For nearly a year, the COVID-19 pandemic has ravaged the nation. Black communities have found themselves disproportionately impacted by the pandemic, highlighting the health disparities and social inequities that exist in our society.
Faculty, students and staff across the University of Michigan have dedicated their research, scholarship and academic studies to understand why these inequities exist, educate others on the consequences of disparities, and identify the best methods to advocate for and implement change.
In a Feb. 24 panel discussion hosted by U-M Public Engagement & Impact, three faculty members from Michigan Medicine and the School of Nursing and two students from the Medical School and the School of Public Health explained why these disparities exist, how they contribute to mistrust of medical systems, and what can be done to address them and impact change.
Oluwaferanmi O. Okanlami, assistant professor of family medicine, physical medicine and rehabilitation, and urology, and interim director of Services for Students with Disabilities, moderated the conversation and opened with a description of why the conversation is necessary to have.
“Why do we need to talk about health disparities and social inequities? I think it is important to have these conversations not just for ourselves and our communities, but for those who look to us as an example of what it should mean to be the leaders and best,” he said.
Jade Burns, assistant professor of nursing, discussed how social and racial inequities contribute to social determinants of health.
“We know through the literature, the news and social media, that inequity has been a hallmark of this pandemic, both locally and globally. Inequities in health have always existed, but at this moment there is an awakening to the power of racism, poverty and bias in amplifying economic pain and hardship imposed by this pandemic,” she said. “These inequities have put racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19.”
Throughout February, Black History Month has provided an opportunity to focus on the stark disparities facing Black communities. These issues have been addressed in a series of interviews and podcasts highlighted by Public Engagement & Impact.
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“Our job is to make sure that we tell the full story, unvarnished, with all the contradictions that are a part of human history, and Black History Month is a way to anchor our efforts to do that very thing,” said Earl Lewis, Thomas C. Holt Distinguished University Professor of History, Afroamerican and African Studies and Public Policy, and founder and director of the Center for Social Solutions.
Riana Elyse Anderson, assistant professor of health behavior and health education in the School of Public Health, studies negative impacts of discrimination on the mental health and well-being of Black individuals and how to “drop-kick racism.”
podcast and interview
She explained that policies and practices throughout history have contributed to ongoing disparities and, in the past year especially, increased stress and anxiety. Not only is access important, she explained in a recent episode of the Michigan Minds podcast, but encouraging utilization and ensuring the quality of care are just as vital.
Through her studies and lived experiences, public health student Kennedy DuBose said it is important for everyone to understand that public health infrastructure plays a large role in driving health disparities, which existed prior to the pandemic.
“The foundation of Black health is built on inequity. Black hospitals and communities are often less equipped and underfunded. There are also barriers like lack of transportation to medical facilities, and lack of health insurance and a myriad of other barriers that Black Americans face that make them less likely to seek or receive adequate medical treatment,” DuBose said.
Lack of trust in medical settings is also a concern being investigated by researchers across the nation, including Lola Eniola-Adefeso, University Diversity and Social Transformation Professor, and professor of chemical engineering, biomedical engineering, and macromolecular science and engineering.
podcast and interview
She recently co-authored a paper examining disparities in health research funding in which white biomedical researchers get funded twice as much as Black researchers, despite equal levels of achievement. She said these inequities contribute to the distrust of medicine in Black communities.
“We’ve worked hard over multiple decades to pull back or unwind that distrust, but we have not made the progress that we could have made because of this lack of diverse Black scientists at the forefront of medical research, medical technology and medical innovation,” Eniola-Adefeso said.
“If a group of people are already likely to be suspicious of our medical enterprise, and then they continue to not see people that look like them at the forefront of technology, you could see how conspiracy theories will take hold.”
Not only is it important to examine these issues of racial and ethnic disparities within health care, but it is crucial to identify ways to alleviate inequalities.
Arrice Bryant, a medical and public health student, explained her passion for addressing these health disparities.
“Every day, I think as a medical student and as a future physician, ‘What is it that I can do, myself, to address health disparities?’ If there are other medical students out there, other doctors, whether they look like me or don’t, whether they’re from where I am or not, it’s making sure that we have patient-centered conversations and that we value their opinion and experiences as much as we value our knowledge and our training,” she said.
Hesitancy around the COVID-19 vaccine has been a topic of conversation across the nation since the vaccines became available. Data has shown a significant amount of hesitancy across many communities, but disproportionately within Black communities.
Matthew Wixson, assistant professor and associate chair of diversity in the Department of Anesthesiology, said he thought he had a responsibility to volunteer for a COVID-19 vaccine trial last year.
“I felt I could use my position as a Black male anesthesiologist who has been taking care of COVID-19 patients since day one of the pandemic to say, ‘I trust the science. I trust this process.’ So much so that I’m willing to put myself into an experiment to show that I really do believe in this,” Wixson said.
Erica Marsh, S. Jan Behrman Collegiate Professor of Reproductive Medicine, and associate professor of obstetrics and gynecology in the Medical School, and associate professor of women’s and gender studies in LSA, works to address disparities through her role as a medical professional and a member of the Precision Health at U-M Health Disparities Task Force.
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In a recent interview, Marsh discussed access concerns regarding the COVID-19 vaccine, especially as hesitancy begins to decrease, and how important it is to ensure that the vaccine is accessible to individuals who are open to receiving it.
“We need to strike while the iron is hot. While we have people saying, ‘You know what? I am willing to get vaccinated. Where do I go get vaccinated?’ and I just think it’s really important that we’re there and ready to say ‘thank you’ for making that choice. We have the vaccine for you. Come and get it,” she said.
College of Engineering Dean Alec D. Gallimore said there’s no better time than now to advocate for change and to act on it.
“In this sad yet hopeful moment, this nation and many others are grappling with the long legacy of anti-Black racism. And sometimes you have to seize the moment. Now is such a moment. Change is achievable. But it requires intentional effort,” said Gallimore, Arthur F. Thurnau Professor, Richard F. and Eleanor A. Towner Professor of Engineering, and professor of aerospace engineering.
“Each of us owns a portion of responsibility for stemming the pandemic of racism. I challenge each of us to get educated — we all can gain some knowledge about the problem and possible solutions — then get active.”
What I find disheartening is that the WHO, CDC, Michigan Department of Health, and the public health community in general are letting politics push the science aside re. the pandemic.
Yes, minority and other disadvantaged communities are being hit especially hard by COVID-19, however, valid, peer-reviewed studies starting early on in the spring and summer of last year and up to this day show that among people who are infected with SARS-CoV-2 and go on to develop COVID-19, at least 60% and up to 75% in some countries, men are the ones who are dying from the disease. This is true for all categories of race.ethnicity and age groups, and the CDC’s own numbers clearly show this, yet this is not addressed in discussions re. health disparities, let alone accounted for when developing mitigation strategies.
More broadly, men’s health has been an afterthought at best, as is shown by the fact that for at least several decades men die about 6 – 7 years earlier than women (in the Hispanic and African American communities this is even greater) and have greater morbidity and mortality from 19 of the top 20 chronic diseases. This pandemic only adds to the evidence that man’s health needs to be brought out of the ‘wilderness’ and taken as seriously as women’s health. We’re human too.