COVID-19 Disparities and the Black Community: A Health Equity–Informed Rapid Response Is Needed

Brown, Ivan W.; Khan, Ayesha; Slocum, Jamar; Campbell, Linelle F; Lacey, Jahmil R; Landry, Alden

doi:10.2105/ajph.2020.305804

Cited by 17 publications

(18 citation statements)

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“…Hypertension, diabetes, asthma, and other chronic diseases are prevalent in Black and Hispanic populations, resulting in an elevated risk factor for COVID-19. Blacks and Hispanics are disproportionately represented as essential workers without the luxury of working from home [ 63 ]. Many Blacks and Hispanics are more likely to live in densely populated housing, perhaps placing them at increased risk for transmission of the virus.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 pandemic-related changes in wellness behavior among older Americans

et al. 2021

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Background COVID-19 has taken its toll on citizens in all 50 states of the United States. The United States (U.S.) leads the world with 30,291,863 confirmed reported cases and 549,664 deaths as of March 29, 2021 compared to globally confirmed cases at 127,442,926 and 2,787,915 deaths as of March 29, 2021. The U.S. federal government primarily left the response to the virus to individual states, and each implemented varying measures designed to protect health of citizens and the state’s economic well-being. Unintended consequences of the virus and measures to stop its spread may include decreased physical activity and exercise, shifting access and consumption of food, and lower quality-of-life. Therefore, our primary goal was to quantify the impact of COVID-19 on health and well-being by measuring changes in physical activity, mental health-quality of life, food security and nutrition in adults ages 40 and older. We believed shifts in health behaviors would be more prevalent in minorities, less educated, lower socio-economic status, older adults, and those with underlying health conditions, so a secondary goal was to determine the impact of COVID-19 on these sub-populations. Methods We conducted an online survey with 9969 adults 40 years and older between 9 August and 15 September 2020 in urban areas across the four U.S. census regions. The survey included questions about demographic variables, pre-existing health conditions, physical activity, access to food, quality-of-life, and nutritional food status and asked participants to respond with information from pre-pandemic and pandemic conditions. We used paired-sample t-tests to detect changes in variables after the start of the pandemic and Cohen’s d to determine effect sizes. Results Our main findings showed a decrease in physical activity since the onset of COVID-19 for minorities and non-minorities. Food security also slightly increased for minorities during the pandemic, but we found no other changes in food security, quality-of-life indicators, or nutritional status of those who responded to this survey. Conclusions It is concerning that physical activity declined. Such activity helps maintain physical and mental health, and it is also an important time to socialize for many older adults. In many ways, our data indicate that the older adult population in U.S. cities may be more resilient than expected during the pandemic. However, the pandemic could have negative impacts that we did not detect, either due to the survey instrument or the timing of our survey, so the health and well-being of older adults should continue to be monitored in order to mitigate potential negative impacts.

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Section: Discussionmentioning

confidence: 99%

COVID-19 pandemic-related changes in wellness behavior among older Americans

et al. 2021

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“…These findings reinforce mounting evidence that racial, ethnic, and age disparities in exposure to SARS-CoV-2 exist, regardless of geography. 3,4,7 -9…”

Section: Discussionmentioning

confidence: 99%

“…8,9 Compared with non-Hispanic White people, non-Hispanic Black people are more likely to contract COVID-19 and are twice as likely to die of COVID-19-related complications. 3,4 Non-Hispanic Black and Hispanic people may be at greater risk of exposure to COVID-19 than non-Hispanic White people because they are more likely to be essential workers and also tend to live in densely populated areas and multigenerational households; examples include Chicago, Illinois, and Milwaukee, Wisconsin, 8,9 2 city centers examined in our study. Preliminary COVID-19 research into the causes of disparity primarily indicates social factors rather than medical factors.…”

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confidence: 98%

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confidence: 99%

“…2,3 New and ongoing research has found disparities in COVID-19 distribution, morbidity, and mortality, particularly among racial/ethnic minority groups and urban dwellers as compared with non-Hispanic White people. 3,4 We used a sensitive and specific SARS-CoV-2 immunoglobulin G (IgG) assay (SARS-CoV-2 IgG assay) to test convalescent serum as a reliable method for assessing exposure in a population. 5 Characterizing the magnitude and distribution of the SARS-CoV-2 virus by relying on detection of active SARS-CoV-2 viral RNA shedding has proven to be impractical because of such factors as a lack of symptoms, mild or varying symptoms, and/or limited testing opportunities.…”

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confidence: 99%

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Disparities in Seroprevalence of SARS-CoV-2 Immunoglobulin Antibodies in a Large Midwestern Health Care System

et al. 2021

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Objectives Increased exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a result of having an essential job is compounded by factors such as age, race, and ethnicity. We used a cross-sectional study design to describe disparities in the seroprevalence of SARS-CoV-2 immunoglobulin G (IgG) test results by demographic characteristics and clinical roles among a cohort of health care workers employed by the largest Midwestern health care system in the United States. Methods We collected 16 233 SARS-CoV-2 IgG serum samples from June 8 through July 10, 2020, from a convenience sample of Illinois- and Wisconsin-based adult health care workers. The research team, in collaboration with ACL Laboratories, used a SARS-CoV-2 IgG assay to detect the presence of SARS-CoV-2 IgG antibodies. Study data included SARS-CoV-2 IgG assay results and demographic characteristics of workers (age, sex, race, ethnicity, clinical role, zip code). We generated crude and adjusted odds ratios (ORs) to describe disparities in seroprevalence distribution among demographic and social factors. Results Of 16 233 IgG serum samples tested, 622 (3.8%) test results were positive for SARS-CoV-2. We found significant disparities in SARS-CoV-2 positivity by age, race, ethnicity, and clinical role. Participants aged 32-82 had lower adjusted ORs (aORs) of positive IgG than participants aged 18-31 (aOR range, 0.54-0.66). Odds of positivity were higher among Black (aOR = 3.86), Asian (aOR = 1.42), and mixed-race (aOR = 1.99) workers than among White workers; among Hispanic workers (aOR = 1.80) than among non-Hispanic workers; and among coronavirus disease 2019 (COVID-19) clinical workers (aOR = 1.86) than among nonclinical workers. Conclusions Public health efforts should focus on increasing COVID-19 safety messaging, testing, vaccination, and other prevention efforts for people who are young, non-White, Hispanic, and working in COVID-19–clinical units.

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Development of a health equity journal club to address health care disparities and improve cultural competence among emergency medicine practitioners

Smith

Harris

Albazzaz

et al. 2021

AEM Education and Training

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Health care disparities have been magnified by the COVID-19 pandemic. Only recently has the medical community acknowledged implicit bias and systemic racism as a public health emergency. Graduate medical education has been slow to adopt curricula beyond lecture-based formats that specifically address social determinants of health (SDOH) and its impact on communities. Curricula addressing unconscious (implicit) biases and their influence on patient care has not been widely adopted. The emergency department (ED) has a unique role in addressing health care disparities. Approximately 69% of emergency medicine residency programs incorporate cultural competency training in their curricula. Most are primarily lecture-based without a longitudinal component, and gaps exist in content, quality, and expertise of the presenters. Lecture-based formats may not be best suited to manage the nuanced conversations necessary to dismantle biases and socialized beliefs that result in disparities for marginalized communities. Reporting little or no education in medical school related to SDOH, residents acknowledge that barriers to care exist, but have limited or no knowledge of what those barriers are or how mitigate them. To improve health equity, understanding and competence in caring for culturally and ethnically diverse populations, we developed a monthly, longitudinal, SDOH-and cultural competency-based "health equity journal club" (HEJC) for all levels of ED staff. Four educational domains were developed, and specific content within each domain was selected based on predetermined criteria. Content for each session was mapped to the ACGME program and core competency milestone requirements, ACGME Clinical Learning Environment (CLER) mandates, and The Joint Commission's institutional recommendations for culturally competent care. The HEJC series has been successful in reducing barriers to identifying biases in health care; translating literature to clinical care; generating initiatives and interdisciplinary research;

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COVID-19 Disparities and the Black Community: A Health Equity–Informed Rapid Response Is Needed

Cited by 17 publications

References 1 publication

COVID-19 pandemic-related changes in wellness behavior among older Americans

COVID-19 pandemic-related changes in wellness behavior among older Americans

Disparities in Seroprevalence of SARS-CoV-2 Immunoglobulin Antibodies in a Large Midwestern Health Care System

Development of a health equity journal club to address health care disparities and improve cultural competence among emergency medicine practitioners

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