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Disparities in COVID-19 Outcomes: Understanding the Root Cause Is Key to Achieving Equity []


By La Quandra S. Nesbitt, Journal of Public Health Management & Practice (January/February 2021), December 2020

As the number of COVID-19 cases in the United States increased, and public reporting of demographic characteristics improved, the stark disparities in COVID-19–related incidence and mortality became evident.1 While these disparities were alarming to many, for others, they illuminated the unfortunate inequities in health and health care that exist and persist in the United States despite expanded access to health insurance coverage and advances in health care technologies.

Just as an effective response to the COVID-19 pandemic requires a whole of government and community approach, an effective approach to eliminating disparities in COVID-19–related health outcomes must (1) recognize that root causes are due to systemic causes that are beyond the acute nature of the emerging infectious disease; (2) engage multiple sectors of government beyond governmental public health and implement short- and long-term solutions; and (3) effectively mobilize public-private partnerships.

To eliminate disparities in COVID-19–related health outcomes, our collective actions must be intentional in 3 key areas: (1) access to health care; (2) social and structural determinants of health; and (3) structural and institutional racism. Fundamental to the success of this work is the need to have public dashboards with data by race/ethnicity and geography that not only create accountability for public health and elected officials but also allow private industry, health care providers, community-based organizations, and citizen scientists to contribute innovative solutions to the whole of community response.

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