Episode 2 – Health Disparities with COVID-19 and Beyond. What Can We Do to Equalize Care?
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Editor’s Note: Below is a lightly edited transcript of the podcast.
Welcome to the Treat Us Right Podcast. I am your host, David S. Williams, Founder and CEO of Karen Health Services. At Karen Health Services, we help you own, store, generate, access, and share your personal and family health information.
This is episode 2 of the Treat Us Right podcast and we’re coming to you from the Karen Health Services Home HQ. In our last episode, we discussed COVID-19 with Board Certified Emergency Physician Jabari Reeves who shared his views in the early days of the pandemic and how we could protect ourselves.
The entire world has changed since that episode in the first week of March. In what many people call the longest month of their lifetimes, March brought a cascade of extraordinary events.
On March 11, The National Basketball Association suspended its season after Rudy Gobert of the Utah Jazz tested positive. This action was followed by other major sports leagues and events—including the NCAA basketball tournaments—also known as March Madness for both men and women.
Schools began to close and then suspend classes for the remainder of the academic year at all levels from college to pre-school.
“Social distancing” as a term and a practice took hold of our collective consciousness as we as a people took action to reduce the spread of coronavirus.
Stay at home and Shelter in Place orders became the norm in most states. The hashtag StayHome began trending as people used social media to post their experiences while living in confined quarters. Cousin to social distancing was the concept of “flattening the curve” referring to the restricting the typically bell-shaped distribution of new cases over time to keep the number of total cases to a minimum.
Absolutely heroic healthcare workers have done their best to help those in need, even when overrun with patients and without personal protective equipment to keep them from catching the virus. We can’t thank them enough for their grit, stamina, dedication, sacrifice, and sheer will in the face of a global pandemic.
It is this world that is still ongoing with perhaps the first ray of light shining this week as the number of new cases and death rates begin to reduce.
Are we there yet? Are we at our destination? Not even close. We all need to remain diligent in the face of this novel virus. COVID-19 is changing our way of life and how we will interact socially, politically, and with the healthcare system.
It is on this point where I have to pause. The aggregate data on coronavirus, its spread, the response, and other metrics are definitely important. But just in the past week data has begun to emerge about who is getting COVID-19—by race. And the results are infuriating.
NPR: QUOTE: “New York City officials last week said black and Latino residents were dying at twice the rate of white people. In Chicago, more than 70% of virus-related fatalities were among African Americans — a percentage more than double their share of the population. Black residents in Milwaukee County, Wis., have seen similarly disproportionate rates.” UNQUOTE
The Atlantic: QUOTE: “the disparities between the size of the black population and the percentage of black people infected with, hospitalized with, or dead from COVID-19 appear to be the most severe. A Washington Post analysis found that majority-black counties had infection rates three times the rate of majority-white counties. A Centers for Disease Control and Prevention analysis of nearly 1,500 hospitalizations across 14 states found that black people made up a third of the hospitalizations, despite accounting for 18 percent of the population in the areas studied. An Associated Press analysis of available death data found that black people constituted 42 percent of the victims, doubling their share of the populations of the states the analysis included. In Louisiana, more than 70 percent of the people who have died so far from COVID-19 were black, more than twice their 32 percent share of the state’s population, and well above the 60 percent share of the population of New Orleans, where the outbreak is worst. In New York, African Americans comprise 9 percent of the state population and 17 percent of the deaths.” UNQUOTE
It seems that Black folks are dying at a rate DOUBLE our population representation in each community across the country. This begs the question of why?
At first it was my intent to explore this question from multiple perspectives. As a trained economist with my undergraduate degree from The Wharton School at Penn and my graduate degree from UCLA Anderson, perhaps the economy could shed light on why more African Americans were dying.
Sadly, the default narrative in the government and the media was the “black people don’t know how to act” argument.
I hope you didn’t see it, but the Surgeon General of the United States condescended so hard to people of color I won’t repeat his words here. Suffice it to say, it was ignorant on many levels. The goal was to encourage those wild, savage, outdoors-seeking black people to Stay at Home.
Economics is about behavior change and the monetary impact of said decision. Fortunately Pew Research did the homework for us.
From the Atlantic Article: Quote: “A national survey conducted by the Pew Research Center between March 10 and 16, long before racial disparities in infection rates were documented, found that black respondents, at 46 percent, were more than twice as likely as white respondents, at 21 percent, to view the coronavirus as a major threat to their own health. An additional 32 percent of black respondents considered it a minor threat. Slightly more white respondents (23 percent) than black respondents (21 percent) considered the coronavirus to not be a threat.
Days later, Pew and Dynata conducted a survey that again found that black people (59 percent) were significantly more likely than white people (44 percent) to be very concerned about their health during this pandemic.”
So if Black folks are more concerned than average about COVID-19, they’re more likely to follow guidelines, and be prepared. And we spend money to prepare ourselves! That can’t explain why more of us are dying.
So I’m going to have to combine the academic research and intuitive “I’m a black man in America” perspective:
Health disparities are caused by racial inequities.
Remember that Atlantic article? The Title of the article is this:
Title: Stop Blaming Black People for Dying of the Coronavirus
By: Ibram X. Kendi
Just let that title sink in for a moment given where we are as a nation.
How can we as black people defeat the institutional structures that cause such pronounced health disparities?
This is where having health information ready for any situation matters. Think of the profile of people most vulnerable to COVID-19. Seniors, people with pre-existing conditions including diabetes, heart disease, auto-immune conditions. Their care needs are very complex. And many people in the African American community have these pre-existing conditions.
If those most vulnerable are receiving care in emergency situations, then they need more than care for COVID-19 symptoms. The goal of emergency physicians, according to Dr. Reeves, is to stabilize the patient. Then they have to treat the whole person with complex care needs..
But how can doctors treat us right when they don’t have a full picture of our health history, especially when lives hang in the balance? With COVID-19 or any other situation, knowing a person’s health history, any pre-existing conditions, medications taken, and other critical information can reduce unintended errors while informing treatment plans.
But access to that health information is sparse. Our health information resides with each doctor we have—and if we have pre-existing conditions, we have multiple physicians.
What can we do?
We have to learn the lesson right in front of us from COVID-19 and that is to Be Ready for any health situation within our family—children, spouses, and parents. It could be an emergency or a regular doctor visit. For yourself or someone you’re caring for, you have to be ready.
Here are the four Karen Health Services “Be Ready” Recommendations:
1. Get Your Health Data from your doctors.
The data belongs to you by law. They have to give it to you for FREE. You can make the request by email.
In the email formally request a DIGITAL copy of your records. Sometimes doctor’s offices want to send it all on paper. Do not allow that.
Get your health records in a PDF format. It will be a lot of pages. Don’t let the size intimidate you. It’s better that you have your data in your possession.
2. Save Your Family Health Information in One Place
Children, Aging Parents, Spouses. You want all of it accessible from the same source.
And that source must be HIPAA-compliant. That means it meets strict government standards for privacy and security for healthcare information. Popular cloud-based services like iCloud are NOT HIPAA compliant so be sure to do your research.
Your data must be Mobile accessible. This is why you shouldn’t just save your health data on your computer. It has to be available to you anywhere, anytime.
3. Chart Your Health Experience Daily or Weekly
For Yourself and
Those you care for
This means documenting any symptoms you or your loved ones are having. It means marking the times when something unexpected happens like an allergic reaction, a fall, or a seizure.
4. Share Your Health Experience with Family and Care Team
Care Team: Control the flow of your data from doctor to doctor. You can own this process rather than waiting weeks for doctors to get approval, get your consent, compile the data, then send. If you hold the data, you can do this in minutes, not months.
Family: When you’re caring for aging parents especially, other family members want to be in the loop on what’s happening. By granting access to the health information, they are automatically kept up to date on progress and any changes.
If you have your health history, chart your current experience, then you can have a report to share with our care team. This will help your care team treat you right by providing all the information they need for better treatment planning.
If we do this for our families, the healthcare system will have the information it needs to give us the best care. To treat us right. With the disparities in care so well documented, right now with COVID-19 and beyond, we have to have a clear family health approach.
Remember when your parents told you that you have to be 10x better than everyone else just to get the same opportunities? This is just like that. We have to be at least twice as diligent about our health just to get equal care. The numbers prove it.
SUMMARY
We have to take care of each other. We have to use our family villages to ensure our health. Documenting our health experience is under our control. Only we can do it.
So let me leave you with this truth: The best way for the healthcare system to treat us right in every situation—emergency, doctor visit, physical therapy—whatever—is for them to have access to our current health status, health history, and symptom experience—at EVERY interaction. We can do this. This is my mission.
Thank you for listening to the Treat Us Right podcast, brought to you by Karen Health Services. To learn more about Karen, visit us at www.yeskaren.com. Join us next time as we explore more ways we can help the healthcare system Treat Us Right in our times of need—now with COVID-19 and beyond. Take care.