Social Determinants of Health, COVID-19, and minorities – how they’re connected

Over the past several months, we’ve highlighted the topic of the Social Determinants of Health.  For the sake of review, these are the environmental and social factors that affect our overall health.  Where we live.  Access to quality food, healthcare, and education.  Our relationships.  And research has shown that these factors have a greater effect on our health than our genetics.

The recent events in our country (and world) have shed light on these realities in a very real and visible way.  And while the topics of the effects of COVID-19 and racial inequity and inequality may seem mutually exclusive, there’s evidence to support the fact that they are very much related.

The Center for Disease Control has provided a great resource that looks specifically at the issue with its report on COVID-19 in Racial and Ethnic Minority Groups.  This resource speaks directly to how the Social Determinants of Health have played a significant role in the effects of COVID-19 on minority groups on a national level.  Additionally, the Vanderburgh County Health Department has provided ongoing updates on COVID-19 with racial and ethnic breakdowns as well as geographic breakdown (by zip code).
If we look at these two resources together, coupled with what we know of the Social Determinants of Health and Health Equity, we start to see a compelling picture.

For instance:

The Vanderburgh County Health Department reports that, of the total population of Vanderburgh County, 85.8% are white and 9.7% are black.  Of the 362 confirmed cases of COVID-19 in Vanderburgh County (as of June 24), 64.6% are white residents and 23.8% are black.  Why is it so disproportionate?

The CDC sheds some light on that. “Health differences between racial and ethnic groups are often due to economic and social conditions that are more common among some racial and ethnic minorities than whites. In public health emergencies, these conditions can also isolate people from the resources they need to prepare for and respond to outbreaks.”

Living Conditions – “Members of racial and ethnic minorities may be more likely to live in densely populated areas because of institutional racism in the form of residential housing segregation. People living in densely populated areas may find it more difficult to practice prevention measures such as social distancing.” (CDC)

Work Circumstances – “Nearly a quarter of employed Hispanic and black or African American workers are employed in service industry jobs compared to 16% of non-Hispanic whites.”(CDC)

Underlying health conditions and lower access to care – “Compared to whites, Hispanics are almost three times as likely to be uninsured, and African Americans are almost twice as likely to be uninsured. In all age groups, blacks are more likely than whites to report not being able to see a doctor in the past year because of cost.” (CDC)

If we isolate the 47714 zip code of Vanderburgh County, we can see that it accounts for less land area than most of the other counties; however, it has the highest concentration of residents of all of the zip codes at 33,635.  Of these residents, 73.5% are white and 13.4% are black.  47714 also has the highest number of confirmed cases with 100.  The next most populous zip code, 47713 has 30,759 residents with 49 confirmed cases.  The 47714 zip code is densely populated and has a larger minority population as compared to the county overall and, according to the CDC, these minority residents are more likely to have living, work, and healthcare circumstances that make them more susceptible. 

This is just some of what we can take away from the resources that are provided to us.


This matters because…

Effective action requires understanding.  By understanding how threats, such as COVID-19, affect people differently, we can begin to shape unique, equitable approaches to addressing the needs.

Please take some time to take a look for yourself.


Resources
Vanderburgh County Health Department COVID-19 Data Dashboard
CDC: COVID-19 in racial and ethnic minority groups
WBF Advocacy Blog