I can’t unsee what I saw on the front lines and I can’t unsee the politics of it.

People call us healthcare heroes. We were just doing our job. I am not saying this out of humility but because I feel like we have to do more. Those of us who bore witness to the front lines of the COVID-19 pandemic must use our position to enact change.

We witnessed loss of lives and destruction of communities firsthand.  During my month as a front line worker in the COVID-19 units, of the patients I helped care for, a small fraction were white.  My experience is unlikely to be unique, since multiple reports demonstrate that COVID-19 has disproportionately impacted black communities, resulting in more cases, hospitalizations and deaths.  In New York City, black individuals account for 37.5% of deaths due to COVID-19 but only 24.3% of the population, according to the NYC Department of Health and census reports.  Across the country, statistics are even more pronounced.  

There are innumerable health conditions that disproportionately affect minority communities, many of which are risk factors for severe COVID-19 infection.  Diabetes affects 11.7% of non-Hispanic black people versus only 7.5% of non-Hispanic white people, according to the American Diabetes Association.  Hypertension affects 41.2% of non-Hispanic black people versus only 28.0% of non-Hispanic white people, per Centers for Disease Control and Prevention (CDC) reports.   Mapping Police Violence, a research collaborative that collects comprehensive data on police killings nationwide, reports that black individuals are three times more likely to be killed by police than white individuals, which I believe to be a public health crisis, not a political issue. 

How can we truly be heroes?  The answer depends on what we, as healthcare professionals, decide to do next.  

Is your patient unable to complete a telehealth visit due to lack of reliable internet?  Consider asking local schools to open their doors, as Elizabeth Ellis, DNP did when her rural health clinic in Bedias, Texas lacked high speed internet to serve her patients during the pandemic.  

Is there a medical issue that predominantly affects black individuals that you feel is not getting enough attention?  Write to your professional organization asking what they plan to do to address this discrepancy and to the NIH asking to pledge research dollars.  

Are your patients living in crowded conditions?  Do they not have paid sick leave or health insurance?  Vote for officials who pledge to address these issues and write to current leadership demanding a pledge to action.  

Most importantly, there is always more work to do, beginning with keeping our eyes and hearts open as we continue to witness injustices.  Our communities clapped for us every single day at 7 p.m.  Now let’s stand up for them.

Sources:

NYC Department of Health.  Age-adjusted rates of lab confirmed COVID-19 nonhospitalized cases, estimated non-fatal hospitalized cases, and patients known to have died 100,000 by race/ethnicity group as of April 16, 2020. Accessed June 6, 2020.  https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-deaths-race-ethnicity-04162020-1.pdf

NYC Census.  Updated July 1, 2019. Accessed June 6, 2020.  https://www.census.gov/quickfacts/newyorkcitynewyork

Statistics About Diabetes.  American Diabetes Association.  Updated March 22, 2018.  Accessed June 6, 2020.  https://www.diabetes.org/resources/statistics/statistics-about-diabetes#:~:text=The%20rates%20of%20diagnosed%20diabetes,12.5%25%20of%20Hispanics

Yoon SS, Carroll MD, Fryar CD. Hypertension Prevalence and Control Among Adults: United States, 2011-2014. NCHS Data Brief. 2015;(220):1-8. https://pubmed.ncbi.nlm.nih.gov/26633197/

Mapping Police Violence.  Updated May 29, 2020.  Accessed June 6, 2020.  https://mappingpoliceviolence.org/

COVID-19 in Racial and Ethnic Minority Groups.  Center for Disease Control.  June 4, 2020.  Accessed June 6, 2020.  https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html#10


COVID-19 Pandemic 8: Rural Health Disparities & COVID-19 panel.  Rural Health Disparities Podcast.  May 29, 2020.  https://podcasts.apple.com/us/podcast/the-health-disparities-podcast/id1460206582?i=1000476165442