Since the beginning of the pandemic, COVID-19 hospitalization and death rates have been higher for minorities nationwide. This is likely multifactorial, according to Institute Faculty Scholar and Co-director of the Center for Health Economics and Policy, Karen Joynt Maddox, MD, MPH. “The evidence is overwhelming that minority populations including African Americans, Native Americans, and Latinx groups are being disproportionately affected by COVID-19,” Joynt Maddox says. “For example, age-adjusted case rates per 100,000 population are four to five times as high in Black and Latinx communities compared to white ones, and Native American groups have case rates that are as much as six times higher than whites.”
While the disparities are clear, the reasons underlying them are less so. It is likely that these inequities arise from a combination of occupational exposure, lack of access to testing and treatment, population density, and medical comorbidities (having multiple medical conditions at the same time), all of which can be traced back to structural racism and other systemic causes. To help understand these inequities, and work to find solutions, the Institute for Public Health has launched a university-wide work group focused on social determinants of health in COVID to help make an impact in these vital communities.
According to Dr. Joynt Maddox, the goals of WashU’s COVID-19 and Social Determinants of Health Working Group is to “connect people across the university around this important topic to enable novel collaborations and help create meaningful change in clinical care and policy.”
So far, the work group has had attendees from the Institute for Public Health, Brown School, the Schools of Medicine, Law and Business, and members of the community. Some of the projects shared by members of the work group include:
- The Center for Health Economics and Policy has partnered with the Missouri Hospital Association to build on their first report related to COVID inequities in St. Louis, and enable further study of racial disparities;
- Aaloke Mody, MD, and the Center for Dissemination and Implementation is researching inequities in testing access using novel statistical methods
- Beth Prusaczyk, PhD, MSW, and the Harvey A. Friedman Center for Aging to study how COVID-19 is affecting older adults in the community;
- Josh Landman and Randi Foraker, PhD, MA and the Public Health Data and Training Center are using BJC clinical data to assess racial inequities in admission and mortality for COVID;
- Kim Thuy Seelinger, MA, and Julia Uyttewaal, MA, of the Center for Human Rights, Gender and Migration in partnership with the Center for Community Health Partnership and Research are working to understand the impact of COVID on migration and refugees, and among immigrants in St. Louis
- Because many patients have persistent symptoms post-COVID, which are generally poorly understood, the work group has offered assistance in registry development for WashU’s post-COVID clinic. The clinic works with COVID-19 patients to study the course of their symptoms and offer referrals.
“There is so much more work that needs to be done,” says Dr. Joynt Maddox. “We want to continue to connect with more faculty at WashU who are involved in COVID-19/Social Determinants of Health work to form lasting collaborations even after the pandemic ends.”
She continues, “Understanding the causes of racial inequities is a first step in designing interventions to reduce them, and work being done across the University in this area has the potential to meaningfully impact the community.”