In a forum hosted by the University of Kentucky Tuesday, experts discussed the disturbing reality that African Americans are disproportionately affected by the coronavirus.
According to Gov. Andy Beshear, nearly 14% of known cases are black and 18% of deaths are black, even though African Americans make up around 8% of the population.
"It makes me very sad that you have a patient population that's truly at a disadvantage just because of your race," panelist and UK College of Pharmacy Assistant Professor Dr. Trenika Mitchell said.
Mitchell, along with other panelists, acknowledged that countrywide health inequity for the African American population began long before the pandemic began.
"Really since the inception of this country, the health status of African Americans has been disparate," panelist and UK College of Medicine Associate Professor Dr. Anita Fernander said. "The COVID-19 pandemic has only shown a brighter light on disparities."
In an interview before the forum, Mitchell said there are numerous reasons why the disparities exist.
"People unfortunately believe that the disparities either don't exist or that the disparities are because the black community doesn't care or that the black community is lazy," Mitchell said. "People have some really bad misconceptions about why these disparities exist. Really, when you think about COVID-19, the high mortality rate is because there are more of us in the vulnerable patient population."
She, and other panelists explained, at length, the multitude of reasons why the black community is considered a vulnerable patient population.
"There are issues related to accessing care and being able to have health care coverage, adequate health care coverage, insurance coverage," Fernander said. "These are all policy issues that need to be addressed."
They also discussed how the black community generally has distrust for the healthcare system, a reality that can be traced back centuries.
"You can go back to slavery times and how medical care was provided or withheld on plantations," Fernander said.
She said health care systems must keep that historical context, including many other examples since, including the Tuskeegee study, in mind when treating patients.
"There's a long history that has contributed to the levels of distrust in the health care system, and health care providers need to understand that so they can then interact with minority or African American patients with that in mind, and engage with them appropriately and provide appropriate treatment recommendations," Fernander said.
They also discussed issues regarding access to care. For example, some may not be able to get transportation to a doctor. An increased demand for telehealth during COVID-19 has also posed issues.
"We need to be aware that there is a disparity in the amount of technology or computer access that many racial ethnic minority populations experience, so utilizing that may or may not be either possible or something that they have enough familiarity with in order to use it appropriately," University of Louisville College of Nursing Professor Dr. Vicki Hines-Martin said. "We are increasingly trying to improve the access for the West Louisville community so that we can do telehealth, but the people that are at highest risks are older adults who are not technologically savvy, do not have access in their homes. They're finding that increasing numbers of those individuals are not keeping telehealth appointments because they don't know how to do that or they don't have access to do that."
The same could be said for those who do not have access to a car, as drive-thru COVID-19 testing becomes more available. Even for those who have access to care, Fernander said some health care providers have a history of not taking symptoms of minority populations as seriously.
"We need to make sure that on both sides, on the patient side as well as on the provider side, there is education and knowledge so that they can engage and interact with one another in a culturally appropriate manner so that their symptoms and illnesses and risks for morbidity and mortality can be addressed appropriately," Fernander said.
In order to start addressing these challenges, panelists suggested different sectors and organizations collaborate with each other on solutions.
"Let's pool our organizations together," Fernander said. "Banks can partner with health care institutions. Community organizations can partner with educational institutions to coalesce in specific goals."
In the meantime, Fernander suggested a simple way to increase access to care by using UK's mobile van to go into neighborhoods to provide testing and information and to follow up with those who have chronic conditions and need care.
"I would just challenge those health professionals and those who are in charge of making some of these more policy level decisions to really consider and think out of the box and creatively about how to reach some of the under served communities that are really experiencing these disproportionate rates of COVID-19," Fernander said.
"This is an opportunity for us to do things differently," Hines-Martin said. "I hope we choose to do it."
You can watch the full panel discussion here.
