Disparity needs own Operation Warp Speed
Disparities in COVID-19 infections have brought to light what many have known all along: there is no equity in health in the United States. Notice I did not say health care. It is true, there is a lack of equity in health care as well. Five million Texans do not have health care coverage, and that number is bound to grow as businesses close and people lose their jobs — and health insurance. However, watching COVID infections ravage communities of color, sometimes devastating several generations in a single family, it is obvious that COVID-19 found an easier place to take hold in certain populations than in others.
The drivers of morbidity and mortality from COVID-19 in Black and Hispanic communities are twofold: increased risk of infection and increased risk of severe disease or death from infection. Individuals from communities of color are more likely to be in high-exposure environments that result from close physical proximity to others at work and home and an inability to work remotely or to isolate themselves. In addition, these same communities are overly burdened with chronic illnesses — heart disease, diabetes, obesity, chronic obstructive pulmonary disease, kidney disease — and are more likely to suffer from a COVID infection that requires hospitalization due to severe illness. The most recent data from the Centers for Disease Control and Prevention shows that Black and Hispanic people are three times more likely to be hospitalized with a COVID infection and
two times more likely die.
While the nation breathes a collective sigh of relief that vaccines are being administered, and day by day, more individuals are protected from the infection, we cannot lose sight of the necessity to address the social factors that make certain communities more prone to poor health. Poverty, low academic achievement, unemployment, food and housing insecurity, discrimination, violence, social isolation and polluted environments negatively influence an individual’s ability to live a healthy life. In contrast, a livable wage, quality education, employment, access to healthy foods, stable housing, social privilege, safety, connectedness and clean water and air greatly promote good health. Good health, in turn, increases the likelihood that when an infection like COVID strikes, a person will have a better chance of surviving the physical assault.
So while health care systems and public health agencies encourage, cajole or implore patients and community members from diverse backgrounds to get vaccinated, we should also apply a full-court press on the negative social factors that impact health. What would communities look like if a collection of brilliant minds and wellfunded innovations were unleashed on poverty, homelessness and failing schools? What if those innovative strategies had to be enacted within a year? What if Operation Warp Speed not only produced five vaccines in less time than ever before in the history of the world but also included transforming communities into social and physical environments that promoted health? What if ?
My first piece of advice to everyone, especially members of Black and Hispanic communities, is to get the COVID-19 vaccine as soon as you can. Protect yourselves and your families. My second piece of advice to leaders and decision makers both nationally and locally is that real protection from high morbidity and mortality rates — whether from the next pandemic or from the mountain of chronic diseases plaguing minority populations — will come from inoculating communities of color with good health. Address the negative social, environmental and economic factors that impact health and the disparities in health outcomes will begin to disappear. When all is said and done, that’s the lasting kind of herd immunity we all seek. Barnes is chief medical executive at Harris Health System, which provides a health care safety net for low-income Harris County residents. She is board certified with the American Board of Internal Medicine, a clinical associate professor of medicine at Baylor College of Medicine and is a published author of numerous clinical journal articles and book chapters.