Racism, Health & COVID-19

Communities of color have experienced significant disparities in health outcomes from COVID-19, as well as barriers to accessing testing. Predominantly white communities have had access to more testing sites than communities that are predominantly made up of Black and Latinx residents. An analysis by the Surgo Foundation found that nearly two-thirds of rural counties have no testing sites, and 35% of rural Black Americans live in testing deserts.

• The National Academy for State Health Policy is tracking how states are reporting COVID-19 data by race and ethnicity.
• Through a NIHCM Foundation grant, the Journalist’s Resource, a project of Harvard Kennedy School’s Shorenstein Center on Media, Politics and Public Policy, published a research roundup/explainer focusing on the state of rural health care and tips for covering rural health care amid COVID-19.

COVID-19’s disproportionate impact on Black and Latinx communities and the protests against police brutality have led to widespread calls to acknowledge systemic racism as a public health crisis. Many organizations and communities are responding by placing an emphasis on addressing structural racism and health inequities.

• Anthem and the Anthem Foundation have pledged $50 million over five years, aimed at advancing racial injustice, strengthening communities and addressing health inequities.
• In Florida, GuideWell launched the Equity Alliance, an initiative focused on addressing systemic racism and the resulting health disparities for Black Americans. Guidewell, Florida Blue and its foundation also announced $25 million in investments over five years to organizations focused on diversity, inclusion and health equity.
• In Arkansas, a grant from the Blue & You Foundation for a Healthier Arkansas will support community health navigators and COVID-19-related outreach in the Hispanic and Marshallese communities in Northwest Arkansas.

Explore more resources and racial equity tools:

• ESRI - maps, data and tools on health, racial and economic equity
• Racial Equity Tools - research, tips, curricula and ideas to support racial equity work
• National Health Care for the Homeless Council - a curated list of anti-racism resources

Older adults are at the highest risk for severe illness from COVID-19. Among the elderly, deaths from the virus are concentrated among those living in long-term care facilities. The devastating outbreaks in nursing homes raise questions about the future of long-term care.

• COVID-19’s toll in nursing homes is linked to staffing levels, quality and concentration of disadvantaged residents.
  • Black and Latinx residents have historically resided in lower-quality nursing homes, which are more likely to have COVID-19 cases and deaths.
  • The CDC and the National Association of Counties have developed resources to guide nursing homes’ COVID-19 prevention and response activities.
  • A recent USC Center for Health Journalism webinar, produced under a NIHCM Foundation grant looks at the dangers facing nursing home residents and discusses the importance of reporters covering the current crisis.

Disparities in COVID-19’s impact persist outside nursing homes, including the 1.6 million older adults in low-income housing who have been overlooked and live in fear of COVID infection.

• Black Americans enrolled in Medicare were around four times as likely as their white counterparts to be hospitalized for COVID-19.
• COVID-19 is also impacting the 1 in 5 adults in the U.S who are caregivers. Caregivers do unpaid work and the pandemic has increased the toll on their health and finances.

The Pandemic's Impact on Maternal & Reproductive Health

Pregnant people may be at increased risk for severe illness from COVID-19 and are facing increased challenges during a pandemic. Social distancing and the disruption caused by the pandemic have created physical and economic barriers to contraception and other sexual and reproductive health services.

• A Blue Cross Blue Shield analysis shows that an increasing number of women in the U.S. experience pregnancy and childbirth complications. This trend has been exacerbated and intensified by COVID-19 and racial disparities in maternal health.
• Telemedicine can be used to improve access to maternal health services both in response to COVID-19 and for underserved populations. Nearly all prenatal care is in-person, but there is potential for some pregnancy related services to be delivered virtually.
• COVID-19 is placing high stress on expectant moms and increasing their risk of postpartum depression and other mental health issues.
• COVID-19 has also caused delays in reproductive health care and preventative services for reproductive health.
• A third of women want to put off having children due to COVID-19. Pandemic-related worries about finances, job stability and general unease about the future may be shifting how women feel about having children.

Explore more resources:

• Every Mother Counts - resources for new moms, mothers-to-be, physicians, midwives and doulas
• The CDC has information for pregnant people and breast-feeding during COVID-19 as well as tracking data on COVID-19 during pregnancy
• The American College of Obstetricians and Gynecologists - resources for obstetrician-gynecologists and other health care practitioners

COVID-19 & Social Determinants of Health

COVID-19 has placed a spotlight on the importance of addressing the social determinants of health. A recent analysis identified social deprivation – including a lack of access to food, medicine, employment and transportation – as a leading COVID-19 risk factor.

• The National Alliance to Impact the Social Determinants of Health released a commentary on the relationship between social determinants & COVID-19.
• Commonwealth Fund’s recent podcast featuring Dora Hughes explores the disproportionate impact of the pandemic on Black and Latinx people and the role of social determinants of health.
• The Alliance for Health Policy produced a webinar under a NIHCM Foundation grant on the first 100 days of COVID-19, which included a discussion of addressing the social determinants of health and health inequities.
• Cities and counties are using maps and dashboards to address food needs and shortages and accelerate the delivery of shelter and services to homeless people in this time of crisis.
• The Community Living Policy Center released a brief on housing disparities for individuals with disabilities in the U.S.
• NIHCM’s infographic on social determinants of health
• NIHCM’s webinar & infographic on food insecurity and the impact of COVID-19
• NIHCM’s webinar & infographic on homelessness and health