Pandemic Disparities in Obesity, Health, and Care

Living through this pandemic may leave us feeling isolated and separated. So maybe it’s ironic that it seems to bring a sharper focus onto disparities that have kept us apart for far too long. As we’ve noted, the coronavirus is an acute problem. But as it takes the lives of people we love, it is exploiting chronic disparities in obesity, health, and care that have been harming us across many lifetimes.

A Disparate Impact on People of Color

Research for many decades has shown that Black and Latino people receive inferior healthcare and enjoy less health because of it. The burden of chronic diseases is dramatically higher in these populations. Mortality due to heart disease and diabetes stands out among many conditions with a disparate impact. Obesity is an important part of this picture of disproportionate impact.

So it is no surprise that this new coronavirus is taking lives in communities of color at dramatically higher rates. As this fact becomes more painfully obvious, the explanations for it multiply.

They start with baseline health – more chronic health problems in these populations. The virus attacks more viciously in a person whose health is already compromised. But social and economic factors amplify this risk. People in these communities are more likely to find themselves in jobs that don’t give them the option for social isolation. They face more exposure to the virus in the first place. Then it takes a bigger toll.

In addition, we have the issue of access and quality of care. Kaiser Health News tells us that disparities in care are creeping into the patterns of care for COVID-19. It points to analyses that have shown that doctors may be less likely to refer African American patients for testing when they present with symptoms. Disparate resources are an issue. James Hildreth, an infectious disease specialist at Meharry Medical College, explains:

There’s no doubt that some institutions have the resources and clout to maybe get these materials faster and easier.

A Call to Action

Writing in the Journal of the National Medical Association, Kathi Earles, Jamy Ard, and Fatima Cody Stanford call for change. They call for a higher standard of care in the Black community:

No longer should we accept as adequate the idea of only treating the complications of obesity without addressing the root cause of those diseases, i.e., the obesity. It is therefore incumbent upon us who care for these patients that bear the greatest burden of obesity to begin the conversation. We must rise up, educate, and act in order to combat the disease that has affected so many persons of African descent.

The larger problem persists with our consent. It persists because we are all too happy to claim our own place at the front of the line and leave others behind. It will stop because we will ultimately realize that this virus will continue to spread through the population until it ravages us all. We cannot be safe and well while others are not.

Click here for the perspective from Earles, Ard, and Stanford. For more on the disparate impact of COVID-19, click here.

U Street Metro, photograph © Elvert Barnes / flickr

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May 12, 2020