Understanding and Promoting Racial Diversity in Healthcare Settings to Address Disparities in Pandemic Crisis Management

Abstract

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States. Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: Healthcare, raci*, ethnic*, discriminant, hosti*, harass*, insur*, education, income, psychiat*, COVID-19, incidence, mortality, mechanical ventilation. Statistical analysis was conducted in Review Manager (RevMan V.5.4). Unadjusted Odds Ratios, P-values, and 95% confidence intervals were presented. Results: Discrimination in the United States is evident among racial groups regarding medical care portraying mental risk behaviors as having serious outcomes in the health of minority groups. The perceived health inequity had a low association to the majority group as compared to the minority group (OR = 0.41; 95% CI = 0.22 to 0.78; P = .007), and the association of mental health problems to the Caucasian-American majority group was low (OR = 0.51; 95% CI = 0.45 to 0.58; P < .001). Conclusion: As the pandemic continues into its next stage, efforts should be taken to address the gaps in clinical training and education, and medical practice to avoid the recurring patterns of racial health disparities that become especially prominent in community health emergencies. A standardized tool to assess racial discrimination and inequity will potentially improve pandemic healthcare delivery.

Exploring Inequalities in the Use, Quality, and Outcome of the Diabetes Management Program of Indonesian National Health Insurance

“… 33 In addition, highly educated people may be more likely to have positive prior health care experiences positively impacting trust in health authorities, batter access to reliable health information sources, and better understand the perceived benefits of regular visits to the diabetes management program compared to the low educated people. 14 , 16 …”

“… 14 Moreover, cultural factors such as norms, beliefs, and trust play a critical role in the decision to use health care, and these factors tend to influence vulnerable groups strongly which may cause the low use of health care for this particular group. 15 , 16 In the context of Indonesia, studies have shown that poorer groups use health services less frequently than wealthier groups, even though all of these groups are covered by the NHI program. 17 This suggests the potential for inequalities in access to diabetes management programs among NHI beneficiaries with different backgrounds.…”

The efficacy of anakinra compared to standard care of treatment for COVID-19: a metaanalysis

“…A study conducted among those with Arab ethnicity found significant differences in mortality on the use of anakinra (24% in the intervention vs. 67% in the control group, P = 0.013). The only RCT included in this meta-analysis was conducted in France, suggesting that the availability of racial and ethnically stratified data is scarce when it comes to the assessment of anakinra as a viable treatment option for COVID-19 [ 18 ].…”

“…The CORIMUNO trial found that the requirement for invasive mechanical ventilation was reduced among those treatments with anakinra (Odds ratio = 0.38, P = 0.02), and the mortality risk was also reduced in nonintubated patients (Odds ratio = 0.32, P < 0.001) [ 18 ]. The trial’s objectives were to assess the safety and efficacy of anakinra in nonhospitalized intubated patients.…”

The role of innovative technologies in reducing health system inequity

“…20 The pandemic also revealed the need for a diverse and culturally competent HHR to cater to the requirements of marginalized communities. 21 Specific populations (e.g., ethnic minorities, Indigenous communities, and low-income people) were disproportionately impacted by the virus due to preexisting social determinants of health and systemic inequities. 19 Geography and the rural divide Canada's vast geography presents unique challenges for accessing healthcare, particularly in rural areas.…”