Lessons Learned from Health Disparities in Coronavirus Disease-2019 in the United States

Cross-disciplinary rapid scoping review of structural racial and caste discrimination associated with population health disparities in the 21stCentury

“…There is consistent agreement among the studies in our review that racism and casteism need to be considered as structural determinants of health disparities among historically marginalized populations, specifically Black people and Native Americans in the United States, Indigenous peoples in Canada and Australia, and Dalits in Nepal (Browne et al, 2016; Bailey et al, 2017; Thapa et al, 2021; Martin et al, 2022; Diaz et al, 2023). Health disparities cannot be attributed simply to behavioral or cultural factors, “rather, they are embodied manifestations of the complex interplay of socio-historical, political, and economic determinants of health” (Browne, 2017; Goodman et al, 2017).…”

“…Finally, eighteen articles dealt with reparative policy considerations. Thus, structural racism or casteism has been recognized as a determinant of health disparities in at least eight articles reviewed (Bloche, 2004; Gee & Ford, 2011; Browne et al, 2016; Bailey et al, 2017; Williams et al, 2019; Martinez et al, 2021; Diaz et al, 2023; Sweeting et al, 2023). Other articles reviewed specifically included six reports on genetic variations, genetic testing, and epigenetics, seven reports on racial discrimination in Indigenous peoples, and three articles on intergenerational trauma.…”

“…Therefore, reducing health inequalities depends on reducing socioeconomic and other inequalities (Marmot & Allen, 2014). The 2008 WHO Conceptual Framework for Action on Social Determinants of Health (WHO CSDH) looked at social determinants of health to explore the root cause of disparities and develop actionable opportunities for addressing health disparities (Marmot and Allen, 2014; Diaz et al, 2023), while the conventional aggregate classes may even be deemed by some scholars no longer important as a determinant of health in the modern society (Zhao and Wodtke, 2018). Many studies reviewed were consistent on several of these individual social determinants, such as race, employment, housing, income, education and healthcare (Sankar et al, 2004; Sims, 2010).…”

“…Many studies reviewed were consistent on several of these individual social determinants, such as race, employment, housing, income, education and healthcare (Sankar et al, 2004; Sims, 2010). More recent studies have explained that there are mutually reinforcing inequitable systems in these social determinants of health such as housing, education, employment, income, healthcare, criminal justice and so on, which are, in turn, reinforcing discriminatory beliefs, values, and distribution of resources that altogether lead to the risk of health disparities (Bailey et al, 2017), acting together (Williams, 2019, Subica and Link, 2021; Soled et al, 2021; Diaz et al, 2023) or interacting with each other, e.g. interactions between Black race and education, income and occupation (Farmer and Ferrano, 2005), resulting in health disparities at the population level.…”

The Healing Healthcare Initiative: Guiding leaders to heal a traumatized workforce

“…Health leaders and health workers have experienced a life-threatening pandemic that exacerbated pre-existing burnout, 1,2 exposed long-standing health inequities, 3 caused moral injury, 4 and precipitated widespread resignations and staff shortages. 5 Well before the COVID-19 pandemic, health workers were challenged by burdensome administrative tasks and mandates, an emphasis on productivity and volume over relationships and value, insufficient staffing and support, and other issues that diminish the capacity for human connection.…”