Health disparities and COVID-19: Q&A with Dr. Andrea Willis

Dr. Andrea Willis

COVID-19 has left no community untouched. Infecting more than 1 million Americans and resulting in the deaths of more than 75,000 people as of May 8, the coronavirus has taken an especially dramatic toll on African Americans and other communities of color.

While the nation still lacks complete racial data on COVID-19 patients, according to the latest data where race was provided, African Americans accounted for more than one-third (33%) of COVID-19 deaths in the U.S., yet make up only around 13 percent of the population.

This disproportionate impact is seen here in Tennessee, too. Despite comprising only 17 percent of the population, African Americans represent 21 percent of COVID-19 cases and roughly 31 percent of deaths across the state, according to the latest data available.

These startling numbers highlight the troublesome nature of health disparities in our country. Simply put, when compared to white Americans, racial and ethnic minorities often face higher rates of illness and worse health outcomes whether from more common ailments such as diabetes or the novel coronavirus (COVID-19).

As part of her ongoing educational series on the COVID-19 pandemic, Dr. Andrea Willis, senior vice president and chief medical officer at BlueCross, explains some of the factors driving health disparities and what you can do to protect yourself and others who may be vulnerable.

Why is coronavirus impacting African Americans at such high rates?

  1. African Americans have higher rates of pre-existing conditions. Regardless of race, this disease is known to have a greater impact on those with underlying health conditions. According to the Centers for Disease Control and Prevention (CDC), diabetes, heart disease and long-term lung problems are the most common health conditions among Americans hospitalized with COVID-19. African Americans suffer from those health conditions at a higher rate than other groups, making them more vulnerable to the more severe impacts of this respiratory illness. Even when it’s well controlled, a pre-existing condition means the body is expending energy to lessen its impact. When those health issues are not well managed, the body is fighting a potentially losing battle – and coupled with COVID-19, the odds are stacked even greater.These COVID-19 health disparities – often referred to as the “crisis within a crisis” – cause additional stress to the body, which also negatively affects the immune system, at a time when we need our immune systems to function optimally.
  2. African Americans and other minorities are less likely to be able to work from home. African Americans and Hispanics hold a disproportionately higher rate of essential roles that require in-person interaction. Jobs like emergency workers, bus drivers, grocery store clerks, cleaning crews, delivery staff, and nurses are on the front line. They’re often more exposed to others who may be infected, or who are not practicing infection prevention recommendations. Many African Americans hold hourly positions and may not have health benefits or paid sick leave, making it more challenging to seek health care when sick or suffering from chronic conditions.
  3. African Americans’ housing challenges may contribute as well. Social determinants – the circumstances in which people are born, grow, live, work, and age – have a major impact on health outcomes, especially for those in vulnerable communities. For example, African Americans and other racial minorities are more likely to live in densely populated areas, and people living in high population cities and in multi-residence properties may find it harder to practice social distancing. African Americans are also more likely to have multiple generations living together in one home. Younger members of the family who are working among the public in essential jobs may unintentionally bring the virus home and expose more vulnerable elderly relatives. Overall, these living situations lead to a higher risk for spreading coronavirus due to the greater potential contact with other people.

What is BlueCross doing to help lessen the burden in vulnerable communities?

The COVID-19 pandemic is exposing health disparities that exist among minority communities. As we’ve discussed, there are a lot of complicated reasons for that. One is that some members of the African American community may resist seeking care due to their distrust of providers, the health care system, and historical mistreatment. We’ll continue working to gain their trust by partnering with our provider network across the state to make sure culturally competent care is the standard and to bring better health to all the people we serve in Tennessee.

We’ve also offered enhanced support to vulnerable communities by:

  • Educating community members on cost-effective COVID-19 testing available through local health departments
  • Providing funds through the BlueCross Foundation to support free testing for the uninsured population in Memphis
  • Texting online resources from the CDC to BlueCross insured people who are high-risk and face social or health care disparities
  • Proactively calling BlueCross members who fall into certain high-risk categories to discuss safety precautions

We believe the best approach to maintaining health is an active one — we encourage everyone to build a relationship with a primary care physician (PCP) even before one is facing a health problem. For those who may not have an established PCP relationship, there will soon be additional options available to help make primary care more accessible and convenient. BlueCross has entered a joint venture with Sanitas to open eight medical centers in Middle and West Tennessee this fall with extended hours, to foster an environment for consistent care.

 

What should people do to protect their health?

  • Focus on your chronic conditions, even during this pandemic. Continue to maintain preventive care routines and follow-up appointments with health care professionals, even if it’s through telehealth. These virtual services are covered by insurance plans such as BlueCross and provide quality care from a certified physician from the comfort and safety of your home, 24/7. And regular follow-ups are one tool to fight against worsening uncontrolled conditions like hypertension and diabetes, the “silent killers.”
  • Be intentional about getting or staying physically active.
  • Eat a diet that includes fruits and vegetables.
  • Get plenty of rest or sleep.
  • Wash your hands with warm soapy water for at least 20 seconds.
  • Even with businesses starting to reopen, continue to practice physical distancing and wear masks and gloves in public places.
  • Disinfect surfaces in the home frequently.
  • Go to CDC.gov and use the symptom checker if you think you may have COVID-19 symptoms.  The symptom list has now been expanded by the CDC to include fever, shortness of breath, difficulty breathing, chills, shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell.

If you follow this guidance, you can help limit the spread of coronavirus. For ongoing updates about the BlueCross response to COVID-19, visit BCBSTupdates.com. Please visit the Tennessee Department of Health for the most recent data on COVID-19.

 

Dr. Andrea Willis, SVP, Chief Medical Officer, BlueCross BlueShield of Tennessee

Dr. Willis ensures that all clinical care and quality initiatives support the needs of BlueCross members, and contribute to the overall health and well-being of Tennessee communities.

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