Making a Difference Every Day
In the past year, the subject of systemic racism has been addressed and explored widely. For instance, AMDA – The Society for Post-Acute and Long-Term Care Medicine issued a Statement on Racial Inequalities in June. It referenced the murders of George Floyd, Ahmaud Arbery, Breanna Taylor, and Rayshard Brooks, and pointed to evidence that nursing homes with a high percentage of residents of color are twice as likely to have COVID-19 cases and deaths. The document states, “We can and must do better as a nation, not only to heal systemic racism in the U.S., but also to honor our residents of color, and to support those who care for them.”
Black History Month is celebrated every February and is intended to honor the contributions African Americans have made – and are making – to US history every day. At Patient Pattern, we believe we must acknowledge and applaud the many African Americans frontline workers in healthcare who are caring for our most vulnerable and doing so at increased personal risk of COVID-19.
We also need to focus on COVID-19 and its devastating impact on the African American population along with other people of color. Research is providing us with some important guidance.
“Laundry is the only thing that should be separated by color” (Author Unknown).
In our quest to understand the difference in risk and clinical outcomes for minorities, we must make sure that the worse outcomes in people of color are not attributed to genetics alone. In the US the pandemic has become a syndemic. This describes how COVID-19 interacts with pre-existing conditions and is driven by larger political, economic, and social factors.
Statistics to Note
One study, with data up to August 2020, aimed to understand the relationship between ethnicity and COVID-19 and subsequently completed a systematic review and meta-analysis looking at the findings of 50 studies and 18,728,893 patients. Their findings: The pooled relative risk of SARS-CoV-2 infection by ethnic group was: 1.50 for Whites, 2.02 for Asians, 1.77 for Blacks, 0.64 for Native Americans.
Elsewhere, this week alone, the Centers for Disease Control and Prevention , reporting on disparities in health equity, documented differences in populations testing positive for the virus as follows: Whites 7%, Asians 7.2%, Hispanic or Latino 11.9%, Blacks 13.8%. The risk for minorities continues and will until do so until inequities in the social determinants of health that affect risk for exposure to COVID-19 for racial and ethnic minority groups are addressed.
What Does This Mean?
The risk exists and is not the result of ethnicity alone. The Social Determinants of Health are at play here, and we need to recognize all the factors increasing the risk for our minority healthcare co-workers. For CNAs and other frontline workers, for instance, this includes lack of access to transportation or childcare. The also may have food insecurity and lack the financial ability to take time off when they are stressed or burned out.
We also need to consider racial inequalities and social determinants of health as they relate to our residents, many of whom are people of color and at greater risk for poor outcomes for various reasons.
Speaking at AMDA’s Leadership, Ethics, & PALTC Virtual Symposium last year, Diane Sanders-Cepeda, MD, CMD, said that nursing homes are “wonderful places, but one challenge we need to address is how systemic racism impact this space.” She suggested, “This starts by having an honest conversation with leadership….There has to be a commitment on every level. It can’t just be the medical director, DON, or other team leader alone.”
The healthcare of older adults, frail individuals, and senior housing venues are all coming under the scrutiny of politicians, media, citizens, healthcare providers, and researchers. Change will happen as healthcare inequities are addressed. As clinicians in these settings, we must be part of this change.
To start planning for change in your setting, please contact us for a demonstration of our products for measuring frailty and the clinical decision support at patientpattern.com/contact