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Coronavirus Q&A: Dr. Joseph West Discusses Health Care Inequities Along Racial Lines

MIAMI (CBSMiami) – The outbreak of coronavirus in the United States has laid bare socioeconomic and health care inequities that exist along racial lines.

A recent CDC snapshot showed black people, who make up 13% of the U.S. population, accounted for about 34% of confirmed cases.

For a better understanding on these statistics, we spoke with Dr. Joseph West, who teaches at the University of Miami Miller School of Medicine and is a public health sciences and senior researcher at the Florida Institute for Health Innovation.

Q: Doctor, only a handful of states are reporting racial and ethnic data related to COVID-19, and the CDC only started reporting confirmed cases by race and ethnicity a few weeks ago. So is it possible that the disparity is actually greater?

A: It is quite possible. A number of us epidemiologists and scientists alike have been requesting health disparities data and data along demographic lines for quite some time. And so what we know is that persons who have preexisting chronic medical conditions such as diabetes, high blood pressure, heart disease, poor respiratory function are at the greatest risk of poor health outcomes. Well, the African American community has the highest prevalence for any one of these chronic conditions that are just named.

Q: As an expert in population health and health disparities, what do you believe is at the root of the differences in the infection rates? And that's and is there also a testing disparity?

A: Yes, I mean, so the issues that we're seeing are long standing public health gaps in community health and health resources and how we reach people, the ways in which we message really critical public health information to communities. We must also be mindful of the added strain that the current situation has placed on a number of families that may have experienced, you know, may have lived with a limited resources prior to the stay at home orders. Therefore their struggles may be increased and that can lead to poor health also.

Q: There have been so many heartbreaking stories we've all heard about people who were severely ill who believe they were infected with COVID-19, but then were turned away when they tried to get medical help or they couldn't get tested. How much do these stories represent what happens in our healthcare system outside of this pandemic as a whole?

A: They're long standing. I mean, we're now starting to see a lot of data where there are a number of excessive deaths for non-COVID related health conditions because, you know, we can't forget that even though we are dealing with and fighting a very strong pandemic, that people continue to get ill and people continue to get sick. And also we are dealing with real fears of being, you know, concerned of going into the emergency room or going to the hospital, so people are deciding to stay at home and suffer at home. And when those persons show up, generally, they are either, you know, misdiagnosed or their conditions are so far gone or so far bad that they're, you know, really facing dire outcomes.

Q: Well, as we're saying these three openings rolling out now how should people especially those with big families and multi-generations living in a household, how should they continue to approach protections from this virus?

A: Well, individuals in their 20s, 30s and 40s will generally do well, right. But for those, that does not exclude them from any risk, right. There have been cases where healthy persons in their 20s, 30s and 40s have been admitted into the ICU and ED and placed on ventilators, although rare. So we must be mindful of family dynamics, intergenerational care, large families, being empathetic to the difficulties that many families face and adjusting to social distancing and learning routine health habits that are protective, such as frequently washing your hands, cleaning surfaces and learning to communicate with one another in supporting. Especially seniors in our more vulnerable populations with, you know, new ways of helping them with meeting their day to day living needs.

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