Why Do Communities of Color Still Face Health Inequities?

John Whyte, MD; Karyne Jones

Disclosures

June 18, 2021

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JOHN WHYTE: Welcome, everyone. You're watching "Coronavirus in Context." I'm Dr. John Whyte, the Chief Medical Officer at WebMD.

COVID has impacted so many aspects of our lives. But today, I want to spend some time talking about how it's impacted communities of color. So to provide some insight, I've asked my friend Karyne Jones. She's the president and CEO of the National Caucus and Center on Black Aging. Karyne, welcome back.

KARYNE JONES: Thank you so much. It's always a pleasure to be with you.

JOHN WHYTE: Karyne, I want to start off with throwing some statistics at you. Blacks are three times more likely to get COVID than whites. Breaking it down, it's 62 per 10,000. For whites, it's 23 per 10,000. For Latinos, 73 per 10,000.

And Blacks are twice as likely to die from COVID than whites. You talk about health equity. Where's the equity in that?

KARYNE JONES: There is none. And my organization, along with many others, we weren't surprised when we finally got the data, but because we've been working on health disparities for many, many years. But we were obviously outraged in that we hope to -- that we'd seen some improvement in terms of longevity of life and people having access more to some health care. But as you can see, health inequities are still a major issue within communities of color. And COVID just really put a spotlight on that.

JOHN WHYTE: Karyne, we're seeing that with vaccinations right now. People worked hard to enroll people of color in the trials for vaccines. But now, when it comes time to getting people vaccinated, Blacks and Hispanics are lagging behind whites. How do we fix this?

KARYNE JONES: Well, we'd have to go back 400 years in order to fix a lot of this, because a lot of it still is rooted in discrimination and racism. We still have, unfortunately, communities that don't have access to quality health care. We're not talking about having access to a clinic or whatever, but actual access to quality health care.

We have food deserts. We have environmental issues that contribute to our health. We're creating asthma and other respiratory problems, which is one of the reasons COVID was so devastating to our communities.

And so there's so many social determinants that affect our health because in the locations where people live, the environment itself is bad. We live near the plants. We live near the air pollution. We live near all of those things. And as a result of that discrimination and not caring about every human being and valuing them, this is what happens when a pandemic comes along, a major virus, a contagious virus. It spreads like fire in a community that's not healthy.

JOHN WHYTE: And you pointed out it really has shed light on the disparities that have persisted for quite some time. But how do we move forward? What do we have to be doing to eliminate disparities?

KARYNE JONES: Well, we can only hope that the cost of what it has cost this country in terms of the economy and in terms of loss of life --

JOHN WHYTE: 600,000.

KARYNE JONES: 600,000 Americans, Americans. We hear about these things happening in other countries. But now this is in America. We lose 600,000 lives as a result of a virus, something that you never prepare for, but you certainly know that maybe things could have been different for so many people, so many families. A lost life is just not 600,000. We're talking about millions of people who've been affected by not having the kind of quality health that could sustain a virus of this type. So --

JOHN WHYTE: But Karyne, to be fair, Karyne, we see this in cancer in terms of getting diagnosed later with more advanced. We see it in heart disease, not getting the right care in the emergency room. We see it in diabetes care, the list can go on and on and on.

KARYNE JONES: And as I've said to you before, we already knew that when America catches a cold, communities of color get pneumonia. And that is as a result of us not valuing every human life. And so we've got to -- hopefully we've seen what something like COVID has done to these communities. And we'll begin to maybe change the policies and the legislations and the appropriations that go along to improving the quality of life for people.

JOHN WHYTE: Let's talk about how we do that. What could be some low-hanging fruit that could be done, say, in the short term? Obviously this requires many years of interventions. But are there some things that we can start thinking about right now that is going to help create health care that's more equitable, more just?

KARYNE JONES: Well, we've got to stop placing a value on how much money you can -- health you can afford. And so we certainly need to start by making sure that health care is -- looking at health care more as a right than as a privilege. The other thing that we do, can do is to really look at those social determinants that really impact and make a difference on the health of people. When you have a healthy society, you have a productive society. And if you are worried about the bottom line, if you're a capitalist and you think that what's most important in terms of how much money you can make, think how much money you lose when you don't have employees who can work because they're sick or you lose people to early death or ailments or whatever, all kinds of illnesses because of their health.

So if we take a look at the fairness and, again, looking at human value -- and I know it's very hard to change people's hearts. We certainly should be able to change their minds in terms of investing and making sure that people, we put a value on their life in terms of not caring about whether they are insured, uninsured, but that they have access to the quality health care that make them productive. And if we have a productive society, we have a society that thrives.

JOHN WHYTE: Much of this is about advocacy. You spent much of your professional career in this space. What advice do you have for listeners in how we advocate first for change for the system, but even for those who think they may not be receiving the best care, how do they advocate for their own care or the care of a loved one?

KARYNE JONES: Absolutely, because the people who are healthy, they have insurance, they're healthy, they can go to a doctor whenever they want to, they don't have those concerns, you're still paying for it with your insurance rates, because ultimately you're going to pay for it. So it would seem to me that everybody who does have insurance ought to be really working to make sure that everybody else who doesn't have it or they're underinsured that you want to make sure they have insurance so your rates won't go up and you won't have to pay so much for medical costs. It's a very simple formula if you look at it.

But until we -- not only in this country, but until we value every life, until we look at our own humanity, until we get rid of our implicit, our explicit bias, that we look at every person as another human being, we won't change this. And so hopefully we can move towards that. And maybe COVID has opened the eyes of more people.

JOHN WHYTE: We're celebrating Juneteenth, freedom from slavery, Emancipation Proclamation. When are we going to be free from disparities, Karyne?

KARYNE JONES: I don't know. I'm a native Texan. So Juneteenth is nothing new to me. We've celebrated it all my life. It's new to everybody else.

But it is important to recognize it because it's a time when Americans who have contributed greatly to the development and the economy of this country finally had their freedom. Though they weren't that free, because actually, they had nowhere to go because they had no money. They had no land. They had no animals. So most of them stayed on plantations. But that's a whole nother discussion for us.

But I'm hoping, I'm hoping that as we mature after all the hundreds of years that we've been in existence as a country that we really will live up to our creed that all men are created equal. If we treat every man as equal, we shouldn't fear the term "every man being equal." Equal doesn't mean somebody has more than you. Equal is just that, equal treatment. And that should not threaten any American.

And so hopefully we can move past that. And again, I can't stress valuing every human being's life. I think we can move forward.

JOHN WHYTE: Karyne, I want to thank you for taking the time today, for all your advocacy in terms of creating an equitable and just health care system.

KARYNE JONES: And thank you so much for all you do. You help us all in this effort.

This interview originally appeared on WebMD on June 18, 2021

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