The COVID-19 pandemic has hit African American, Hispanic, and poor communities across the United States particularly hard. The health disparities that existed before COVID-19 have been greatly exacerbated, with a disproportionate impact on these communities. The questions are why, and what to do about it.
In this Q&A, we spoke with Icahn School of Medicine at Mount Sinai professor and public health research scientist Luz Claudio, PhD.
Why are we seeing such high rates of COVID-19 among African American and Hispanic people?
Health disparity by race, ethnicity, and income is a thing that we know about. There is even a National Institutes of Health institute dedicated to that issue. COVID has just blown the lid off this boiling problem that was already there. It’s been far too long that minority communities, minority people of color, low-income people have been suffering from higher disease levels and more severe disease in many cases.
How are communities of color particularly vulnerable to COVID-19?
There are several factors that contribute to higher rates of disease and death from COVID-19 among people of color. One is that many work in the newly “essential” jobs—where they are exposed to the virus—and are going back home to their families—further spreading the condition.
Another issue is crowding in the household, as people of color tend to have higher numbers of people living in one household—sometimes several generations in one home. Young people, who are risking themselves out there working, often have no way to self-isolate in their household and may inadvertently expose people who are more vulnerable than they are in terms of age or having other diseases.
Not only do they have these conditions more often, but also they’re out there. They’re working in these jobs and they’re being exposed to everything.
Importantly, as our research and that of many others has found, communities of color have higher rates of the very chronic diseases that increase the risk of death due to coronavirus.
How can health care organizations help to make up for disparities?
One of the things that we can do now, instead of waiting until the pandemic is over, is research, as Mount Sinai and other institutions are doing. We need to make institutional policies that correct the health disparities now, not just track them. We need to act now.
Prioritize the people at risk. If you’re only 46 years old but you have diabetes, that should be part of the priority station for testing you for COVID. We should prioritize people at risk because of their comorbidities, and that is going to be mostly minority people. Another thing that we can do is outreach where there is greater risk. Partner with trusted community-based organizations to get the testing and messaging out.
How can health care organizations alleviate any mistrust between themselves and vulnerable populations?
As an institution, we can partner with community-based organizations that already have that kind of trust as a bridge and really collaborate with them equally.
This is a good example of the way health care institutions can reach and be seen as part of the community. That’s another one of our responsibilities as a health care institution: to build that trust through a bridge of people who are already doing the work at the grassroots level.
The Mount Sinai Health System recently launched the Institute for Health Equity Research, which is dedicated to examining the causes and magnitude of health and health care disparities impacting nonwhite, low-income, immigrant, uninsured, LGBTQ+, and other populations across all ages, abilities, and genders. In partnership with local community groups, the Institute is now launching a survey of the health and social impacts of COVID-19. Speak Up on COVID-19: Help Us Help ALL New Yorkers seeks 10,000 respondents across the area.