Dallas Morning News
How the Trump administration is fighting COVID-19 in communities of color
HHS Secretary Alex Azar & Jerome Adams
July 11, 2020
The HHS secretary and U.S. surgeon general describe the response.
Daily counts of new cases of COVID-19 are rising in Texas, as they are in other areas around the country. With a rapid and comprehensive public health response, from the Trump administration to states, tribes, territories, local communities and families, we will reverse these trends and defeat the virus.
To succeed, we must recognize that the burden of this pandemic has not fallen evenly on all Americans. According to the Centers for Disease Control and Prevention, Black Americans and American Indians and Alaska Natives are being hospitalized for COVID-19 at five times the rate of non-Hispanic white Americans, and Hispanic Americans are being hospitalized at four times the rate. By one estimate, Black Americans and Hispanic Americans have actually lost more years of life than white Americans, despite representing smaller proportions of the population.
As two of America’s top public health officials, we have been battling health disparities long before this pandemic. This virus has laid bare deeper inequalities in our health system and health outcomes that have too often been overlooked. To defeat COVID-19, we have developed a comprehensive response that tackles the drivers of these disparities and empowers Americans to protect themselves.
Why are people of color suffering such disproportionate impacts? First, they are often at higher risk of contracting the virus. Racial and ethnic minorities are disproportionately likely to hold jobs that are deemed “essential.” These occupations often cause individuals to be in close and frequent contact with others, whether at work or while commuting, increasing the risk of exposure. This type and range of jobs reported are a “social determinant of health,” a powerful non-health contributor to health outcomes.
We are working to lower these risks and prevent the spread of the virus in vulnerable communities. The CDC helps investigate outbreaks in high-risk employment settings and works with states to help businesses reduce risks. We’ve now required that all COVID-19 case reporting include race, ethnicity, age, and ZIP code data so we can work with states to continue to focus interventions. We’ve helped set up more than 1,800 community-based testing sites around America, including 201 in Texas, with more than two-thirds of the HHS-contracted sites located in underserved areas. Testing is also offered at more than 90% of the 1,300-plus federally supported community health centers, which serve millions of vulnerable Americans and are often located in underserved areas.
Second, COVID-19 is hitting minority communities hard because of preexisting disparities in access to care, another social determinant of health. We have committed to cover COVID-19 testing and care for the uninsured, with more than $23 million covered in Texas already. We made an intentional investment to support health care providers that serve disadvantaged populations, including $25 billion for Medicaid and safety-net providers, $10 billion for rural providers, and $2 billion for hospitals that serve disproportionately low-income and uninsured individuals. We’ve allocated $500 million for American Indian health care providers and made the single biggest program investment in tribal governments ever through the Department of Treasury’s disbursal of nearly $7.5 billion in funding to tribes.
Finally, many Americans have underlying health conditions that put them at higher risk from the virus. CDC has recently updated its warnings about these risks, noting that conditions such heart disease, Type 2 diabetes, obesity, and kidney disease put patients at a higher risk of severe COVID-19. Because these conditions are often driven by social determinants of health, like safe and affordable housing or economic opportunities, they are often more common in minority populations.
To address these health conditions, we need to combat stigma and bias and engage with communities. Recently, the Trump administration announced a $40 million initiative with Morehouse School of Medicine that will engage organizations with deep connections in racial and ethnic minority, rural and socially vulnerable communities to distribute information about who’s at greatest risk from COVID-19, how individuals can protect themselves and their families, and how to get tested and receive treatment. This will include culturally competent information and information in multiple languages, which is especially important for Texas’ bilingual communities.
We are also progressing on therapeutics to help Americans who suffer severely from COVID-19. A nationwide study of one promising treatment, convalescent plasma, continues to provide encouraging results from a diverse sample of more than 25,000 patients treated, more than 20% of them Black.
We’ll continue to prioritize the factors that have come together in the tragic perfect storm that’s made COVID-19 so deadly for communities of color. In the coming months, the Department of Health and Human Services and the entire Trump administration will continue our work on many other health issues that particularly affect people of color, such as kidney disease, substance misuse, HIV/AIDS, hypertension, maternal mortality, and sickle cell disease. We’re working with the White House Opportunity and Revitalization Council and the business community to promote economic opportunity in struggling communities, making the case that better health and greater prosperity go hand-in-hand.
At a time when many are realizing how far we have to go to achieve equality for all Americans, we know COVID-19is a wake-up call for health leaders in particular. We must redouble our commitment to tackling the stark inequities in American health care, and we won’t waste a moment in doing so.
Alex M. Azar II is U.S. secretary of Health and Human Services and Vice Adm. Jerome M. Adams, M.D.., MPH, is surgeon general of the U.S. Public Health Service.