COVID-19 Impacts/Long-Term Health Impacts

Institutional racism has resulted in Communities of Color being disproportionately affected by several aspects of COVID-191. BIPOC (Black, Indigenous, People of Color) are disproportionately employed as essential workers, and therefore are more likely to be exposed to the virus. In addition to having higher rates of pre-existing health conditions that exacerbate COVID-19, these communities have the highest rates of Coronavirus-related unemployment, housing insecurity, and lack health insurance, all of which impact their ability to access adequate prevention and treatment and increase the risk of additional negative long-term health impacts.  These disparities must be addressed on a systemic level to stop perpetuating the racial and socioeconomic inequities that put these populations further at risk.


Age-adjusted hospitalization rates are the highest for non-Hispanic American Indian or Alaska Native and non-Hispanic Black persons2.


SYSTEMIC DISPARITIES
Populations that lack healthcare access under normal circumstances are left even more vulnerable during crises3

Racial/ethnic minority populations have a disproportionate burden of underlying comorbidities that put them at higher risk of COVID-194.

Disparities in access to health insurance mean that the median direct cost for COVID-19 treatment ($3,045) and median cost of COVID-19 hospitalization ($14,366) are a barrier to accessing COVID-19 treatment for BIPOC individuals5,6.

Explaining the Loop:

Disparities in educational attainment tend to lead to disparities in weekly earnings7. Notably, these educational disparities tend to disadvantage BIPOC8.

Low wage workers tend to work in industries that are higher risk for exposure to SARS-CoV2 (the virus that causes COVID-19). As a large proportion of low-wage workers are BIPOC9, this then leads to BIPOC having disproportionately high rates of COVID-1910

Chronic stress (stress experienced over an extended period of time) can lead to long-term negative health issues11.

As BIPOC in the United States are less likely than their white peers to have health insurance and regular access to quality healthcare, health disparities are further widened12,13. The health conditions (such as diabetes, cancers, obesity) that are disproportionately common among BIPOC due to limited access to healthcare then lead to increased susceptibility to COVID-19 and worse health outcomes after COVID-19 infections14,15.

These issues in turn are exacerbating existing racial and socioeconomic inequities16.

︎ This loop overlaps with:
  • Maternal, Child, and Adolescent Health – People who have experienced chronic stress and the children of those who have experienced chronic stress can experience the long term negative health impacts of these exposures: inflammation, cardiovascular disease, diabetes, cancer, autoimmune syndromes, depression, anxiety, weakened immune systems, and more17,18.



DISRUPT THE LOOP
1. INDIVIDUAL-LEVEL ACTIONS
2. GROUP-LEVEL ACTIONS
  • Call for government to:
    • Freeze healthcare costs
    • Collect more nuanced demographic data to better understand disparities
    • Provide increased funding for more robust public health surveillance systems
SOURCES

1. Gould E. and Wilson V. Black workers face two of the most lethal preexisting conditions for coronavirus--racism and economic inequality. Economic Policy Institute. Published June 1, 2020. https://epi.org/publication/black-workers-covid/

2. Hooper MW, Nápoles AM, Pérez-Stable EJ. COVID-19 and Racial/Ethnic Disparities. JAMA. 2020;323(24):2466-2467. doi:10.1001/jama.2020.8598

3. Ahmed F, Ahmed N, Pissarides C, Stiglitz J. Why inequality could spread COVID-19. The Lancet Public Health. 2020;5(5):e240. doi:10.1016/S2468-2667(20)30085-2

4. “People with Certain Medical Conditions.” CDC. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. Published February 11, 2020. Accessed June 29, 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html

5. Bartsch SM, Ferguson MC, McKinnell JA, et al. The Potential Health Care Costs And Resource Use Associated With COVID-19 In The United States. Health Affairs. 2020;39(6):927-935.doi:10.1377/hlthaff.2020.004262.


6. Artiga, Samantha, et al. “Communities of Color at Higher Risk for Health and Economic Challenges Due to COVID-19.” KFF, Kaiser Family Foundation, 7 Apr. 2020, www.kff.org/coronavirus-covid-19/issue-brief/communities-of-color-at-higher-risk-for-health-and-economic-challenges-due-to-covid-19/.


7. Torpey, Elka. “Measuring the Value of Education : Career Outlook.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, Apr. 2018, www.bls.gov/careeroutlook/2018/data-on-display/education-pays.htm.

8. “Status and Trends in the Education of Racial and Ethnic Groups.” National Center for Education Statistics, NCES, Feb. 2019, nces.ed.gov/programs/raceindicators/indicator_RFA.asp

9. Cooper, David. “Workers of Color Are Far More Likely to Be Paid Poverty-Level Wages than White Workers.” Economic Policy Institute, 21 June 2018, www.epi.org/blog/workers-of-color-are-far-more-likely-to-be-paid-poverty-level-wages-than-white-workers/.

10. Morgante, Michelle. “Low-Wage Work Is Linked to Spread of COVID-19, Study Finds.” Low-Wage Work Is Linked to Spread of COVID-19, Study Finds | Newsroom, University of California Merced, 21 July 2020, news.ucmerced.edu/news/2020/low-wage-work-linked-spread-covid-19-study-finds.


11.“Understanding the Stress Response.” Harvard Health Publishing, Harvard Medical School, 6 July 2020, www.health.harvard.edu/staying-healthy/understanding-the-stress-response.


12. Artiga, Samantha, et al. “Changes in Health Coverage by Race and Ethnicity since the ACA, 2010-2018.” KFF, Kaiser Family Foundation, 5 Mar. 2020, www.kff.org/disparities-policy/issue-brief/changes-in-health-coverage-by-race-and-ethnicity-since-the-aca-2010-2018/.

13. Artiga, Samantha, et al. “Disparities in Health and Health Care: Five Key Questions and Answers.” KFF, Kaiser Family Foundation, 4 Mar. 2020, www.kff.org/disparities-policy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answers/.

14. Price, James H., et al. “Racial/Ethnic Disparities in Chronic Diseases of Youths and Access to Health Care in the United States.” BioMed Research International, vol. 2013, 23 Sept. 2013, pp. 1–12., doi:10.1155/2013/787616.

15.“Health Equity Considerations and Racial and Ethnic Minority Groups.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 24 July 2020, www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html.

16. Wilson, Valerie. “Inequities Exposed: How COVID-19 Widened Racial Inequities in Education, Health, and the Workforce: Testimony before the U.S. House of Representatives Committee on Education and Labor.” Economic Policy Institute, Economic Policy Institute, 22 June 2020, www.epi.org/publication/covid-19-inequities-wilson-testimony/.

17. Mariotti, Agnese. “The Effects of Chronic Stress on Health: New Insights into the Molecular Mechanisms of Brain–Body Communication.” Future Science OA, vol. 1, no. 3, 1 Nov. 2015, doi:10.4155/fso.15.21.


18. Timmermans, Steven, et al. “A General Introduction to Glucocorticoid Biology.” Frontiers in Immunology, vol. 10, 2019, doi:10.3389/fimmu.2019.01545.

19. “Living in Shared Housing.”Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 July 2020, www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/shared-housing/index.html.

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