For one, cramped living conditions and a fast-moving virus make a dangerous mix. We have to take into consideration the ways in which epidemics … often reveal the fissures within our society.” “I like to say that all epidemics are both biological and social. Taylor also says she worries about food insecurity and ongoing care for her patients, many of whom have HIV and very tight budgets. Those who fear a high bill may delay seeking care, a wait that could cause medical complications, notes Barbara Taylor, MD, associate professor of infectious diseases at the University of Texas Health Science Center (UT Health) at San Antonio. “And tens of millions of Americans have no health insurance at all.” “Also, even if they have insurance, many people feel very concerned about what a medical visit will cost,” she adds. “There are people who have jobs where they don’t get paid if they stay home - and even risk losing their livelihood,” says Mary Bassett, MD, MPH, director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University. Poverty underpins so much of what makes the coronavirus potentially devastating, experts note. We are asking them to navigate a really complicated system.”īracho-Sanchez says she hopes her vulnerable patients will be able to avoid the worst fallout from the novel coronavirus.īut, she adds, “We can’t build solutions on hopes.” The problems And now we are asking them to follow CDC guidelines, make decisions about the virus, and wrap their minds around fast-moving information. “They’re working through complicated and ever-changing immigration law, jumping through hoops to obtain federal food and housing benefits, and sometimes dealing with complex health issues. “So many families I see were already struggling at baseline, before coronavirus,” she notes. “Those communities that are marginalized, that are underresourced or underserved, will always suffer more during a crisis like this.”ĭavid Acosta, MD, AAMC Chief Diversity and Inclusion OfficerĮdith Bracho-Sanchez, MD, a pediatrician at Columbia University Vagelos College of Physicians and Surgeons, treats children who live in low-income neighborhoods or shelters in New York City. What's more, addressing a coronavirus outbreak among these groups will require creative approaches and extensive collaboration among numerous stakeholders, from policymakers to leaders of medical schools and teaching hospitals. Among them are that marginalized populations often live in conditions that fuel ill health, suffer from diseases that could complicate infections, and have trouble accessing care if they need it. So, experts worry that although emergency legislation the House passed on Friday provides some forms of relief, the outbreak may be devastating for those at risk because of social or economic issues such as racism, poverty, and xenophobia. For example, flu-related hospitalizations in poor neighborhoods are double those in higher-income areas, according to a 2016 Centers for Disease Control and Prevention (CDC) analysis. In fact, prior experience suggests that viral outbreaks disproportionately impact the poor. “Any health inequities that they already experience will only be exacerbated by a pandemic.” “Those communities that are marginalized, that are underresourced or underserved, will always suffer more during a crisis like this,” says David Acosta, MD, the AAMC’s chief diversity and inclusion officer. They also may lack trust in a system that has failed them in the past. Homeless people, people without health insurance, those living paycheck to paycheck, and other marginalized groups can’t necessarily afford to miss work and may have no steady health care provider and no way to avoid crowded conditions. These are all commonsense guidelines for avoiding the coronavirus that causes COVID-19 - except for the millions of people across this country whose lives make such steps challenging or even impossible. Avoid close contact with people who are sick. Residents receive food from the National Guard near a containment area set up to halt the spread of COVID-19 in New Rochelle, New York.
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