When Obesity, COVID-19, and Health Disparities Collide

When Obesity, COVID-19, and Health Disparities Collide

Humans can rationalize anything. But that doesn’t make it rational. And sooner or later, reality intrudes to lay bare the irrationality of some systems that humans construct. What else should we call the deeply embedded racial and ethnic disparities in systems of healthcare around the world? They are simply irrational. By synergistically destroying the health of so many people of color, obesity and COVID-19 are making those disparities unmistakeable. But do we really understand them?

A new editorial in the International Journal of Obesity addresses this directly. Matt Townsend, Ted Kyle, and Fatima Cody Stanford make the case that we need to know more about how these factors interact with COVID-19. They sum it up:

A critical knowledge gap remains to understand the interaction between ethnicity, obesity, and class in COVID-19 outcomes.

Biological, Social, and Economic Factors

Townsend explores the diverse factors that contribute to racial and ethnic disparities in health outcomes from obesity and COVID-19. Biological mechanisms may play a role. Patterns of behavior and sociology may contribute. Public health strategies may simply fail for Black, Asian, and minority ethnic (BAME) populations because they are constructed to serve dominant racial and ethnic groups. All of this operates in a context where obesity prevalence is higher and the impact of obesity is greater for BAME populations in multiple countries.

So many factors are working in concert to yield poor outcomes for these groups that focusing on a single one yields a terribly incomplete picture.

Incomplete Science Yields False Explanations

Responding to a paper on African American phenotypes that contribute to obesity, Max Jordan Nguemeni Tiako joins with Dr. Stanford to explain the problems of an incomplete narrative about race and health. To begin with, the definition of race is very loose. Sometimes it’s self-reported. Sometimes it’s a guess by a healthcare provider. But the fact is that racial identity does not have a specific biological or genetic basis. Migration patterns, epigenetics, and socioeconomic conditions come into play. These factors all have powerful effects on health.

But incomplete science has been a supporting rationale for abhorrent agendas of white supremacy and eugenics. The residue of those agendas continues to cause great harm. Likewise, such incomplete explanations lead to poor care, as Tiako and Stanford explain:

Incomplete scientific evidence presented to medical trainees contributes to wrongly held beliefs about African Americans’ supposed difference, and materializes itself in worse care.

One Pandemic Exposes the Harm of Another

In Lancet Diabetes and Endocrinology, yet another commentary completes the picture. Crystal Johnson-Mann, Monique Hassan, and Shaneeta Johnson explain the overlapping disparities in COVID-19 with obesity. They write:

One pandemic has unearthed a second; one of inequity in health care that continues to have a devastating impact on the Black community. With equitable access to health care and by adequately treating the disease of obesity, we can improve the health, and consequently reduce the severity of COVID-19, in these individuals. We are duly bound as a community to address these health disparities immediately, and to eliminate bias as a barrier to care.

People are dying because of their racial and ethnic identities. How much longer can we rationalize this?

Click here for the Townsend editorial, here for the Tiako letter, and here for the Johnson-Mann publication. For more on racism in health and obesity care, click here and here.

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July 11, 2020