Like I’ve mentioned in a few of my previous posts, this pandemic has brought on a lot of changes for everyone– but there is variation in how COVID-19 has impacted different groups of people. The experience of racial and ethnic minorities during this pandemic has been very different from other groups and is reflective of health outcomes that often exist for minorities in the U.S.
COVID-19
In New York City, the death rates for Black/African American individuals is much higher due to the virus, than it is for other racial/ethnic groups (1). The chart below shows the disproportionality of the effects of COVID on the population of African American individuals in a few states.
Compared to the total state population, the majority of patients affected by COVID are African American (2).
These disparities exist not only during this pandemic, but in healthcare in general:
Reasons for the Disparity
People who belong to racial or ethnic minority groups experience the health care system differently than others– many of the existing disparities in society lead to poorer health outcomes, as well as greater vulnerability to viruses and other illnesses. Many minority groups live in heavily populated areas or live in households with multiple generations, where social distancing might not be possible (1). Many work hourly, so health benefits are not part of the package and health services become difficult to access (2). There is also a much higher population of racial and ethnic minorities in jails, prisons, etc. which are again, places that increase the risk of spread of viruses and other illnesses (1).
Also, because of the social distancing measures that have to be taken because of the pandemic, there has been a decrease in quality of care for patients who don’t speak English (4). Before, interpreters/translators could be present in person during a patient’s visit, which makes it much easier to translate and understand the patient’s concerns and symptoms. Now, a lot of interpreters have to work over the phone and it’s possible that a lot of information is getting lost in translation because it’s just harder to have a conversation and understand each other that way.
While the pandemic has affected everyone in one way or another, it has not affected everyone equally. The social determinants of health that I talked about in my first blog, in addition to factors such as racism, geographic location, and poverty, play a large part in deciding how an individual is affected. Unfortunately, the same level and quality of healthcare are not available to every person. Moving towards a system that addresses these disparities and provides excellent health care to each patient will involve first resolving the inequalities that exist in health care delivery in general and access to healthier food, exercise, etc. Additionally, training healthcare providers to better understand cultural differences and barriers to care could improve health outcomes for minority groups (3).
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Connexins are the structural components of gap junctions and hemichannels that mediate the communication and exchange of small molecules between cells, and between the intracellular and extracellular environment, respectively. Connexin (Cx) 46 is predominately expressed in lens fiber cells, where they function in maintaining the homeostasis and transparency of the lens. Cx46 mutations are associated with imp
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Targeted marketing has caused a recent surge in teen e-cigarette usage. In all-age surveys, we isolated adolescent data (13-20 years) to assess age alongside e-cigarettes, traditional tobacco, and dual usage of both with sleep quality and cough. Based on existing adult literature, we hypothesized an association between dual usage and increased sleep latency.
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Concurrent extrahepatic autoimmune disorders (CEHAID) are frequently observed in autoimmune hepatitis (AIH). It is not clear whether there is any prognostic significance of CEHAID on AIH. The aim of this study was to examine the prognostic impact of CEHAID and the correlation with the disease severity of AIH.
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Digoxin is commonly prescribed for heart failure and atrial fibrillation, but there is limited data on its safety in patients with chronic kidney disease (CKD). We conducted a population-based cohort study using the pre-end stage renal disease (ESRD) care program registry and the National Health Insurance Research Database in Taiwan. Of advanced CKD patient cohort (N = 31,933), we identified the digoxin u
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The glucagon-like peptide-1 receptor agonist exenatide (EXT) is an effective treatment for type 2 diabetes. However, this peptide has a short biological half-life and the delayed release characteristic of current formulations limit its clinical application. Herein, we prepared EXT-loaded inside-porous poly(d,l-lactic-co-glycolic acid (PLGA) microspheres with outside layers (EXT-PMS) using a W1/O/W2 emu
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Background Immune infiltration has an important impact on the development of clear cell renal cell carcinoma (ccRCC). This article aims to investigate the association between immune infiltration and the clinical features as well as prognosis of clear cell renal cell carcinoma. Methods Analyze the immune infiltration in ccRCC by applying ESTIMATE and CIBERSORT methods on basic of dataset in TCGA and GEO. And iden
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EBV transforms B cells in vitro and causes human B-cell lymphomas including classical Hodgkin lymphoma (CHL), Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL). The EBV latency protein, EBNA2, transcriptionally activates the promoters of all latent viral protein-coding genes expressed in type III EBV latency and is essential for EBV’s ability to transform B cells in vitro. However, EBNA2 is not expressed in
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National averages obscure geographic variation in program performance. We determined Parliamentary Constituency (PC)-wise estimates of TB notification to guide political engagement.
We extracted district-level TB notification data from the 2018 annual TB report. We derived PC-level estimates by building a ‘cross-walk’ between districts and PCs using boundary shapefiles. We des
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To investigate the influence of treatment regularity with intravitreal aflibercept injections (IVT-AFL injections) on visual acuity (VA) outcomes in patients with neovascular age-related macular degeneration (nAMD) enrolled in the PERSEUS trial who received at least 7 IVT-AFL injections during the first year.
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Many patients with dilated cardiomyopathy (DCMP), presenting with only dyspnea, have hidden ischemic etiology. In low-income countries, logistic and financial restraints lead to reduced identification of this ischemic burden. We aimed to assess the role of coronary angiography in patients with cardiomyopathy presenting predominantly dyspnea.
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In Tg glands, FAE increased the luminal progenitor cell population at 5 weeks of age but did not alter MEC composition at 10 weeks of age. Tertiary mammosphere-forming efficiency was greater in the WT glands of FAE animals at 10 weeks of age. Tumor latency was decreased in the FAE group. Flow cytometry analysis indicated that FAE females developed tumors with an increased basal cell population. CONCL
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Here, we provide updates on some of the major areas of preclinical kidney research involving β2AR signaling that have advanced to describe molecular pathways and identify potential drug targets some of which are currently under clinical development for the treatment of kidney-related diseases.In this study, we synthesized and modified titanate nanotubes (TNTs) under different conditions of acid rinsing and calcinatio
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In the US, the growing demand for precision medicine, particularly in oncology, continues to put pressure on the availability of genetic counselors to meet that demand. This is especially true in certain geographic locations due to the uneven distribution of genetic counselors throughout the US. To assess these disparities, access to genetic counselors of all specialties is explored by geography, cancer type,
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For pediatric complex care programs to target enhanced care coordination services to the highest-risk patients, it is critical to accurately identify children with medical complexity (CMC); however, no gold standard definition exists. The aim of this study is to describe a point-of-care screening algorithm to identify CMC with high health care use, a group that may benefit the most from improved care
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Membranous nephropathy (MN) is an immune complex mediated disease. Although limited to the kidney, in up to 20% of patients MN is associated with other autoimmune, infectious or malignant diseases. The initial pathogenetic event in what is still considered “primary” MN is the binding of circulating autoantibodies to proteins (autoantigens) expressed in glomerular podocytes. This antibody binding leads to t
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