SERIES: COVID-19’s Long-Term Policy Implications - Health Disparities in the Era of COVID-19

The COVID-19 pandemic has rightly become the sole focus of the public health policy world, but it is also having far reaching effects into policy landscapes way beyond healthcare. This blog post is the first in a series that will explore how COVID-19 is changing American life, and as a result, impacting various policy areas. This series will explore changing American attitudes, examine new policy ideas, and project on legislative and regulatory activity we may see as a result of the virus in the months ahead.

As the virus continues to spread throughout our communities, existing health disparities are being exacerbated at a rapid pace. Underlying health issues that disproportionately affect African Americans, such as diabetes and hypertension, are major contributors to the higher rate of infection. In addition to these important factors, differences in access to high quality jobs and economic stability, quality education, health care services, quality neighborhoods, and structural racism— the social determinants of health—are the foundation for these health disparities. 

Current Data And The Need To Gather Better Information

The limited data and analysis that we do have, is showing that African Americans are being hospitalized and are dying at disproportionately higher rates; in fact counties that are majority-black have three times the rate of infections and almost six times the rate of deaths as counties where white residents are in the majority.

Michelle Lujan Grisham, governor of New Mexico, has also sounded the alarm about health disparities in her state. Native Americans in New Mexico have been disproportionately affected by the disease, representing 25 percent of the positive COVID-19 cases, even though they only represent 6 percent of the overall population.

Despite calls from Obama-era officials and Members of Congress, the Administration has yet to release comprehensive Medicare data about racial and ethnic outcomes in COVID-19 cases. Others are calling for a national system that would capture data on coronavirus patients based on race, ethnicity, and other factors.

The Congressional Black Caucus (CBC) has led the charge in calling for the Centers for Disease Control (CDC) to begin immediate racial data reporting for COVID-19 in every state.

The bottom line, according to Rep. Robin Kelly, Chair of the Congressional Black Caucus Healthcare Braintrust, is that “without this data, we will continue to risk the lives of people in this country.”

Steps Taken by the Administration

President Trump and members of his Coronavirus Taskforce have acknowledged the additional challenges faced by minority communities and noted the need for improvement. Currently, CDC is reviewing new web content for racial and ethnic minority groups, in addition to new social media campaigns, culturally relevant graphics and illustrations, and a public service announcement for the African American community. The agency also is planning a Coronavirus listening session with experts working on health disparities among racial and ethnic populations.

Congressional Efforts in COVID 4.0 and Beyond

Congressional Democrats, led by members of the CBC, are pushing for provisions to address racial and ethnic disparities in a potential fourth coronavirus relief package, widely referred to as “COVID 4.0.” This would include extensive testing and collection of data by the CDC so the full effects of the virus on communities of color can be understood.

For many minorities and non-English speakers, factual and trusted communication about the coronavirus that is tailored to their population is lacking. Rep. Debbie Mucarsel-Powell (D-FL) is pushing to include a provision in the next package that directs federal funds to multilingual and culturally inclusive educational efforts on public television and radio.

House Majority Leader Steny Hoyer (D-MD) has said the next relief package will hopefully begin to address some of these disparities. Among other ideas, Leader Hoyer said House Democrats want to see more funding for community health centers, which often serve minority populations.

“This ought to really energize us in looking at this disparity because it is stark, it’s dangerous and it’s unacceptable,” Hoyer said.

Proposals From Think Tanks

Academics and policy wonks based at Washington-area think tanks are also weighing in on potential ways to address the disparities the COVID-19 pandemic has brought to the forefront of policy conversations. These ideas include solutions such as ensuring essential workers have paid sick leave and hazard pay, increasing testing and triage centers in minority neighborhoods, and making sure that public health materials are available for non-English speakers. We are also seeing these groups echo the need for additional data to be made available by the Administration.

Health Equity In Campaigns

The Trump campaign has not made public any policies that would address these issues, although some would call attention to the fact that U.S. Surgeon General Jerome Adams has been absent from White House press briefings on the COVID-19 response since he used this platform to call attention COVID-19’s threat to minorities.

Meanwhile, the Biden campaign addressed this issue in a public statement, saying that COVID-19 “is shining a light on so many inequities in our society…and unsurprisingly it’s also amplifying the structural racism that is built into so much of our daily lives, our institutions, our laws, and our communities.” In addition, the former vice president joined his Democratic colleagues in calling for the CDC and other agencies to release more data on age, race, and income.

As we look forward to crafting solutions to this pandemic, we are sure to see policy makers continue to try and address some of these challenges. Things like telehealth, which have the potential to help vulnerable and low-income populations, are already expanding and taking hold.

As the pandemic continues, and the government’s role and spending to tackle the crisis expand, Plurus will be tracking and monitoring developments in this space.