The Downward Spiral of Health Inequality – And What We Can Do to Prevent It

Written by: Ricky Illindala

Designed by Annie Liu

America is knee-deep in combating the dangerous threat posed by COVID-19. The coronavirus pandemic is currently testing the government’s ability to protect its people and has thrown nearly all Americans’ lives into disarray. Most of us desire a return to normalcy; a life where we can go about our daily routines without fear of catching a life-threatening virus at any time. However, for some people, their lives have been riddled with impending difficulties stemming from their inherent disposition prior to this pandemic. 

People of lower socioeconomic status (SES) have been burdened with poor health and a lack of healthcare access in recent years. These groups face more health problems while receiving less healthcare, an obstacle referred to as health inequity. The current coronavirus pandemic only serves to highlight those inequities. 

Therefore, while the pandemic deserves much of our attention right now, we should also pay attention to healthcare inequity in order to lessen the damage that this pandemic and future health crises can cause.

According to 2017 United States Census Bureau data, the median household income was $68,145 for white people while it was $50,486 and $40,258 for Hispanic and Black people respectively. Furthermore, according to 2017 educational attainment data, 34.2% of White adults have a high school degree or less while 60.5% and 44.9% of Hispanic and Black adults, respectively, have a high school degree or less. Those identifying as Black and Hispanic people generally have lower incomes and less education attainment than White people. If we also take a look at the CDC data on COVID-19 hospitalization rates per 100,000 population, white people have a rate of 40.1 while Black and Hispanic people have rates of 178.1 and 160.7, respectively. The income and education statistics above correlates well with the significantly higher hospitalization rates for Black and Hispanic people compared to White people. 

According to Dr. Samuel Dickman, at the University of California, San Francisco, low SES individuals are particularly vulnerable to poor health conditions. When these Americans fall into bad health, the minimal availability of healthcare resources for them enables their health to worsen. As the healthcare industry pushes resources into well-performing hospitals in affluent areas, poor Americans have no means of securing the health care they need. As their health worsens, they can’t work, thus making it increasingly more difficult to afford necessary medications or treatments. This leads to a downward spiral that traps Americans in a cycle of poor health and poverty. Ultimately, this further stresses both the US economy and healthcare system as low SES groups develop complex conditions and are unable to work. It is in all of our best interests to advocate for healthcare equity. 

While the coronavirus has illuminated such issues of healthcare inequity and health disparity, they have been haunting the US for many years now. Consider, for example, patterns of chronic conditions affecting minority groups.  A report conducted by the National Academy of Medicine indicated that minority groups, when compared to white persons, have limited access to appropriate cardiac care, kidney transplants or dialysis, and quality treatments for stroke, cancer, or AIDS. While these conditions are currently affecting less people than the coronavirus, they are still causing avoidable deaths that stem from a lack of proper healthcare for lower SES citizens. 

Now that we know about the level of inequality in our healthcare system, what can we do with this information? Federal and state governments determine policies that dictate access and affordability of healthcare. You can have the government hear your voice by spreading awareness of healthcare issues in your local community, voting in local and federal elections, and reaching out to local government officials regarding your concern for healthcare inequality. If patiently waiting for change in government policies does not suit you, there are still plenty of other pathways to take action and create change. 

There are plenty of community-based organizations (CBO), such as the National Collaborative for Health Equity, that we should join and get involved with. CBOs like the National Collaborative have infrastructure and opportunities set up to promote health equity, making them a great opportunity to get engaged immediately. Being a part of one of these groups can serve as a guide for those who want to be active in their community but are not sure how. 

Those in or aspiring to be in healthcare jobs (physicians, pharmacists, nurses, healthcare management, etc.) should also use their unique position to influence the healthcare industry. You should express your concerns for healthcare inequality among your peers and interact kindly with patients of different classes and identity. The causes of inequity ultimately stem from people’s mindsets. If everyone who enters a healthcare job can care for their patients’ health and identity, we can transform the general mindset of the industry to care for all people, regardless of identity. 

Even if the above options are too complex or demanding, we owe it to each other to take on the following fundamental duty: enact real change by altering the way we treat each other. Health disparities are rooted in long-standing beliefs of privilege and bias. If we all, little by little, day by day, open our minds up to people of different races and social classes, we can gradually drive out the poisonous ideals that promote inequality in our society. 

Edited by Rena Lenchitz

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