Report: How COVID-19 Revealed — and May Help Alleviate — Healthcare Inequity

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  • New research shows that more Black individuals have died from COVID-19 than Latino and White individuals combined.
  • In response, the Department of Health and Human Services (HHS) will now require patients to include demographic information with their COVID-19 tests.
  • Seema Verma, administer for the Centers for Medicare and Medicaid Services (CMS), has advocated to maintain relaxed telehealth regulations after the pandemic.

COVID-19 pandemic has impacted everyone, but the impact has been particularly devastating for communities of color.

A study from the JAMA Network shows how the pandemic has disproportionately affected Black communities. According to the study, COVID-19 mortality rates “are substantially higher among African American/Black individuals” with 73 deaths per 100,000 infected patients. This is in stark contrast to the Latino community, which experienced 36 deaths per 100,000, and White individuals, who saw 22 deaths per 100,000.

The higher death rate among African-American individuals has been attributed to a wide variety of factors involving socio-economic disparities and discrimination. According to another study published in May 2020 from the JAMA Network, COVID-19 testing centers are “more likely to be in well-off suburbs of predominantly White residents than in low-income neighborhoods that are predominantly Black.” Additionally, according to “billing data for COVID-19 testing from several states,” African American “patients with symptoms such as cough and fever were less likely than White individuals with the same symptoms to be given a test.”

Even increased testing has not helped. In another study comparing two “boroughs of residence” in New York City for COVID-19 testing and outcomes, the borough with the “lowest levels of income and education and the highest proportion of Black and Hispanic persons” had the “highest rate of COVID-19 hospitalizations and deaths,” despite having the “the highest rate of COVID-19 tests performed.” This was compared to the predominantly White borough, which had the lowest COVID-19 hospitalizations and deaths despite having “the highest population density.”

Healthcare leaders and public officials are taking notice of these disparities and are working on a strategy that includes the following:

  • Reporting demographic information with COVID-19 tests – The Department of Health and Human Services (HHS) will now require patients to submit additional socio-demographic information along with their COVID-19 tests. According to ADM Brett P. Giroir, Assistant Secretary for Health, “the requirement to include demographic data like race, ethnicity, age, and sex will enable us to ensure that all groups have equitable access to testing, and allow us to accurately determine the burden of infection on vulnerable groups.” HHS considers this data as a “critical piece to better understanding the impact on socially vulnerable populations.”
  • Developing existing telehealth policy – COVID-19 drastically increased telehealth adoption across the U.S., and the Centers for Medicare and Medicaid Services (CMS) relaxed provider reimbursement regulations for virtual visits for Medicare Advantage patients. However, it is unclear if those regulations will remain in place after COVID-19. Seema Verma, Administrator for CMS, stated in a live-streamed interview with STAT News that “expanded access to telemedicine should continue after the coronavirus pandemic recedes and that officials are examining ways to act without waiting for legislation from Congress.”

In addition to utilizing data analytics and expanding telehealth policy, it is also critical to utilize the skills and knowledge of providers. Providers in underserved areas have unique knowledge of their community’s needs. Carlos Covarrubias, MD, from Baltimore, Maryland, for example, continued to “provide emotional and spiritual support” to his anxious patients after he had to close his practice due to COVID-19. Dr. Covarrubis, who understood his community’s need for mental health support, was able to help alleviate their anxiety during the pandemic.

While using the data to inform actionable measures can help healthcare administration alleviate social disparities with respect to COVID-19, such actions will address just a small portion of the entire ecosystem of medical care inequity.

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