As coronavirus cases in North Carolina continue to rise, researchers and health officials are expressing concerns for at-risk groups – and that means more than just the elderly population.
Dr. Giselle Corbie-Smith is a UNC Professor of Social Medicine, the Director of the Center of Health Equity Research and a Professor of Internal Medicine. She is recognized for her work on the practical and ethical issues of engaging communities in research to achieve health and equity.
She said the impact of health disparities on minority groups and at-risk populations during the pandemic is a complex issue. These populations can include Latinx communities, people of color, incarcerated citizens, indigenous peoples, and those living in rural areas.
Corbie-Smith said one of her biggest concerns is that these vulnerable populations with chronic illnesses are not being cared for.
“The things that put people at risk for morbidity like hypertension, cardiovascular disease, diabetes and other chronic illnesses are issues that we need to be addressing now,” Corbie-Smith said. “Also making sure people are in care so those issues don’t become more burdensome as this pandemic continues to evolve.”
She said race and ethnicity are a big determinant of at-risk populations, but the reporting of COVID-19 rates by race are complicated by several factors.
“In all healthcare settings, we have incomplete data on race and ethnicity,” Corbie-Smith said. “In the setting of a pandemic, where there might be distrust of the medical system or the testing might be happening in places where it’s difficult to be able to collect that data – all of these things lead to incomplete data and people might be less willing to report incomplete data.”
She said misclassification also throws off the data, especially when reporting groups like Native Americans – who have less access to care in rural communities.
Corbie-Smith said, when looking at data and rates of infection, those in poverty and low-income households pre-pandemic are more likely to be exposed to the virus. Additionally, as many front-line workers consist of minorities, that further increases their odds of exposure. That also means that those who live in multi-generational households are predisposed to spread the virus to the rest of their family.
She said we’ve seen how these congregate living settings are more prone to outbreaks through data from nursing homes and prisons, where the ability to social distance is limited.
“When we look at congregate settings – when we look at nursing homes and imprisoned populations – this is huge,” Corbie-Smith said. “Not only for the people who are imprisoned, but also those who are working those prisons.”
As we continue to address these minority and disadvantaged groups mid-pandemic, Corbie-Smith said it is critical that we have enough multilingual contact tracers and expand telehealth options for all patients as this pandemic isn’t over.
“I think it would be dangerous to underestimate how much this pandemic is still raging on,” Corbie-Smith said. “We are not out of the woods yet. We have loosened some of the restrictions, but we are not out of the woods.”
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