Through the lens of COVID-19: Researchers offer a holistic look at health as the collateral damage of social inequality

A professor and a doctoral student in the Robert Stempel College of Public Health & Social Work have pulled together statistics that lay bare the devastation of COVID-19 on the United States’ most economically vulnerable populations.

In a paper recently published in the Journal of the National Medical Association, Nasar U. Ahmed and Ian J. Lee present numbers that underscore the disproportionate rates of illness and death among minorities and the poor.

Among factors contributing to the harsh reality, the authors cite the wealth gap, lack of access to health care, poor community and living environments as well as racial and ethnic discrimination. They also draw attention to the disproportionate number of minorities who work in so-called essential jobs—such as service and transit workers as well as caregivers and nurses—that put them squarely in the line of fire.

The work highlights the convergence of long-existing societal disparities with an unprecedented public-health crisis.

“All of these things,” says coauthor and Ph.D. candidate Lee of social determinants that drive unequal health outcomes, “they’ve been here, but the pandemic really focused everything in, basically just exposed all of it all at the same time. It made it so much more clear and easy for people to see.”

Lee is speaking in particular of longstanding inequities that have a continuing impact on the Black population, among them higher incarceration rates and worse medical treatment than whites, both of which are referenced in the paper.

“What’s most surprising,” Lee says, “is how far back in history these issues stem from. We’re not talking about 10, 15 years ago. We’re literally talking about 75 years ago, you know, redlining mortgages in Georgia [a reference to discriminatory housing practices] and really even how populations congregated together after the end of slavery.”

Lee added that discussing why the pandemic has so overwhelmingly impacted the Black community can itself present a minefield.

“Not a lot of people like the term ‘systemic racism,’ but the data are all there and really about that disadvantage that goes back hundreds of years,” he says. “That kind of clicks in your mind when you’re studying these things. This isn’t something that we can just fix in a couple years. It’s really been building for many, many decades.”

Says coauthor Ahmed of the inherent value in highlighting and dissecting systemic problems as a means to improving conditions for those of lower economic status, “The pandemic is awakening us to rethink our societal structures. Whoever is down, whoever is up, it doesn’t matter. If the ship goes down, everybody goes down.”