While it has long been apparent that communities of color experience higher rates of pre-existing heath disparities, the COVID-19 pandemic has further exposed the serious consequences of health inequity for these groups. People of color¹:

• Experience higher rates of pre-existing conditions like asthma, high blood pressure, diabetes, and obesity compared to Caucasians.
• Are more likely to lack health insurance and a medical home, which impacts their access to COVID-19 testing and the associated treatments.
• Are employed at higher rates than Caucasian people in front-line service positions, like restaurants, retail stores, and hospitality which have an increased risk of COVID-19 associated lay-offs.
• Are more likely to live in homes with multiple generations or in public housing, making it difficult to self-isolate or social distance.
• Are not able to telework due to the nature of their jobs and are more likely to use public transportation increasing their risk of COVID-19 exposure.

Due to these inequities²,

• Black Americans have a mortality rate more than twice that of White Americans (1 in 1,840 compared to 1 in 920 respectively).
• Latino Americans have a mortality rate 1.5 times the number of White Americans (1 in 1,360 compared to 1 in 920 respectively).

Although fixing the deep-rooted causes of health disparities will take time, there are a few actions hospitals can take now to ease the disproportional impact of COVID-19^{2, 3}:

• Emphasize quick communication of your facility’s new COVID-19 policies and procedures by ensuring that your operators, unit clerks, and schedulers know how to accurately answer patient and visitor questions before they arrive.
• Use your care-coordination and outreach teams to spread information to patients about how to monitor their health at home and when to call their provider.
• Ensure that informational materials are located around your facility in high-traffic areas and are presented in multiple languages to maximize understanding of new COVID-19 policies and procedures. The Centers for Disease Control and Prevention (CDC) regularly posts updates in multiple languages.
• Leverage your community partnerships to extend communication channels and strengthen prevention efforts. This could include having discussions with faith leaders about reiterating the importance of staying home and attending virtual congregations, partnering with local food pantries to disseminate critical prevention information, and ensuring that community health workers have necessary information to distribute educational materials while delivering medicine, food, and other essentials.
• Continue to collect as much Race, Ethnicity, and Language (REaL); Sexual Orientation and Gender Identity (SOGI); and Social Determinants of Health (SDOH) data as possible to ensure that diverse communities are not being undercounted regarding COVID-19 implications.

We are the Health Quality Innovation Network, and we are prepared to help you with COVID-19

One of our focus areas for quality improvement is responding to public health emergencies like the COVID-19 pandemic, so we are accountable for helping hospitals. Our organization has already been supporting nursing homes in outbreak areas by assisting them to assess their infection prevention and emergency response programs, identify root causes of virus spread and adopting best practices for prevention. This has prepared us to assist in the hospital setting.

Using proven program assessment tools like the Centers for Disease Control and Prevention (CDC) Comprehensive Hospital Preparedness Checklist for COVID-19, we are ready to help you in any area where you identify a need. Our individual technical assistance is available for many topics including adherence to hand hygiene, proper use of personal protective equipment (PPE), availability of PPE, patient flow, environmental cleaning, daily employee and patient screening for COVID-19 symptoms, employee testing and eventually, vaccine distribution. Let us be the extra set of hands your facility needs during these times.

Email us at hqic@hqin.org.

Sources:

1. Double Jeopardy: COVID-19 and Behavioral Health Disparities for Black and Latino Communities in the U.S. 2020, samhsa.gov/sites/default/files/covid19-behavioral-health-disparities-black-latino-communities.pdf.
2. “COVID-19 Deaths Analyzed by Race and Ethnicity.” APM Research Lab, apmresearchlab.org/covid/deaths-by-race.
3. 5 Actions to Promote Health Equity During the COVID-19 Pandemic. April 2020, aha.org/system/files/media/file/2020/04/5-actions-to-promote-health-equity-during-the-covid-19-pandemic.pdf.