That the U.S. healthcare system struggles with endemic problems isn’t a surprise to many; that a pandemic would expose a gaping chasm starkly revealing just how much lower income and minority communities disproportionately suffer and die in pandemic conditions evidences the need for an intelligent, creative and entrepreneurially-focused upgrade to the entire system as we know it—it is that time. The latest study highlighting the systemic imbalances in health systems across the country originates from Beth Israel Deaconess Medical Center’s just completed study showcasing substantial differences in COVID-19-related hospitalizations and deaths as those in poor and minority communities (e.g. African American, Hispanic) in New York disproportionately shoulder the burden of the pandemic.
New York City has been the epicenter of the COVID-19 pandemic in America with over 15% of the total cases nationally. Researchers from Boston used data from the U.S. Census Bureau and the American Hospital Association such as median household income, poverty, education), and hospital bed capacity across the five boroughs of New York City. By evaluating rates per 100,000 people of COVID-19 testing, COVID-19 patient hospitalizations, and COVID-19-related deaths according to patients’ borough residence based on data from the NYC Health Department, the differences are stark. The findings were published in the Journal of the American Medical Association (JAMA).
The research team uncovered that COVID-19 hospitalization and death rates varied considerably across New York City boroughs. The Bronx—the area with the highest proportion of racial and ethnic minorities, the most persons living in poverty, and lowest levels of educational attainment—had higher rates of hospitalization and death related to COVID-19 than all other boroughs. In contrast, hospitalization and death rates were lowest in Manhattan, the most affluent borough, which is comprised of a predominantly white population. The number of COVID-19 deaths per 100,000 persons was nearly two times greater in the Bronx than in Manhattan.
This shouldn’t be a surprise to many that study matters of ethnicity and race, income and access in the nation; but to watch it unfold in real time intensifies the alarm and natural urge for reform. It actually is an outcome of the growing disparities in American society witnessed over the past couple of decades. As lead author Rishi K. Wadhera, MD, MPP, MPhil, an investigator at the Richard A. and Susan F. Smith Center for Outcomes Research and physician at BIDMC and Harvard Medical School commented, “Prior studies have shown disparities in health outcomes across New York City’s five boroughs—Brooklyn, the Bronx, Manhattan, Queens, Staten Island.” He continued, “We wanted to evaluate whether similar patterns have also emerged amid the COVID-19 pandemic.”
The differences in death rates across the city are substantial and “concerning” reported Wadhera and emphasize the “…need to understand the extent to which underlying comorbid illness, occupational exposure, socioeconomic determinants of health, and race-based structural inequities explain the disparate outcomes among boroughs, to help shape ongoing public health strategies and policies that aim to mitigate and contain COVID-19.”
Rishi K. Wadhera, MD, MPP, MPhil, an investigator at the Richard A. and Susan F. Smith Center for Outcomes Research and physician at BIDMC and Harvard Medical School
A number of other authors are involved and can be reviewed at the source.