A Spotlight on Health Care Disparity During COVID-19

Drug Topics®: Hi, my name is Gabrielle Ientile with Drug Topics® and today we're talking to Dr Devin English, [PhD], assistant professor at Rutgers School of Public Health. Dr English’s research is focused on how forms of oppression lead to health inequalities in the United States, and today we're talking about how COVID-19 pandemic is affecting minorities. Dr English, thanks so much for joining us today.

English: Thank you so much for having me. And thank you for focusing on this this important topic.

Drug Topics®: So before we get started, I'd love for you to provide a little bit of your professional background and your day-to-day during quarantine.

English: Absolutely. So as you mentioned, I'm assistant professor at Rutgers School of Public Health. My training is in clinical community psychology. And as you mentioned, my research focuses on how forms of oppression can lead to some of the health inequities that we see across race and sexual orientation such as those in major depression and HIV. During the pandemic, I've been teaching remotely, mentoring remotely, and trying to continue to shine the light on the ways in which structural oppression is playing out in the [United States]. But me being able to stay at home and do these things, I think is something tied into this as it's a privilege. It’s something that I'm able to do that many of our neighbors are not able to do in New York and New Jersey.

Drug Topics®: Thanks for shedding light on that. And this is kind of a complex topic, can you break down a little bit the issues that inform minority health and why we might be seeing disproportionately higher coronavirus cases in minority populations?

English: So bear with me a little bit because I'm going to get into a little bit of history. Because I believe to understand the inequities in COVID-19 that we're seeing, we must understand the history of the United States. In the example of racial inequities that we're seeing in COVID-19, we must see how the [United States] has become extremely racially and economically segregated. Because what we're seeing with COVID-19 is completely predictable, policies like redlining and systematic disinvestment have led to racial segregation that we see in black and Latinx communities today. Now, this matters because we know that your zip code often determines whether you have high levels of pollution and overcrowding and whether you have access to quality health care and economic opportunity. Right now, black and Latinx communities, where there are additional disproportionately high levels of pollution and overcrowding and low levels of access to health care and economic opportunity; there are also high levels of COVID-19 related risk factors: these include conditions like asthma, the inability to socially isolate or socially distance because there are lots of low paying yet essential jobs. And there's lower quality health care in overcrowded and under resourced local hospitals. Because of this, we are seeing that black and Latinx communities make up huge percentages of COVID-19 related deaths.

Drug Topics®: And the New York Times reported that most cities and states aren't reporting race where they're confirmed cases and fatalities. Why do you think this might be?

English: That's a good question, and I understand that not all places and not all states and cities are race and ethnicity recorded at time of death. However, that is the failure at multiple levels of government, because this information should be required of hospitals and health care facilities. And this is a decision that governors and mayors can make today, so that we are collecting this information. And this information is essential because we know that one of the most profound forms of oppression is the erasure. It is saying that the experience is not happening that is actually there. If we're not collecting this data, then the federal government, state governments and city governments can say that it's not happening. So it is an absolute imperative that we are collecting race ethnicity data - that we're collecting data on sexual and gender identity, in addition to what many places already collecting around age, and other demographic factors.

Drug Topics®: Dr English, thank you so much for shedding light on this super important topic today. And stay safe out there.

English: Thank you so much for having me.

Editor’s note: This interview transcription has been lightly edited for style and clarity.

Check back to drugtopics.com for part 2 of this interview and more expert interviews on COVID-19.