Public Health 101: Why do Minorities Have a Higher COVID19 Infection and Death Rate?
The novel Coronavirus or COVID19 has shown no mercy in the U.S, with a grappling 175,00 lives lost from COVID19 and almost 6 million people infected in the U.S in a mere 5 months. We have seen the virus infect all types of people across the country, but we have seen it infect some people more than others, particularly the minority population. When taking a deeper dive into the numbers, we see that the Latino and Black population are three times more likely to become infected, compared to Whites. This also applies to states where the Native American population is highly present, like in Arizona where Native Americans are three to four times more likely to be infected, and is also the community with the highest death to population ratio. When looking at death rates, 1 in 1,250 Black Americans have died from COVID, 1 in 2,200 Latinos have died from COVID19, and 1 in 1,500 Indigenous Americans have died from COVID19. This is up to 3 times higher if not more, compared to Whites, even after adjusting for age.
When putting these numbers into perspective, if the death rate was similar between minorities and White Americans, 24,670 lives could have been saved.
So why is the death rate and infection rate of minorities higher than Whites? One short answer: The Social Determinants of Health.
The social determinants of health are all the variables that affect ones health outcomes besides physiology. These include things like ones socioeconomic status, employment, level of education, access to healthcare and insurance, housing, access to food and the list goes on. The social determinants of health are the bread and butter of public health. Public heath experts research, analyze and study the social determinants of health to help improve the overall health of the population.
Research has seen correlations between health outcomes and the social determinants of health. One example of these correlations is type 2 diabetes. Type 2 diabetes is a chronic condition in which ones body does not produce enough insulin or ones body resists the effects of insulin. Risk factors for type 2 diabetes include obesity, inactivity, and family history, among others. Extensive research has been done in diabetes and research notes that recommendations for management of diabetes including changing diet by eating healthier and exercising are effective. Despite this the data shows high rates of diabetes in the U.S with an upward trends of type 2 diabetes. Many medical professionals are asking themselves, why? That is seen because of the social determinants of health. Imagine there is a patient coming in for diabetes treatment. This patient is low income, lives about 45 minutes away from a local food market and lives in Arizona where it is 100–115 degrees more than half of the year. They are told to eat more vegetables, cook with healthier ingredients and take a walk at least once a day. But due to the social determinants of health like their income level and living in a food desert, they can’t follow their treatment plan.
This has occurred with COVID19 as well. The minority population has more social determinants of health that affect their exposure to COVID19. Some of these include income, employment, housing, and access to healthcare. Many racial and ethnic minorities have jobs that make them more exposed to COVID19. This includes jobs in healthcare, grocery stores, public transportation, among others. Many of these jobs, have no paid leave, or vacation time off, leaving employees with only the option to work or quit. The minority population is also twice as more likely to be living in poverty versus their white counterparts, with 9% of Whites in the U.S population living in poverty, versus 19% of Hispanics and 22% of Blacks living in poverty. This creates obstacles like quitting their job, and decreases the flexibility of changing jobs. The inability to take time off work also makes getting access to healthcare more difficult. Housing arrangements also affects this population. As known by research, COVID19 is highly transmissible, and the more people in the home the more one is exposed to COVID19 because more people can bring it home. In minority households it is common to see immediate and extended family members at home. This increases their chance of getting the infection from someone that lives at home. They also don’t have the monetary capital to get another home or relocate or isolate family members that have become infected, as some people did.
The minority groups have had to make the hard choice this pandemic between their health or work. Most have had no choice but to choose work, and that has cost some of them their lives.
The social determinants of health that have caused the increased infection rate of covid19 and death in the minority population are not new, instead they have been accentuated by COVID19. These inequities have been present for decades. One can see them in the U.S data on chronic illnesses, like diabetes, hypertension and obesity. In the past decade these numbers have continued to increase, despite the huge amount of research on these conditions. One of the reasons for this is because no matter how much research is done on treatment, if one does not find a solution for these social determinants of health the treatment plans won’t be able to be executed by patients, and we will continue seeing an increase in chronic illness in the U.S in the minority population.
Solutions for these barriers to better health outcomes will not occur from one day to another. It will occur little by little, through the efforts of not only public health professionals, but by doctors, lawmakers, managers at grocery stores, principals at schools, deans at university institutions. It will occur through the help of everyone because these barriers have become part of a systemic issue.
The social determinants of health that are negatively impacting the minority community are part of a bigger issue known as systemic racism.
In order to start fixing these issues, there needs to be advocacy for new policies by not only lawmakers but by the people themselves. There needs to be new policy that increases the minimum wage, that gives paid leave time to all employees in the U.S, that give paid family leave, that creates a pathway for minorities into higher education and much more. There needs to be equitable policy. Only will this start tackling the systemic racism dilemma that has taken the lives of minorities everyday for the past decades.