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The health care inequities that continue to harm members of racial and ethnic minority groups have been exacerbated by COVID-19.
The pandemic’s disproportionate impact has been documented by a host of sources, including a CDC report, which found that “social determinants” of the quality of health care “contribute to racial and ethnic minority groups being disproportionately affected by COVID-19 and influence disparities in COVID-19 vaccination.”
Disparities that make COVID-19 care worse for minorities include: living in less healthy neighborhoods that receive poorer health care, being more likely to hold “essential” jobs that don’t allow them to stay at home, and disparities in wealth and education that impact the quality of health care and health awareness, the CDC report said.
A study published in The Lancet analyzed 2,102,364 cases in the United States and U.K. in March 2020 and found members of certain groups, including non-Hispanic Blacks in the United States, were more likely to test positive for COVID-19. “This elevated risk was associated with living in more deprived communities,” the study found.
An extensive analysis of CDC figures obtained by The New York Times found that “Black and Latino people have been disproportionately affected by the coronavirus in a widespread manner that spans the country, throughout hundreds of counties in urban, suburban and rural areas, and across all age groups.”
These, and similar studies, inspired the theme chosen for this year’s National Minority Health Month: “Give Your Community a Boost!” As the National Institute on Minority and Health Disparities explains, the message is meant to reaffirm the importance of ensuring that everyone receives a COVID-19 vaccine booster, especially in communities of color.
A perfect storm
In a broader context, health care systems across the world are riddled with disparities that disproportionately affect minority ethnic and racial groups. These differences could make it more difficult for people to get the health care they need to ensure good health outcomes.
Heart disease, for example, is not only the biggest cause of mortality in the United States, it also exacerbates historic and systemic imbalances in the American health care system, according to a blog post written by Clary Estes for the Biotechnology Innovation Organization (BIO). She explains that race, wealth, and the environment all have different effects on heart health.
Estes reviews the Novartis and CQ Roll Call online discussion about “A Path to Improving Cardiovascular Disease Outcomes in the US: Lessons Learned from a Public Health Crisis,” which includes discussion from U.S. Rep. Larry Bucshon, MD (R-IN), a cardiothoracic surgeon: “It’s just a perfect storm honestly here in rural America,” Bucshon says. “It doesn’t take a $1,000 bill from a hospital to prevent someone from seeking care. People who have even $25 or $30 copays can’t afford to go see a physician.”
There are similar problems in urban areas, Estes notes. “Oftentimes, in my community, school is the only place students are getting a balanced meal,” she quotes Georgia State Rep. Billy Mitchell as saying.
Inclusion of minorities in clinical trials
“I think another really important area with respect to diversity is diversity as it relates to clinical trials. It’s incredibly important to have representation of different populations in our clinical trials if we’re going to be able to develop medicines that address the needs of the whole population,” says Yvonne Greenstreet, CEO of Alnylam and one a small number of Black women leading a drug company.
Black, Hispanic, and other communities have been typically underrepresented in clinical studies, the U.S. Food and Drug Administration (FDA) points out. This implies that the medical community lacks knowledge that may aid in the discovery of the next therapy or cure.
Medications can have varied effects on different racial and ethnic groups, according to the National Institutes of Health, and the FDA has set guidelines to address this concern.
Clinical trials also allow patients to have early access to experimental therapies for a variety of disorders. Prioritizing diversity within research will assist in guaranteeing that people of color are not excluded from potentially life-saving opportunities and will get us closer to a more equitable health care system.
BIO, which has its own agenda to promote equity, seeks to address disparity in clinical trials with their website that assists patients in finding clinical trials, by adding a special section on diversity in clinical trials.
“The biopharmaceutical industry acknowledges past wrongdoings and continues to develop and put in place measures that close gaps in clinical trial representation and ensure firm patient protections across diverse populations,” BIO notes.
