COVID and the Black Community: Health Inequity and Poor Outcomes

On Tuesday April 14, New America Indy and The Indianapolis Recorder continued an online series on the impact of the COVID-19 crisis on the Black Community. In this conversation, co-moderated by The Recorder's Oseye Boyd and New America's Molly Martin, we discussed public health inequity faced by the Black community, generally, and during the COVID-19 pandemic. We were joined by:

• Dr. Virginia Caine, M.D., Director - Marion County Public Health Department
• Carl Ellison, President/CEO - Indiana Minority Health Coalition
• Antoniette M. Holt, Director - Office of Minority Health, Indiana State Department of Health
• Dr. Erica Renee Huddleston, M.D., Community Health Network
• Dr. Woody Myers, M.D. Owner - Myers Ventures, Fmr. Indiana State Health Commissioner
• Dr. Jennifer Sullivan, M.D., M.P.H. Secretary - Family and Social Services Administration, State of Indiana

A few takeways from the session:

• It's important to understand what the virus is and how to protect yourself.
  • See FAQs about the virus (in Spanish and English) here.
  • Understand resources/programs available from the state here.
  • Having trouble accessing a provider? In Marion County call 317-221-5500. Across Indiana call 877-826-0011.
  • Dr. Huddleston recommended that if you feel that you may have been exposed, you should isolate for 14 days.
  • Dr. Huddleston also suggested that, unless you are a public-facing healthcare worker, a basic mask [available at drug stores] or homemade mask will suffice when you are out in public. Masks are intended to prevent the wearer--even if he/she is asymptomatic--from exposing others.
  • Some residents remain skeptical that Black patients are being hospitalized early enough. While panelists reported that they had not seen evidence of this, they understand the trauma some Black patients have experienced at being dismissed.
  • Understand your rights: currently, expansion plans or changes to HIP are on-hold to address the virus. You cannot lose coverage right now.
  • You can see Side Effects Public Media's "You Asked, We Answered" on COVID-19 and the Black community here.
    

• In Indiana, as in much of the U.S., Black residents are bearing the brunt of COVID-19 mortality:
  • Projected data shared by Dr. Virginia Caine, Director of the Marion County Public Health Department, shows that African Americans represent 42% of COVID-19 deaths in Marion County (a death rate of 18 per 100,000); Africans Americans are 28.9% of the population in Marion County. "The death rate for African Americans is currently more than twice that of whites, who have made up 40% of deaths in Marion County. The death rate is based on relative population size."
  • In Indiana, African Americans represent 17.6% of COVID-19 cases and 20.9% of deaths. African Americans are 9.8% of the population in Indiana.
  • Read more about current data in The Indianapolis Recorder.

• Many Black patients continue to report poor experiences with healthcare institutions (access, affordability, implicit bias, dismissal of symptoms, lack of cultural competence). Deliberate and continual training of healthcare personnel--built into required curriculum--is incredibly important, as is the recruitment and development of more Black providers.

• Black scientists, providers, and advocates must be involved in public health policy conversations from the beginning.

• Access, affordability and poor outcomes are not just clinical matters. While Black Americans are impacted in disproportionate numbers by diabetes, heart disease and other underlying conditions that may exacerbate poor outcomes from COVID-19, the reasons for high death rates for Black Americans are also tied to social constructs. Systemic bias and mobility barriers result in a disproportionate number of Black residents living in poverty [and experiencing associated health complications], smaller/more crowded housing, and reduced options to isolate during a pandemic. Black workers are also less likely to have the option to telecommute and are over-represented in lower-paying retail and service jobs that involve more public exposure but that may be deemed essential. You can learn more in Marion County's 2018 Health Equity Report.

• Addressing social service needs and spending gaps are vital to driving health equity. This requires collaboration across local and state levels, as well as across care providers and community-based organizations. You can see examples of state collaborative efforts to address unmet needs on the IN.gov website, including this Food Assistance Availability Map.

• Concerns persist about inadequate testing.

You can watch the full session below and read the full transcript here.

We look forward to the next conversation and thank our co-hosts, The Indianapolis Recorder, and community partner WFYI Public Broadcasting.