COVID-19 Among African Americans: An Action Plan for Mitigating Disparities

Peek, Monica E.; Simons, Russell A.; Parker, William F.; Ansell, David; Rogers, Selwyn O.; Edmonds, Brownsyne Tucker

doi:10.2105/ajph.2020.305990

Cited by 51 publications

(47 citation statements)

References 27 publications

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“…With respect to race/ethnicity, limited information has been published on its influence on PsA and AS prevalence and treatment, although racial disparities in treatment have been well documented for other diseases, including cardiovascular disease, cancer, and COVID-19 [ 32 – 34 ]. In previous studies, black patients with PsA or AS were found to have more severe disease than white patients, based on various disease and quality of life measurement criteria, including patient-physician global scores, PSORIasis Index of Quality of Life, and Short Form-36 mental component score for PsA and Bath AS Disease Activity Index, Bath AS Functional Index, Bath AS Radiographic Index, and the modified Stoke AS Spine score for AS [ 19 , 20 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in Prevalence and Treatment for Psoriatic Arthritis and Ankylosing Spondylitis by Insurance Coverage in the USA

et al. 2021

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Introduction Patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) may receive suboptimal care, and differences in care by race/ethnicity, sex, and insurance coverage are not well studied. Methods This was a descriptive, retrospective cross-sectional US claims database analysis utilizing the Medicaid multi-state segment of the IBM® MarketScan® Commercial Claims and Encounters Supplemental Database and Optum Insight Clinformatics® Data Mart database for 2019. Patients aged ≥ 18 years with PsA or AS and continuous medical and pharmacy coverage were included. Outcomes evaluated were prevalence and percentage of patients receiving biologic disease-modifying antirheumatic drugs (bDMARDs)/targeted synthetic DMARDs (tsDMARDs) or visiting a rheumatologist. Outcomes were stratified by race/ethnicity, sex, and insurance coverage, with outcomes determined for commercial insurance, Medicare, and Medicaid enrollees. Differences observed in outcomes were numerical in nature. Results Prevalences of PsA and AS were highest for Medicare enrollees (320 and 156 per 100,000 persons [0.32 and 0.16%], respectively) and lowest for Medicaid enrollees (132 and 71 per 100,000 persons [0.13 and 0.07%], respectively). White patients had the greatest prevalence versus patients of other races/ethnicities. Females had a higher prevalence of PsA than males, while AS prevalence was generally lower for females versus males for each insurance category. The percentage of patients prescribed bDMARDs/tsDMARDs was highest for commercial insurance enrollees (PsA 63%, AS 43%) and lowest for Medicare enrollees (PsA 21%, AS 11%). The proportion of patients who saw a rheumatologist was lower for Medicaid enrollees (PsA 12%, AS 10%) than for commercial insurance or Medicare enrollees (PsA 68%, 55%; AS 67%, 42%). For commercial insurance and Medicare enrollees, the percentage of patients visiting a rheumatologist was similar by race/ethnicity but higher for females versus males. Conclusions The prevalence and treatment of PsA and AS differs by race/ethnicity, insurance coverage, and sex in the USA. Efforts for improving access to care are needed to improve outcomes among all patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-021-00370-4.

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Section: Discussionmentioning

confidence: 99%

Racial Differences in Prevalence and Treatment for Psoriatic Arthritis and Ankylosing Spondylitis by Insurance Coverage in the USA

et al. 2021

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“…As a foundation, institutional investment in widely accessible, integrated healthcare delivery will be important to ensure early access to care during future pandemics. Transportation to and from medical appointments, robust language services, and community health worker outreach may be utilized by medical homes to further bridge the gaps in healthcare access and utilization [ 41 ]. Long-term community investments are needed to support the goal of health equity [ 42 ].…”

Section: Covid-19 Disparities In Vaccinationsmentioning

confidence: 99%

Disproportionate Impact of COVID-19 on Racial and Ethnic Minority Groups in the United States: a 2021 Update

Tai

Sia

Doubeni

et al. 2021

J. Racial and Ethnic Health Disparities

122

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The COVID-19 pandemic’s disproportionate impact on people from some racial and ethnic groups in the U.S. persisted throughout 2021. Black, Latinx, and American Indian persons have been hospitalized and died at a higher rate than White persons consistently from the start of the pandemic. Early data show that hospitalization and mortality rates for Black, Latinx, and American Indian children are higher than White children in a worrying trend. The pandemic has likely worsened the gaps in wealth, employment, housing, and access to health care: the social determinants of health that caused the disparities in the first place. School closures will have a long-lasting impact on the widening achievement gaps between Black and Latinx students and White students. In the earlier vaccination phase, Black and Latinx persons were being vaccinated at a lower rate than their proportion of cases due to vaccine hesitancy, misinformation, and barriers to access. Vaccine hesitancy rates among these groups have since decreased and are now comparable to White persons. Aggregated data make it challenging to paint a picture of the actual impact of COVID-19 on Asian Americans as they are a diverse group with significant disparities. All of this highlights that we have much work to do in dismantling systemic racism, engaging communities we serve, and advancing health equity to prepare us for future pandemics and a more just healthcare system.

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“…The need to address trust in order to mitigate the continued impact of COVID-19 especially in minority communities already impacted by health disparities has been recognized in recent literature [ 25 , 26 ]. However, the relationship between institutional mistrust and vaccine hesitancy deserves more attention [ 27 , 28 ], especially in relation to the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Racial differences in institutional trust and COVID-19 vaccine hesitancy and refusal

2021

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Background Previous research has indicated that demographic differences affect COVID-19 vaccination rates. Trust, in both the vaccine itself and institutional trust, is one possible factor. The present study examines racial differences in institutional trust and vaccine status among a nationally representative sample of adults in the United States. Methods Data for the current study was collected as part of Wave 8 Omnibus 2000 survey conducted by RAND ALP and consisted of 2080 participants. Responses were collected through the online RAND ALP survey in March 2021. Results Trust in the scientific community was the strongest predictor for already receiving at least one dose of the COVID-19 vaccine at the time of study. Asians had a significantly higher trust in the scientific community compared to all other groups. Results also showed a significant difference in level of trust of the government’s response to the COVID-19 pandemic with Indian/Alaskan Natives reporting lower trust compared to Whites, Blacks and Asians. Asians also had a significantly higher level of trust when compared to those who identified as racial Other. Those who identify as American Indian/Alaskan Natives had the lowest levels of institutional trust. Trust in the government’s response was not indicative of vaccination within the sample. Conclusions Strategies to increase trust of the scientific community can be employed to address vaccine hesitancy through community-based initiatives and building of partnerships between the scientific community and local community stakeholders.

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COVID-19 Among African Americans: An Action Plan for Mitigating Disparities

Cited by 51 publications

References 27 publications

Racial Differences in Prevalence and Treatment for Psoriatic Arthritis and Ankylosing Spondylitis by Insurance Coverage in the USA

Racial Differences in Prevalence and Treatment for Psoriatic Arthritis and Ankylosing Spondylitis by Insurance Coverage in the USA

Disproportionate Impact of COVID-19 on Racial and Ethnic Minority Groups in the United States: a 2021 Update

Racial differences in institutional trust and COVID-19 vaccine hesitancy and refusal

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