For those of us who don’t have to worry about experiencing bias—even if it’s unconscious—when visiting the doctor’s office or don’t go into a medical procedure fearing for our lives due to high mortality rates of people with our skin color, we must advocate and push for systemic change at all levels. There’s a lot we all should know about how COVID has impacted the Black community, and the first part of that involves acknowledging the racial disparity in healthcare exists in the first place.
Racial disparities in healthcare are very real
More than awareness is needed to address the very real racial disparities in health care. While COVID has brought more attention to the issue, there is a lot missing from the current conversation. First, the system has always been one to dismiss—or completely leave out—Black people; a fact that is evident just by looking at the history of markers and research widely used to determine overall health. This includes the body mass index (BMI), which originally was created using the bodies of white European men as the standard and has not been modified or updated to consider other genders or ethnicities. Additionally, it wasn’t even until 1994 that the National Institutes of Health (NIH) passed guidelines requiring both women and minorities be used as subjects in clinical research, which often determines best practices and gold standards of medical treatment. None of this takes into account the personal experiences of Black people, as they try—often unsuccessfully—to receive unbiased medical treatment in the United States. Researchers admit that discrimination in healthcare is a systematic issue, and fixing it requires more than training. Whole systems need to be addressed, because Black people are needlessly experiencing the effects of racism on physical health, but also on mental and maternal health. For example, the National Partnership for Women and Families notes that Black women are up to four times more likely to experience a pregnancy-related death than white women (and many of these deaths are preventable). If anything, COVID has only shed light on these disparities, with Black people being 1.9 times more likely to die of COVID-19 than white people. Now that the COVID vaccine rollout is underway, we see there are barriers Black people are facing when it comes to accessing COVID vaccination as well as treatment, which is in line with the history of healthcare, but needs to be addressed at both a local and national level.
Barriers Black people face surrounding COVID-19 vaccination
According to the Centers for Disease Control and Prevention (CDC), during the first month that COVID vaccinations began in the United States, over 12 million people received their first dose and of those, only 5% of those people were Black. Researchers note that part of this is due to disparities in vaccine access. In fact, a February 2021 study by the University of Pittsburgh School of Pharmacy and West Health Policy Center, noted that in over 69 counties—a third of which encompass large urban areas—Black residents are significantly more likely than white people to live more than a mile from a vaccination site, be it a pharmacy, health center or hospital. “Obstacles to vaccination, like longer driving distances to potential COVID-19 vaccine administration facilities, will likely make it difficult for Black Americans to receive a vaccine in some areas of the country,” explains Dr. Lucas Berenbrok, Pharm.D., assistant professor at the Pittsburgh School of Pharmacy, who worked on the study. “This is because of inadequate access to public transportation, which may be particularly unreliable in the era of COVID, and because Black Americans are less likely to own a vehicle.” In addition to the physical barriers that are at work, there are other barriers including inequity in the healthcare system as a whole. It has been reported that Black people are hesitant about the vaccine, but this statement oversimplifies the issue. It’s not necessarily the vaccine—though, with the recent history of minorities finally being included in clinical research, it’s warranted—but with the system as a whole. The vaccines are one part of the larger healthcare system which, especially during COVID, has been failing Black people yet again. “When talking about the vaccines, it’s crucial that we address the fears many people of color have around these vaccines rather than shrug it off as an insignificant worry,” shares Angela F. Williams, President and CEO of Easterseals, a nonprofit that provides disability services “These fears are based on real, tragic history. They are based on the way people of color are treated today. By bringing these fears and issues to the forefront, we can better support those who are hesitant and show that vaccines can be safe and effective.”
Vaccine access for disabled people of color must be addressed
When talking with Williams, whose organization Easterseals provides home and community services for those with disabilities—it became evident that another part of the conversation that is often missing is the additional barriers Black people with disabilities face, especially in the face of COVID. Williams discusses factors such as placement in group settings where the chance of COVID transmission is higher and the fact that Black people often staff in-home care for those with disabilities, leading to a higher chance of COVID transmission, as just a few of the issues that need greater attention. “While all people with disabilities may encounter inaccessibility in trying to get the shot, those of color, especially Black and brown people, have faced marginalization that impedes their ability to find and access the vaccine,” adds Williams. “Both disabled people and BIPOC people deal with higher levels of poverty than their white, non-disabled counterparts, and poverty impacts access to technology and transportation that enables them to find and make vaccine appointments and get to them. Also, they fear dealing with side effects at home, without easy access to treatment.” Williams notes that if you are looking to advocate for racial equity for people with disabilities, you should support increased funding for home and community-based services (HCBS), bringing care directly to people and communities versus in a hospital or facility. “Other ways to lend support include donating money to organizations that fight racial inequities or supporting individuals trying to get the message out by sharing their work,” notes Williams. “It’s also important to educate yourself about marginalization so you do not have to better understand what others experience, what they need and how best to contribute.” Not sure where to start? Next up, follow these 30 anti-racist Instagram accounts (because not being racist yourself isn’t enough).
Sources
Angela F. Williams, President and CEO of EastersealsCenters for Disease Control and Prevention (CDC): “Risk for COVID-19 Infection, Hospitalization, and Death By Race/Ethnicity.”Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR): “Demographic Characteristics of Persons Vaccinated During the First Month of the COVID-19 Vaccination Program — United States, December 14, 2020–January 14, 2021.”Dr. Lucas Berenbrok, Pharm.D., assistant professor at the Pittsburgh School of PharmacyHealth Care Financing Review: “Understanding and Addressing Racial Disparities in Health Care.” PMID: 11481746National Institutes of Health, NIH GUIDE: “NIH GUIDELINES ON THE INCLUSION OF WOMEN AND MINORITIES AS SUBJECTS IN CLINICAL RESEARCH.”National Partnership for Women and Families: “Black Women’s Maternal Health: A Multifaceted Approach to Addressing Persistent and Dire Health Disparities.”University of Pittsburgh School of Pharmacy and West Health Policy Center: “Where Black Americans Will Travel Farther than Whites for COVID-19 Vaccination.”
