A tremendous amount of research already tells us that not everyone has the same access to health services and high quality of care, or in other words, health equity. It’s well documented that black, Hispanic, and other minority residents often suffer worse health outcomes than their white counterparts.
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As the COVID-19 outbreak continues to spread in Connecticut, advocates and experts warn that a lack of accurate data on how this pandemic is affecting already marginalized groups of people could have serious short-term consequences and far-reaching outcomes.
“Without these data, we have no way to design the systems to respond, or to gauge how COVID-19 is affecting those who are most medically vulnerable, particularly people of color, and consequently no way to track progress,” said Wizdom Powell, director of the Health Disparities Institute at UConn Health.
The state provides daily reports on the number of confirmed COVID-19 cases, which was up to 5,675 as of Sunday. It also tracks how many people are hospitalized and the number who have died. Cases had previously been broken down only by county, town, age group and gender.
On Friday, the state began to include preliminary racial breakdowns for laboratory-confirmed cases of COVID-19. However, race and ethnicity are still missing from more than 2,500 cases.
Tekisha Dwan Everette, executive director of Health Equity Solutions, said the state has done a lot in its pandemic response, but this is an area where it can improve.
“[What] it has highlighted for us is that our emergency response systems are not set up to be equitable,” she said, “and are not set up to think about equity, particularly racial equity, in response to the needs of the people in a state.”
“Collect the data and then use that data to make sure we are course-correcting where tests are not being given, where people are not being given the tests because of our implicit or unconscious [racial] biases related to it, that we don’t have a gap in who’s dying and who is not.”
One agency that is collecting some of this data is the state Office of the Chief Medical Examiner, which records the race and ethnicity of those who have died. Sunday’s state report noted that 189 people have died from COVID-19 -- the race and ethnicity for about 25 deaths have not yet been identified.
The most recent report shows that the majority of deaths -- about 62% -- have been white residents, followed by black residents at 16%, Hispanic residents at 7% and Asian residents at less than 1%.
But when mortality rate was calculated using the racial breakdown of Connecticut’s total population, it showed that black residents have died at a higher rate.
“People of color in Connecticut are more likely than their white counterparts to live in densely populated neighborhoods, to work wage-based jobs and to suffer from the kinds of health conditions like asthma, for example, that one might expect could exacerbate some of the outcomes that we’re seeing now related to COVID-19,” Powell said.
Health disparities, including differences in mortality rates, have been linked to structural inequality and systematic racism in housing, education, economic and social opportunities -- all of which are being affected by the pandemic.
“We’re definitely concerned that some individuals and some communities are not going be able to rebound from this in a quick and fast way,” Everette said.
Powell said a lack of response to minority populations during the pandemic could later exacerbate existing levels of mistrust in health care systems among people of color, particularly black Americans. She said it could damage the progress that’s been made to bridge that gap.
“Folks are going to more reluctant to show up [to health offices],” she said. “And so, when we build it, they won’t come, and that is tremendously detrimental to our overall fight in the nation to advance health equity.”
Public health officials predict that hospitals and health care systems may see a surge of COVID-19 patients in the coming weeks. Powell said it’s not too late to start collecting accurate racial, ethnic and other data to inform emergency response going forward.
“We can get out ahead of this, especially if we measure adequately who is getting tested, who is getting treated, and who is not,” she said, “because if we don’t measure the inequities, we can’t address them.”