The Mayo Clinic Center for Health Equity and Community Engagement Research recently addressed community health needs related to COVID-19 for hundreds of attendees at virtual town hall meetings in held in Arizona:
Both meetings featured speakers from Mayo Clinic and local organizations such as the Arizona Commission of African American Affairs, the Arizona Hispanic Chamber of Commerce, Arizona State University, and the University of Arizona. These meetings launched an ongoing series of virtual town halls planned in the coming months.
“The purpose of these town hall meetings is to build and reinforce connections with community leaders in order to provide information and answer questions about COVID-19 and to dispel harmful myths,” says Chyke Doubeni, M.B.B.S., director, Center for Health Equity and Community Engagement Research. The meetings also aim to spark discussions about finding ways to lessen the impact of COVID-19 on minority communities and the ways in which research can help.
Presenters cited statistics showing that minority communities are being disproportionately impacted by COVID-19.
Of those patients with race and ethnicity reported, “about 30% of the cases are in African Americans,” observed Dr. Doubeni, speaking at the African American town hall. He predicted that these numbers would change over time as race and ethnicity reporting improves, but he said, “I guarantee you that the proportion will remain higher than the proportion of the population that is African American, which is about 13% as of the last census.”
“And this is not a surprise,” he said. “For all of us, this has been part of the lived experience of African Americans.”
At the Hispanic/LatinX town hall, Judith Flores, M.D., chair of the National Hispanic Medical Association noted that in geographic locations with large populations of Latinos, the Latino COVID-19 death rate is much higher on average than for the general population.
What puts these communities at greater risk? Dr. Doubeni pointed to social injustice.
People in the African American community, noted Dr. Doubeni, are more likely to have high risk jobs without the opportunity to take time off work, more likely to use public transportation, more likely to live in overcrowded housing, and have less access to high quality health care. In addition, he said, “they don’t have a lot of trusted information sources, which may lead to delays and lack of trust in information people receive. It may lead to a delay in taking up protective advice”—such as masking and social distancing.
He also pointed to social injustices related to risks of dying from COVID-19. “If you look at the statistics around cancer, asthma, heart disease, diabetes, kidney disease, and many other preventable conditions, you will find that African Americans have the highest mortality rate.”
It has nothing to do with DNA, he says. It has to do with socioeconomic circumstances. “It’s just a reflection of this environment.”
The presenters at the Hispanic/LatinX town hall said that these communities face similar problems. In her presentation, Dr. Flores cited four main reasons why these Hispanic and LatinX communities are disproportionately impacted by COVID-19: employment, socioeconomic inequalities, health vulnerabilities, and immigration status.
“We are mostly essential workers. We have high risk of exposure,” said Dr. Flores. “I have seen multiple home health aides, all of which were Hispanic, who contracted the disease and some of whom brought it home, had other people be infected, and also had some deaths in the family.” This is just one example.
“We have so many vulnerabilities and all of these things showed up with this pandemic,” said Dr. Flores. “We’re going to be dealing with the consequences and the approach to the situation for years to come.”
“COVID has unveiled the effects of systemic policies and conditions that have existed for decades,” writes Dr. Doubeni. “If nothing is done, the massive social, economic and health fallout from COVID-19 will worsen social inequalities.”
At the African American town hall, he posed an important question: “Can this crisis serve as a turning point for effective policies and actions to improve the health of minority communities?”
The answer is yes. And there is important work to be done on every level: for individuals and communities, and for society and government.
“Despite centuries of adversity, communities of color have demonstrated resilience,” says Dr. Doubeni. “The current experiences call for the communities to unite, create greater awareness of disparities within our communities, and organize to drive the changes needs to achieve equity in physical, social and mental health.”
In partnership with institutions like Mayo Clinic, he said, minority communities should “use our knowledge of prior injustices with research to become drivers of the types of studies needed to improve health and promote wellbeing in the community. This will ensure that we are prepared when the next 'COVID' arrives and can write a better narrative than the current one.”