Conversations about the social determinants of health (SDoH), along with health and mental health disparities, have escalated amid COVID and simultaneously occurring violence.

Elimination of institutional racism has become an ever-present theme across the healthcare industry. The concept has been longstanding through history, although now it is a high priority for every organization.

Conversations about the social determinants of health (SDoH), along with health and mental health disparities, have escalated amid COVID and simultaneously occurring violence. Last year’s reporting about racial bias in medical care decision-making algorithms has yielded major actions and initiatives by healthcare associations and organizations. The third wave of the coronavirus is further decimating disparate communities and their populations. The highest percentages of patients infected continue to be Black and Latinx populations, with the tally as high as 35-40 percent of some communities.

Recent reporting focused on the impact of COVID transmission within an ethnically and racially diverse healthcare workforce has indicated that:

  • COVID transmission rates across the workforce are three times higher for people of color. Reports cite that this fact is related to high percentages of essential workers being employed in areas with high exposure to COVID.
  • A study out of the University of Utah found that Black Americans disproportionately work in nine vital roles that increase their exposure to COVID, including:
    • Nursing assistants
    • Orderlies and transport personnel
    • Food preparation
    • Building and grounds maintenance
    • Security
    • Personal care
    • Office and administrative support
    • Production
    • Social work and community services
  • Lack of appropriate personal protective equipment (PPE) remains a challenge across the transitions of care, and especially for these valued personnel.
  • Underlying co-morbidities across racial and ethnic minorities increase morbidity and mortality rates for the population, with conditions of concern including hypertension, renal disease, asthma, diabetes, and other chronic conditions.

On this related note, the American Heart Association (AHA) issued a presidential advisory last week that appears on its website. The advisory cites institutional racism as a cause of premature death from cardiovascular disease. The statement was clear, noting that “the coronavirus disease 2019 pandemic and police killings of George Floyd, Breonna Taylor, and multiple others, have been reminders that structural racism persists and restricts the opportunities for long, healthy lives of Black Americans and other historically disenfranchised groups.”

The advisory reviews the historical context, current state, and potential solutions to address structural racism in the U.S, cites antiracist principles for review, and suggests strategic actions:

  • Broader research into health equity and structural racism;
  • Awareness, empowerment, and engagement in communities working to dismantle the effects of structural racism;
  • Health equity advocacy; and
  • Innovation in equity.

The actions taken by the AHA make it clear that strategic action needs to happen sooner rather than later; they benefit the healthcare workforce and populations to which that workforce renders care.

Concern about the occupational health and safety of essential workers remains a major theme. To that end, this week’s Monitor Mondays survey checked in with our listeners about the current availability of PPE at healthcare organizations around the country. The results may surprise you and appear here.

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