COVID-19 and Minorities

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As the COVID-19 pandemic continues, it’s becoming clear that minorities—specifically African-Americans, Hispanics, Native Americans and in some studies Asians—are affected more often than other ethnicities, and have a higher death rate. Experts are trying to figure out why, but even before they have definitive answers, there is some reassuring news. Anyone who is a member of a minority group can take extra steps to protect themselves, the experts say. 

What the Statistics Show

Data from the CDC and early records from hard-hit New York City reveal the patterns. For instance, New York City data found that Blacks and Hispanics were more likely to die of COVID-19 than were whites. The rates for every 100,000 in the population were 92 for Blacks, 74 for Latino/Hispanic, but 45 for whites and 34 for Asians.

A CDC report on 580 hospitalized patients found that Blacks are most likely to be hospitalized. Of those for whom data on race or ethnicity was available, 45% of hospitalized patients were white, compared with 59% in the community, 33% of hospitalized patients were Black, compared to just 18% in the community, and 8% were Hispanic, compared to 14% in the community.

The Navajo Nation in Arizona, Utah and New Mexico, with about 174,000 people, has also been hit hard. As of June 19, it has 6,894 positive cases or a rate of about 4%–much higher than some metro areas.  

Because COVID-19 is so new, experts cannot say for sure why minorities are often more hard-hit by the virus. Here are some possibilities.

Is It Underlying Conditions?

Some experts say having underlying medical conditions (which makes everyone more vulnerable to  serious illness if they get infected) could explain the higher number of cases in minorities.

“Race in and of itself does not make someone more prone to get infected or to have a bad outcome,” says Oliver Brooks, MD, chief medical officer of Watts Healthcare in Los Angeles and president of the National Medical Association (or NMA, link here), an organization of African-American physicians dedicated to eliminating disparities in health. 

Instead, he says of minority populations, ”we tend to have underlying conditions at a higher rate.” That includes diabetes, high blood pressure, chronic kidney disease, chronic obstructive lung disease (COPD),and obesity, he says. 

In addition, experts pointed out early in the pandemic that these underlying conditions don’t bode well for anyone who becomes infected, regardless of their ethnicity.

Do Other Factors Play a Role? 

Besides the underlying conditions, Brooks say, other factors may play in: living in crowded housing that makes social distancing impossible; taking public transportation; or working in jobs with constant exposure to the public.

Could it Be Biological Differences?

Gary Puckrein, PhD, is president and CEO of the National Minority Quality Forum (NMQF), a nonprofit devoted to eliminating health disparities in minorities. He doesn’t think the explanation of higher rates of COVID-19 illness in minorities is as simple as saying it’s due to the underlying illnesses. “We are trying to understand what explains the higher risk,” he says. His organization has begun researching this.

Researchers from Oxford University in the UK examined the medical records of more than 5,600 patients who died of COVID-19.  They concluded that Blacks and Asians were at higher risk of death than were whites, and that underlying conditions do not explain the differences fully. Their study is a preprint, not yet peer-reviewed. So more research is needed, they say, to figure out why minorities are more severely affected.

Meanwhile….How to Reduce Risk

Until researchers tease out differences that might be specific for minorities, the only action plan at the moment is to take care of your underlying conditions the best you can. Brooks offers this advice: “If you have an underlying condition, make sure it is under control.” That means getting blood pressure numbers to where they should be and taking this opportunity to try to lose weight if necessary. Pay extra attention to habits such as wearing a mask and washing your hands often, he says.

Puckrein also suggests adapting to the new reality, that COVID-19 is here to stay, at least for the foreseeable future. That may mean making health changes for some to improve their overall health status and their risk for other infections. “Maybe you skipped the flu shot [in previous years], or the pneumonia vaccine,” he warns, “now is the time to pay attention to those measures.”  

Be Part of the Research

Puckrein’s organization is partnering with Centene Corporation, an insurer, to launch a five-state study, aiming to follow 5,000 volunteers who are racial and ethnic minorities for five years to look at the impact of COVID-19 on them and their families. “We are tracking them even before they get infected,” Puckrein says. 

The project will test the general public for free; the first site is in Illinois with other states to be announced soon. For information on the study, go here. 

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