Dr. Jeff Hutchinson works as an adolescent medicine physician, and while he’s not directly working with Covid-19 patients, the virus has crept into his practice.
“Lately, we're talking about the new ways it's presenting with children and the thing called corona toe,” Dr. Hutchinson said. “So skin color makes a difference if you're looking for redness or a color change, and if you're not used to seeing people of color you may miss it. You may overlook it.”
Not getting properly diagnosed is just one symptom of a larger issue—early numbers from the Centers for Disease Control show that minorities are being impacted by Covid-19 at a disproportionately high rate. Estimates published in April show that 30 percent of Covid-19 patients nationwide are African-American, but only 13 percent of the U.S. population is African-American. That gap isn’t quite as wide in Travis county, but it’s still out of line with local demographics. 12 percent of hospitalized Covid-19 patients are black, but they make up roughly 8 percent of the Travis County population.
Jaeson Fournier, president and CEO of CommUnity Care Health Centers, said their testing results so far show a different community being heavily impacted.
“One of the things that we're noting is the positivity rate is the highest within our Latino population,” Fournier said.
In Travis County, Latinos make up 51 percent of Covid-19 hospitalizations. The early numbers did not surprise experts like Dr. Jewel Mullin, associate dean for health equity at The University of Texas at Austin’s Dell Medical School.
“The people who live most vulnerable every day are going to be sometimes the hardest if not the first hit by it, Dr. Mullen said.“We're seeing that now with Covid and the way that we've seen it in the past during hurricanes and other crises as well.”
Living in a vulnerable situation often extends to employment as well, according to Dr. Mullen. “ We talk about social distancing,” Dr. Mullen said. “ Many people who are considered essential workers can't do that.”
A recent analysis of U.S. Census bureau data underscores this issue.In Texas, frontline workers in the pandemic are most likely to be women of color. And it’s not just those frontline workers who are impacted,it’s their families as well.
“I had one patient in particular whose mother tested positive,” Dr. Hutchinson said. “If you have the ability you would quarantine themselves, but without any other income coming to the house, [he] was really forced to go back to a fast food job and now other people are exposed to that potential contagious patient.”
High-risk jobs become even more dangerous when combined with healthcare issues--communities of color have higher rates of preexisting conditions like heart disease or diabetes. Combine that with a lack of healthcare access and the odds for mortality rates become much higher.
Even if income and access to healthcare aren’t issues, bias and cultural competence may be. Recent studies have documented that assumptions about people of color have led to disparate health outcomes, like the high maternal mortality rate in Texas for black mothers.
“We know that there are populations who are treated differently by healthcare professionals. It is part of the bias that we all maintain,” Dr. Hutchinson said. “So who gets chosen to be tested has been a disparity too, and likely a big source of why populations of color have had higher numbers and worse outcomes than populations that have resources.”
Experts say the inequities apparent in Covid-19 hospitalizations and mortality rates did not come on suddenly. They’re the result of a host of other issues building up over time. Still,they’re holding out hope that Covid-19 will motivate people to address these issues head-on.
“We have to have those conversations continue and realize that they're not specific conversations just about housing or education or about policing,” Dr. Mullen said. “It's not about the virus. It’s about how people live.”
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