COVID-19 and Health Equity—A New Kind of “Herd Immunity”

Abstract

Three articles recently published in JAMA provide insight into the large racial/ethnic differences associated with coronavirus disease 2019 (COVID-19) and highlight the need for, and potential opportunity to, redouble efforts in the US to develop strategies that would enable society to slow and ultimately eliminate the spread of inequities in health. 1-3 COVID-19 is a magnifying glass that has highlighted the larger pandemic of racial/ethnic disparities in health. For more than 100 years research has documented that African American and Native American individuals have shorter life spans and more illness than white persons. Hispanic immigrants initially tend to have a relatively healthy profile but with increasing length of stay in the US, their health tends to decline. A black infant born in the US is more than twice as likely to die before his or her first birthday compared with a white infant. In adulthood, black individuals have higher death rates than white persons for most of the leading causes of death.

COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States

“…Among patients with recent diagnosis of SUD, African Americans had significantly higher risk of COVID-19 than Caucasians, an effect that was strongest for African Americans with OUD and they also had worse outcomes (death and hospitalizations). This is consistent with data from states and counties across the US showing that the coronavirus affects African Americans at a disproportionately high rate and that the they suffer a greater death toll [28][29][30][31]. We showed that adult African Americans with recent diagnosis of SUDs had higher prevalence of asthma, chronic kidney disease, type 2 diabetes, hypertension, obesity and HIV compared to adult Caucasians.…”

COVID-19 disparity among racial and ethnic minorities in the US: A cross sectional analysis

“…Hand hygiene is vital to prevent the spread of infection. Racial and ethnic minorities continue to face a lack of indoor plumbing [ 15 ]. Indigenous peoples, African-American, and Hispanics are much more likely than Caucasian households to lack access to complete plumbing, electricity, & sanitation among other essential amenities.…”

Historical Insights on Coronavirus Disease 2019 (COVID-19), the 1918 Influenza Pandemic, and Racial Disparities: Illuminating a Path Forward

“…However, misinformation, oversight, and delayed mitigation strategies alone do not fully explain differential COVID-19 incidence. Many have deeply analyzed the effect of social determinants on COVID-19 disparities (15,65,66). This historical inheritance, of which the 1918 influenza pandemic forms just 1 episode, shapes how social conditions obstruct minority participation in public health mitigation and containment measures.…”