Friday May 20, 2022

Unequal toll

January 25, 2022

I am a global public health professor with expertise in multicultural health and health disparities. My teaching and research focus on the social determinants of health: the layers of policies, economic factors and social structures that affect health and quality of life, and the complicated ways they interact. I also study social justice in the context of public health, including the sociocultural context of infectious diseases.

Throughout the pandemic, American Indians and Alaska Natives as well as Hispanics and Latinos have borne more than twice the risk of white people of death from Covid-19, and Black people have been at nearly twice the risk.

Research has shown that the pandemic’s unequal toll on communities of color has been driven by long-standing health inequities: injustice or unfairness in the distribution of good health and well-being in society. Public health experts and professionals call the resulting health gaps ‘health disparities’: the inequitable differences that exist between various groups of people in terms of disease, injury, death and other health issues.

The World Health Organization describes health inequities as differences in health status or the distribution of health resources between certain populations of people. The differences are generally caused by the varied social conditions in which people are born, grow, live and work.

In the US, the main drivers of health inequities are structural inequalities. They include poverty, unemployment, lack of health insurance and inability to afford health care, as well as access to healthy food, good education and transportation.

These problems can cut across race and ethnicity. Overall, however, people of color are at higher risk of poor health than non-Hispanic white Americans, whom the U.S. Census Bureau defines as being of European, Middle Eastern or North African ancestry.

For example, Black Americans are twice as likely as their white counterparts to suffer from hypertension and heart failure. Black Americans also have a diabetes rate of 13 percent and an obesity rate of 38.3 percent, compared with 8 percent and 30 percent for non-Hispanic white people in the US, respectively, according to data from the Centers for Disease Control and Prevention.

In a 2021 study, researchers investigated the influence of social determinants of health on Covid-19 outcomes at the county level. They found that counties with higher overall death rates had a greater proportion of Black residents. They also had higher rates of health and social inequities, including low birth weight, uninsured adults or households lacking internet.

In 2020, life expectancy declined across most ethnic or racial groups, according to the CDC. However, while the drop for the majority population of white Americans was 1.5 years, Black Americans’ life expectancy dropped by 2.9 years. For people of Hispanic and Latino descent, life expectancy dropped by three years.

Excerpted: ‘How the Pandemic’s Unequal Toll on

People of Color Underlines US Health Inequities’.