The Black Lives Matter protests occurring globally have once again spotlighted racial inequalities experienced by so many Black communities. The disproportionate toll the COVID-19 pandemic has taken on these very same communities has further emphasized that racism is not just a social illness; it’s a public health issue.
This pandemic has highlighted how interconnected we are as a society and that what happens to one of us can affect all of us.
COVID-19 has resulted in the deaths of more than 100,000 Americans and the current data reveals a stark reality: Black and Brown people are more likely to get sick and die of this virus.
What can health writers do to write about these health disparities in a nuanced, evidence-based manner? How can we raise awareness about health disparities and work towards ending them?
Through this post, I hope to provide answers to these questions.
What are health disparities?
According to the Centers for Disease Control, health disparities are “differences in the incidence, prevalence, and mortality of a disease and the related adverse health conditions that exist among specific population groups. These groups may be characterized by gender, age, race or ethnicity, education, income, social class, disability, geographic location, or sexual orientation.”
In this post, I will discuss the toll of COVID-19 on Black and Brown communities and the lessons health writers can learn from it.
During a public health emergency, racial and ethnic minority populations are at a higher risk of infection and death than the majority population. For example, in Wisconsin – where African-Americans make up 6.7% of the population – data shows that 36% of COVID related deaths were African-Americans. Similar disparities were found throughout the United States.
Nicole Bowens PHD, a freelance medical writer, further notes: “…the pandemic is disproportionately affecting minority groups who already have less access to health care and overall higher stress…I also think the media is severely underreporting cases and deaths in underprivileged populations because these people may be dying in their homes and not seeking health care at all…”
Sally Lehrman, an award-winning science journalist who specializes in race relations, gender and identity, says: “Journalists need to do a better job, helping people understand why communities of color, immigrants and religious minorities experience the higher levels of underlying conditions that make them vulnerable. It’s not just chance, or as some people unfortunately presume, something biological or cultural.”
How can we write about health disparities?
So, how can health writers approach this topic? Sharing statistics and simplistic headlines stating that COVID disproportionately kills minorities is not enough.
This is a commonly seen mistake, according to Dr. Lehrman. “Often health communicators describe health disparities, but they never get to the ‘why’.”
Not providing an explanation could send the message that the blame is on these communities. If you don’t say why health disparities exist, the reader may assume they exist because people make bad health choices. The data, however, does not support this.
Dr. Lehrman provides this example: “Asthma, for instance, is higher in children of color in part because they more often live in neighborhoods with poorer air quality and may not be allowed easy access to their medications in schools.”
Nancy Krieger PhD, a professor of social epidemiology at Harvard’s TH.Chan School of Public Health, founded the eco-social theory of disease distribution which could help us better discuss health disparities. This theory of disease distribution analyzes the environmental and social living conditions people are in and how this affects their disease outcomes.
In the case of COVID-19, we can use this theory to examine people most likely to have low-income jobs that are now deemed essential. What role do overcrowded living conditions and poor ventilation play in their risk of exposure and transmission?
Dr. Lehrman further explains: “Communities already facing health disparities also are the ones most likely to be at the front lines in essential jobs including health services, food service and production, and cleaning and maintenance, making exposure more likely.”
Dr. Krieger uses the eco-social theory of disease distribution to also study the barriers vulnerable groups face when it comes to health care. Are minorities less likely to receive adequate care? Does the lack of health insurance inhibit the care they do receive? Everything is interconnected and omitting underlying factors can lead to irresponsible reporting.
Dr. Krieger states in a recent New Yorker article: “I think a key point to get across is that there are two different kinds of inequities happening here. One is inequities in health status. The other’s an inequity in health care. And they’re not the same thing—they then collide with each other, and it’s much worse.”
What is implicit bias?
Studying the social and environmental determinants of disease in a community is one step health writers can take to address health disparities. But it is by no means enough. Dr. Lehrman suggests health writers also educate themselves on implicit bias and its effect on their work.
Implicit bias is an unconscious assumption or belief you may have against a particular group of people. You may be unaware of these biases however they could be reflected in how you report on these communities. It’s important to examine your beliefs and educate yourself about the life experiences of people who are different from you.
“It’s hard right now to reach out in person,” Dr. Lehrman says. “But we can find spaces on social media and through literature and the arts to learn.”
How does racism lead to health disparities?
When discussing biases, it’s important to also discuss the role of racism in public health.
A literature review published in the Social Science and Medicine journal found that racism does exist in the US healthcare system and was found in the overall healthcare institution as well as individual physicians and clinicians.
Researchers found that racism affected minorities’ abilities to seek and access health care. It also played a role in the quality of care minorities received from physicians.
Another study found that a significant number of medical students held false beliefs about the differences in the way Blacks and Whites feel pain. This racial bias directly contributed to differences in the treatment Black patients received for pain management.
There are many other examples in the scientific literature that explores the role institutionalized racism plays in the healthcare system.
“Government and institutional laws, policies and practices guide resources away from these (minority) communities. We see this reflected in healthcare, neighborhood conditions, and job opportunities, to name a few,” Dr. Lehrman says.
It’s essential that these overarching factors are included in any report on health disparities.
Dr. Bowens has more specific advice for reaching the Black community: “As an African American myself, I am seeing growing distrust in science as we are seeing how great a role systemic racism plays in our society.”
She suggests partnering with local members of the community and providing accurate health information in the form of infographics to reduce this distrust of the scientific community.
What can health writers do?
As health writers, we have a responsibility to educate ourselves and others about the social and environmental factors that increase health disparities in minority communities.
Continued unbiased reporting that spotlights the effects of health disparities in underserved communities is needed.
It is no longer enough to write about health issues in broad general terms, we must dig deeper and present the ‘why’ behind health facts and statistics. Ignoring the systems in place that perpetuate these inequities would be to ignore our calling as health writers.
We have the ability to bring attention to the unique challenges Black and Brown communities are facing while dealing with the pandemic. Now is the perfect time to do so. The whole world is listening.
Related: Check out our piece on Black pioneers in medical writing here >
