Updated on: September 30, 2020

Health Disparities: COVID and SDoH

Original story posted on: September 29, 2020

New studies address health disparities and severity of COVID.

Several major studies continue to advance the impact of health disparities and challenge the industry in how best to mitigate the ever-growing chasm. Research from Epic Health Research Network and the Kaiser Family Foundation validate that patients of color experience COVID-19 at concerningly higher rates, and in more severe forms, than their white counterparts.

Research looked at over 50 million patients within the Epic electronic health record (EHR) network who interacted with a health system and entered race and demographic data in their record. The findings included:

  • Hispanic, Black, and Asian patients comprised the majority of positive COVID-19 test results. Furthermore:
    • Hispanic patients were over twice as likely to test positively for the virus than their white peers.
    • Black and Asian patients were also twice as likely to do so.
    • American Indian/Alaska Native (AI/AN) populations were not included in the study results, although separate data indicated that these communities experience profound racial health disparities.
  • Hispanic, Black, and Asian patients were more likely to receive a COVID-19 test in inpatient settings, usually after presenting to hospitals with symptoms.
    • These populations were also more likely to need oxygen at the time of diagnosis, often along with other respiratory treatments (e.g., nebulizers).

Limited patient access to COVID-19 testing in populations of color was also identified:

  • Hispanic patients were three times more likely than white populations to be COVID-positive: there were approximately 143 positive cases per 10,000 for Hispanic patients and 46 positive cases per 10,000 for white patients.
  • The COVID positivity rate of Black patients were roughly double the rate of white patients — 107 positive cases per 10,000.
  • Black and Hispanic patients had a disproportionate share of COVID-19 hospitalizations and deaths; there were well over 30 Hispanic patients and 27 Black patients per every 10,000 persons hospitalized.
    • For white patients, the share was far less, at seven hospitalizations per 10,000.
  • Finally, Black and Hispanic patients experienced a death rate of 5.6 deaths per 10,000 cases, versus 2.3 per 10,000 for white patients.

The higher infection rate among people of color has been attributed to their increased risk of exposure to coronavirus due to their work, living, and transportation situations. This continues to affirm how one’s residential ZIP code can influence morbidity and mortality.

Programming Note: Ellen Fink-Samnick, a member of the RACmonitor editorial board, is a permanent panelist on Monitor Mondays. Listen to her live reporting on SDoH every Monday at 10 a.m. EST.

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management,  Social Determinants of Health: Case Management’s Next Frontier (with Foreword by Dr. Ronald Hirsch), and End of Life Care for Case Management are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk-Ten-Tuesdays, and member of the Editorial Advisory Boards of Professional Case Management, Case Management Monthly, and RAC Monitor. Ellen also serves as the Lead for Rise Association’s Social Determinants of Health Community.

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