community and rural clinics in calling the ROC-line to learn about the system’s COVID-19 testing and other resources, and to schedule needed health care appointments that included new virtual options. Our strategy aligned with other thought leaders in the research, medical and health equity fields [ 24 – 26 ] and applied a cross-department, process using parallel workstreams to reduce bureaucracy and facilitate an immediate response to health care needs of the local community. The campaign evaluation was designed to answer two stakeholder questions (1) “Did this campaign reach vulnerable populations?” and (2) “Did the campaign help patients that were disconnected from the health care system access care?”.…”

The impact of the COVID-19 pandemic on the wellbeing of Irish Men’s Shed members

“…Gender differences in health behaviors (smoking and drinking), delayed help-seeking and lower adherence to pandemic-specific containment measures (wearing of face masks, hand-washing) have also been highlighted as contributory factors to men’s greater vulnerability to the disease ( Baker et al ., 2020 ). It is also becoming increasingly apparent that the pandemic disproportionately affects more socially and economically disadvantaged population groups in general, and males in particular ( Wang et al ., 2020 ). This reflects a more fundamental pattern of health inequities associated with a steeper social gradient in men’s health, whereby more vulnerable and minority population groups of men carry a disproportionate burden of ill-health and mortality ( WHO, 2018 ).…”