By: Derek Martinez
Public health has been one of the most important fields in combating the COVID-19 pandemic. Though the virus itself affects us the same biologically, certain demographics were disproportionately impacted by the spread of COVID, and public health is an extremely important science to identify the causes of this. Latino, African-American, and Native American populations were at higher risk of hospitalization and death due to COVID compared to other demographics. To illustrate just how big this disparity is, the Native American population was at risk of being hospitalized at 3.7 times the rate of the White population in the US.
So why were these 3 populations so heavily affected by the pandemic? Professionals use categories called the Social Determinants of Health to determine the causes of healthcare disparities and identify areas for improvement. These determinants are economic stability, education, social and community context, health care, and neighborhood and built environment. As one can probably tell, a lot of these categories have to do with living conditions and social equity rather than medicine. Thus, much of the work done to improve healthcare is social work, rather than medical research.
Economic stability is mostly defined by employment rate, food security, and housing stability. All of these factors contribute to COVID’s effect on each of the demographics mentioned. Native American communities often struggle with food insecurity due to historical systems that caused a lack of resources and near extinction of essential animals for Native peoples. Commercial food prices are also significantly inflated in reservations, making it difficult for Native people to receive proper nutrition. This undoubtedly contributes to the many Native deaths due to COVID. The Latino population in the United States also struggles with employment instability since a large amount of the population is undocumented. This restricts undocumented Latinos to certain jobs that usually do not pay enough to financially support themselves and their families. Because of this, a large portion of the Latino population does not have access to equitable healthcare. The African American population also struggles with housing stability due to redlining and gentrification in many neighborhoods that are majority black. Many African Americans, unfortunately, end up unhoused because of this, which is especially dangerous during the pandemic. These financial hardships cause a cruel cycle that intersects with education. Citizens with a bachelor’s degree generally have a higher income than those who do not. Many families from these three populations cannot afford to send their children to higher education institutions, and there are several instances where high school students need to drop out of school to support their families. Without any financial resources for higher education, families likely cannot improve their socioeconomic status.
Social and community contexts refer to factors like civic participation and discrimination. The American medical system has a significant history of medical racism and discrimination. Many people from Latino, Indigenous, and African American communities were given forced sterilizations and were given poor healthcare throughout history. This has caused communities today to feel wary about receiving healthcare and getting tested for COVID-19. This is also prominent in vaccine distribution, where citizens from these populations did not get vaccinated due to fear. Health literacy also influences this. The majority of the Latino population are immigrants and non-native English speakers, and it is especially difficult to translate information in indigenous communities. This makes it quite difficult to propagate important health information about COVID-19 to these communities.
The neighborhood and built environment category is slightly more intricate compared to the other determinants of health. It mainly looks at environmental conditions and housing quality. Naturally, this discriminant has many intersections with economic stability. If a family’s housing does not have suitable access to resources such as electricity, water, and ventilation, it is more likely that the household will have more hospitalizations and a higher risk of disease. Due to the factors mentioned relating to economic stability, a higher percentage of minority populations lack these resources. This has had a critical impact during the pandemic since most people were working from home and spent most of their time at home. Environmental conditions fall under a broad category, but what was most relevant to the pandemic was peoples’ access to public facilities. Many gyms were closed as well as greenspaces, making it difficult for people to get proper exercise. As a result, many people were much less healthy during the pandemic than they were before, making it harder to combat COVID-19.
All of these indicators of health also indicate social inequity across these communities. In order to flatten the curve and lower COVID cases to a minimum, policies need to be in place to improve the living conditions of populations across the United States, and the world. That way, we can be more prepared for health crises like these.
Educational Content: Q: What do each of the 5 determinants of health consider when evaluating public health?
A: Economic stability analyzes a person’s ability to afford everyday costs, as well as essential resources such as housing and food. Additionally, it investigates how affordable healthcare costs are to the public. Education looks at a community’s ability to have high graduation and matriculate rates so that socioeconomic statuses can improve. To a certain extent, education also includes health literacy. Social and community context mainly focuses on a demographic’s willingness to receive healthcare and looks at causes of distrust between the public and the medical system. Health is one of the more direct determinants, seeking to examine equity in healthcare. Lastly, neighborhood and built environment is a critical examination of a person’s living environment and their access to facilities that promote healthiness.
Q: Why were Latino, Native American, and African American communities disproportionately affected by COVID?
A: There are many reasons for this. What is likely the most significant factor in the disproportionate effect is financial instability, since this influences every other determinant of health. Without economic stability, it is not likely that people are able to receive a quality education that could potentially improve their socioeconomic status. It is also unlikely that low-income communities would be willing to receive healthcare due to the high costs. Likewise, people would also be unable to afford essential living resources like electricity, water, and other appliances.
Sources:
Seattle Children’s Research Institute
Image Source
No changes were made, https://commons.wikimedia.org/wiki/File:Social_Determinants_of_Health_Infoviz.jpg, License: Creative Commons — Attribution 4.0 International — CC BY 4.0