The pandemic paints a severely acute picture of longstanding disparities neglected by the medical system — and Americans are finally taking notice. Yet solutions, not just awareness, are necessary.
While African-Americans account for approximately 13 percent of the U.S. population, they comprised 21 percent of deaths from COVID-19 between February and May, stated recently released data from the Centers for Disease Control and Prevention (CDC). The CDC has also documented that non-Hispanic American Indian or Alaska Native persons have a coronavirus hospitalization rate about five times that of non-Hispanic white persons, non-Hispanic black persons have a rate roughly five times that of non-Hispanic white persons, and Hispanic or Latino persons have a rate approximately four times that of non-Hispanic white persons.
Today’s crisis has also compelled a deeper examination of these inequities. Disparities do not result from the color of one’s skin, but rather the socioeconomic factors associated with race and ethnicity. Those who do not have housing circumstances that permit social distancing nor jobs that provide sick leave are more likely to contract the virus and struggle to treat it. At the same time, ever-present comorbidities for minorities such as heart and lung disease place them at far greater risk of dying from COVID-19.
Further, the pandemic has exposed that racism — not race — drives the healthcare system’s disparities. The disparities exist because the system allows them to persist, including through blatant prejudice when it comes to diagnosis, screening, and access to care.
The urgency of this time means there is no way to avoid engaging in difficult conversations on racial inequities and to focus on attaining outcomes that will bridge these gaps. It starts with strengthening diversity among students in healthcare degree programs and consequently, in the medical workforce. The aforementioned 13-percent Black share of the U.S. population is treated by a workforce where physicians are only 5-percent Black, according to the Association of American Medical Colleges. Research shows that African-Americans have higher levels of trust in Black doctors and more frequently listen to their recommendations, which is more crucial than ever during this pandemic. Black patients need to see themselves in the medical exam room.
Today’s students must be exposed to the academic and career options which are in front of them, and the earlier that exposure occurs, the earlier they can take the steps necessary to enter health programs. This means equipping high school students with more of the hard and soft skills that will allow them to gain admission to a college which later prepares them for medical school; this toolbox includes not only health and science education, yet also competencies such as study skills and time management. The pipeline of applicants to health programs will also be expanded if students from lower socioeconomic backgrounds can increasingly obtain that skill set outside the context of the privileges often enjoyed by their more advantaged peers, like private tutoring.
Initiatives such as Health Professions Week (HPW) — a free online event for high school and undergraduate students, teachers, advisors, and counselors from November 14-19, 2020 — represent one important step toward building a more diverse pipeline. A nationwide collaboration between healthcare and education organizations designed to provide reliable, accessible resources to explore more than 20 career options in the health professions, HPW was providing those resources through its virtual events long before virtual conferences became the norm.
With the pandemic necessitating a response from the entire healthcare workforce — from intensive care to nursing to dialysis to home health to respiratory therapy to epidemiology and more — HPW opens the full realm of possibilities for students from all backgrounds who previously lacked knowledge about their options. Without this awareness, the average student is much more likely to seek to become a pediatrician or cardiologist than an optometrist or respiratory therapist, simply because of the images they witness in popular culture.
Ultimately, encouraging a more diverse group of students to enter a wider range of health professions will infuse the U.S. medical system with the pipeline of professionals it needs to not only react to confirmed cases of COVID-19, but to more effectively prevent the spread of the virus.
Dr. Kameron Matthews is a board-certified family physician based in Washington, D.C., and the co-director of Tour for Diversity in Medicine, an initiative seeking to bring premedical enrichment activities to minority high school and undergraduate students across the country.
By Kameron Matthews