Oral eversion

 COVID-19 racial and ethnic health disparities 

Preparedness and response interventions towards COVID-19 have been the goals of most individuals, governments, families and health care stake holders in the last about 2 years since COVID-19 was declared a pandemic. Slowing the transmission and protecting communities require the participation of every member of every community to take action. This requires that everyone understands and adopts individual protection measures. Easy, right? How then do we explain the fact that the infection rates continue to rise globally and locally? What are the dynamics driving how information and instructions are received and appropriated among different groups and demographics? Why are racial and ethnic minority groups so disproportionately more severely affected by the disease compared to other groups?

Any effective response and intervention should take the perspectives of affected communities into account. Public health and social measures such as movement restrictions and wearing of mask work best when they are discussed, understood accepted and supported by the particular community. For the minority populations in the US, cultural and historical contexts are major drivers of knowledge, attitude, practices and perceptions. Interventions are most effective if they address the real pain points in ways that are responsive, empathetic, transparent, contextualized and consistent with known and accepted trends.

Health equity is when all members of society enjoy a fair and just opportunity to be as healthy as possible. The subject of health disparities and inequality in access to health resources and information has been discussed often and on different forums. COVID-19 Pandemic has highlighted the issue in new and significant ways as COVID-19 has unequally affected many racial and ethnic minority groups compared to others.

In the USA, racial and ethnic minority populations are disproportionately represented among essential workers and industries. Essential workers are inherently at higher risk of being exposed to COVID-19 due to the nature of their work as care givers, food industry workers and security personnel.

Discrimination which includes racism leads to chronic and toxic stress that can put members of minority groups at higher risks for COVID-19 infection. Unfortunately, discrimination exists even in systems that are meant to protect those at risk such as health care, housing, criminal justice, education and finance. 

Chronic stress puts members of minority groups at higher risks for other lifestyle related chronic conditions such as obesity, hypertension, cardiac diseases and diabetes all of which increase the risk for death through COVID-19

Social determinants of health affect how members of minority groups access and use healthcare. Historical events and cultural contexts have led to reduced trust in healthcare systems and the government. Economic factors such as lack of insurance, transport, childcare and ability to take time off work can make it harder for minority groups to seek care. Living in crowded conditions can make social distancing very challenging and increase the risk for disease transmission.

These challenges call for more bold approaches to address the disparities; strategies that acknowledge one size does not fit all and that the mindset of health consumers, including members of minority groups is constantly evolving. Programs need to be strategically planned to enhance resonance between the message the messenger and the receiver. 

Understanding the none formal governance of these communities provide opportunities for connecting.  As an example, clergy and spiritual leaders are well trusted in their local settings and can be excellent partners with health providers or health educators in spaces where mistrust of modern science/medicine is a barrier.