Good Data, Targeted Action Needed to Reduce COVID-19 Disparities

Quality data on race, ethnicity, and gender is needed to reduce disparities in confirmed COVID-19 cases and deaths, according to a report from researchers at the Medical College of Georgia.

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The marked racial disparities that have come to light in the midst of the COVID-19 pandemic reveal the urgent need to ensure adequate testing and treatment for African Americans, as well as safer working and living conditions so that they can better protect themselves, the researchers noted.

"A colorblind approach to public health surveillance and response cannot bring about equity when both the health care system and the structural conditions that inform it are so weak," said corresponding author Dr. Steven S. Coughlin, interim chief of the Division of Epidemiology in the MCG Department of Population Health Sciences.

Poverty, lack of health insurance, and limited access to healthcare are factors that have contributed to longstanding healthcare disparities among black populations. Research has shown that a higher percentage of African Americans work in jobs where it’s difficult or impossible to work from home or maintain a safe social distance at work.

For example, in New York City, reports based on US Census Bureau statistics indicate that about 75 percent of frontline workers in the city – including those who work in grocery stores, trucking and postal services, and family services – are African American.

"To mitigate racial disparities in COVID-19 infection and mortality, safer working conditions and living environments (also) are needed that include provisions for personal protective equipment, social distancing, and hand/surface hygiene," the researchers said.

The team also found that as recently as late April, many states did not release confirmed cases and deaths broken down by race, and the data was often limited on the states that did. For the states and cities that did break down data by race and ethnicity, it was clear that the virus had a disproportionate impact on black populations, the researchers noted.  

In Wisconsin for example, African Americans make up six percent of the state’s population, but 25 percent of COVID-19 cases and 39 percent of deaths. In Georgia, a state that is nearly 31 percent black, African Americans accounted for 31 percent of COVID-19 cases and 52 percent of deaths.

Nationally, the CDC had reported that one in three people who became sick enough to require hospitalization were African American while they make up just 13 percent of the population.

Significant gaps still exist in COVID-19 data on race and ethnicity, the researchers noted, and should be addressed in order to improve the disparities that exist in communities of color.

"You can't test the whole world but you can test segments where you know there are potential problems ... if you are able to document those problems, then you can divert resources to those communities to try to work on processes that make the community more aware of the things they could do to support each other with regard to stopping transmission of the disease," said  Joseph Hobbs, chair emeritus of the MCG Department of Family Medicine and a senior author on the paper.

States and cities can look to non-traditional community organizations to reduce coronavirus-related disparities, the team said.

"Black churches can serve as testing and triage centers, health action zones to bridge government resources with community resources, and serve as a platform to overcome trust issues related to health care," the researchers stated.

In the long-term, leaders should work to address the structural issues at the heart of the problem – including poverty, unemployment, and household and neighborhood crowding.

"Our editorial calls for improved public health surveillance data to monitor the COVID-19 epidemic in different, diverse communities," Coughlin said.