As of early October, over 700,000 Americans have died as a result of the coronavirus. While the average number of COVID-19 related deaths in the state has decreased since the introduction of vaccines, Georgia was home to five out of ten counties in the nation with the highest numbers of COVID-19 related mortalities just last year. Further, among these counties, over half were labeled as ‘majority-minority’, or counties where the majority of residents identified as racial or ethnic minorities.
The trends observed in these counties serve as a poignant example of a pattern common throughout the entire nation, in which a disproportionate number of people who have died from the coronavirus have been members of the Black, Latinx or Native American communities. Nationwide, Black people have died at a rate two times higher than that observed among White people, while Latinx individuals have rates 2.3 times higher and Native Americans have rates 2.4 times higher. Further, COVID-19 related hospitalizations are 3.5 times higher among Native American populations and 2.8 times higher among Balck and Latino populations compared to White populations.4
Multiple studies have attempted to dissect the factors underlying this tragic pattern and have a wide variety of causes, notably discriminatory housing practices and environmental policies, economic and educational inequality and inequitable access to healthcare services. Nevertheless, all of the underlying bases for these discrepancies share a common source: systemic inequalities which are perpetuated by public policy.
Given that this issue is so multi-faceted, multiple approaches will be required to remedy it, and they will vary in the amount of time it takes for their impact to be felt; there is no “one quick fix” to prevent these fatal inequities. Still, to prevent a vicious cycle from continuing, it is important that we act now to mitigate the disproportionate impact of the COVID-19 pandemic on marginalized communities and to prevent similar trends in the future, if not simply to right an existing wrong. Two potential policy-based solutions to this crisis include recognizing and addressing the significant barriers to COVID-19 related resources that marginalized communities face and increasing funding for public health.
The first of these policy options — recognizing and addressing barriers to COVID-19 related resources — could have a significant and immediate impact in confronting the inequities which the pandemic has exacerbated. Ensuring that testing sites and vaccine clinics are both available and accessible to communities of color is a remedy that has been identified by multiple sources., This can be done by placing these resources near locations frequented by these communities, such as locally-owned businesses, places of worship or community centers, as well as by reducing or eliminating costs associated with being tested and investing in culturally-sensitive health education campaigns which ensure that people know they do not need insurance to receive vaccines.
One such policy which has been implemented in both New Jersey and Los Angeles County is the implementation of walk-up clinics in communities of color that are known to have low access to healthcare services.7 Another potential policy solution implemented in Wisconsin is the creation of community testing events in areas with high COVID-19 rates or known lack of access to testing or vaccines through partnerships with local health departments.7
There are a variety of long-term policy approaches which can and must be enacted to address the systemic inequities in public institutions from housing to education to the economy to comprehensively prevent similarly inordinate trends from plaguing American communities in the future. One such approach involves investing more in public health.6 Thousands of primary care and community-based health clinics have taken serious hits since the advent of the pandemic, and many have closed. These local safety-net clinics are often either a primary source of available and accessible healthcare for marginalized communities or the only one available due to a lack of insurance, financial or language barriers or geographic isolation.8
This is the case in many rural Georgia communities, which have been particularly slammed by the COVID-19 pandemic and where many primary sources of medical care have closed. While providing funding to local safety net clinics is particularly important in times of crisis, it is a critical policy avenue to explore for mitigating existing healthcare disparities. These disparities are created by a variety of social factors but are exacerbated by limited access to medical care, which means that many chronic conditions which can be treated or prevented go undiagnosed and unaddressed for far too long. Such underlying health conditions can place people at higher risk for more acute healthcare conditions like the coronavirus or for previously more common illnesses like pneumonia.
While the COVID-19 pandemic has had unequal impacts on various racial and ethnic communities across the state and the nation, it has only highlighted pre-existing patterns of injustice. Exploring policy-based solutions to systemic inequalities will go a long way not only in mitigating the disparate impacts of this crisis, but in addressing crises of inequity that have been impacting marginalized communities across Georgia and the U.S. at-large for decades.