Darnell Dent, principal of Dent Advisory Services and a member of the Managed Healthcare Executive® Editorial Advisory Board, discusses health disparities for people of color - specifically Blacks and Latinos - and how COVID-19 has highlighted our failure at the intersection of public health, healthcare and social justice.
In the midst of the COVID-19 pandemic, an age-old societal issue has surfaced to the top of our collective consciousness. I am talking about the differences in health status of racial groups, better known as health disparities — patterns of observed differences in the care and treatment of certain groups. Here we are talking about health disparities for people of color; specifically, Blacks and Latinos.
COVID-19 has highlighted our failure at the intersection of public health, healthcare and social justice. Recent data show that African American and Latino communities are disproportionately affected by this disease. The CDC has reported that the age-adjusted hospitalization rates for COVID-19 among Blacks and Latinos are 4.5 and 3.5 times that of non-Hispanic Whites, respectively. In many areas of the country, these same groups are more than twice as likely as Whites to die from COVID-19.
These startling statistics have helped peel back the reluctance to deal with health disparities, a reluctance that may deflect, muffle and temporize but, ultimately, draws upon racism. COVID-19 numbers are so stark and the world’s focus on the pandemic is so intense that they illustrate the need to finally address the inequities in health care services and outcomes and move to a more viable system of caring for every citizen of our country.
The COVID-19 spotlight on health disparities has brought new attention to social determinants of health (SDOH) and health status as a consequence of long-standing structural inequalities that follow racial and ethnic lines. Broadly speaking, these social factors include food security, education, economic stability, affordable housing and access to healthcare. Advocates for addressing SDOH have been outspoken for quite some time, but the gap between word and deed is large, partly because the problems are so large and entrenched.
At one level, the cost of health disparities on human potential and opportunities can’t be measured. At other levels it can, and the real cost is astounding. The W.K. Kellogg Foundation and Altarum estimate that disparities result in about$93 billion in spending on excess medical care and $42 billion in lost productivity.
To improve chances of success, action on SDOH must draw lessons from the past. The historical record highlights the vulnerability of health care policies incorporating SDOH to resistance from entrenched interests. Systemic racism and discrimination have made it virtually impossible to address these issues in a systematic matter, but these are precisely the social determinants that are responsible for the racial and ethnic disparities of COVID-19 and most other illnesses.
COVID-19 is laying bare the sobering reality that we have allowed racism and health disparities to exist far too long, resulting in a disproportionate number of lives in communities of color to suffer the consequences of their effects. In this country, more than 200,000 people have died and more than 7 million have been infected.
We can’t waste this moment when eyes — and hearts — have been opened to seeing and caring about health disparities. We have the chance this coming decade to see significant health gains for disadvantaged populations, but that will take diligence. And we need policies and programs directed at the core causes of the disparities.
This strategy must be complemented by engaging a broader base of constituents, as witnessed during this current phase of social justice reckoning fueled by the Black Lives Matter movement. This is an unprecedented period in American history, and we must seize the opportunity to enact policies that bring attention to SDOH into every healthcare transaction, without regard to race or socioeconomic status.
Darnell Dent is principal of Dent Advisory Services and a member of the Managed Healthcare Executive® Editorial Advisory Board.