There is an old adage within the black community that says, “When White America catches a cold, Black America has pneumonia.” African American patients with COVID-19 are dying at a significantly higher rate compared to other races. These statistics are currently reported within the state of Louisiana and cities of Chicago and Milwaukee. At the time I am writing this, on April 8, 2020, there are only nine states publicizing the racial and ethnic demographic data of patients diagnosed with COVID-19. As an African American, these results are frightening, and as a physician, I am absolutely baffled. In the year 2020, the issues surrounding health care inequalities have been placed back on a pedestal as a result of this pandemic. An indiscriminate virus has resulted in the evident discrimination of mortality. This disturbingly disproportionate mortality rate demands an important discussion that needs to be had on the topic of social determinants of health and its effects on race. It is imperative to be proactive with these harrowing statistics in order to solve this problem now while it is active.
Minorities have been plagued with socioeconomic inequalities as a result of structural racism. The United States has made advances to address the disparity recognized in health care by attempting to focus on the social determinants of health. Although progress has been made, there continues to be clear inequalities within our health care system. This pandemic has highlighted that this inequity continues to be a paramount issue that necessitates immediate attention. Meticulous scrutiny of our health care system is needed to unravel this lethal disparity. COVID-19 does not distinguish amongst different races, and we will ensure that neither does our health care system. Experts have suggested that this difference may be due to the increased comorbidities observed in African Americans or the greater portion of African Americans without health insurance. Proper recognition, education, and early treatment of patients who fall into these categories can potentially be lifesaving. Resources can be used to bring attention and provide valuable information to these communities. In addition, treatment protocols need to be established in order to mandate equal access to lifesaving treatment. With these protocols, we will be able to monitor differences in testing, hospital admissions, interventions, randomized control trial enrollment, and overall outcomes.
Our state representatives have begun the call to action regarding this health disparity. Senators Elizabeth Warren, Kamala Harris, Cory Booker, and representatives Robin L. Kelly and Ayanna Pressley have written a letter to the secretary of Health and Human Services, Alex Azar II, to monitor and address racial disparities in our response to the COVID-19 pandemic. In this letter, they petition for the public reporting of racial and ethnic demographic information of patients tested for and affected by COVID-19. With their support on a national level, we can continue to push from a local institutional standpoint by demanding health systems to publish and address this information. With heightened awareness and acknowledgment of this issue, we can aim to solve it in the midst of the process. As a community, it is our duty to recognize this disparity and do what we can to reverse it.
It is critical that we obtain racial, ethnic, and socioeconomic transparency at a national level for all patients with COVID-19. With this information, we can develop a plan to eliminate this potentially deadly disparity. Resources can be mobilized to combat the findings and save as many individuals as possible. Each human being should have an equal chance to live under any circumstance including through a pandemic. There are many physician advocates greater than I, but my indignation for inequality compels me to refrain from silence. As a healer, I will not stand idly by for such an injustice.
Daniel K. Amponsah is an internal medicine physician.
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