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Covid-19 Illustrates How Racial Inequities Affect Health Outcomes

Proceedings of the National Academy of Sciences
Medical sample estimated mean pain ratings and treatment recommendation accuracy as a function of false belief endorsement (plotted 1 SD below and above the mean). (A) Average pain ratings (pain rating scale: 0 = no pain; 10 = worst possible pain).

In North Carolina today, people of color face inequities that affect their health and their vulnerability to diseases like Covid-19.  CDC and North Carolina Department of Health and Human Services data show that minorities now represent a disproportionate number of both Covid-19 cases and fatalities.  Social factors and implicit bias play a significant role. 

Less than 200 years ago, American physician J. Marion Sims conducted medical experiments, including surgeries, on enslaved people without anesthesia.  The prevailing medical belief at the time:  blacks experienced less pain than whites. 

But according to a 2016 study published in the Proceedings of the National Academy of Sciences, false beliefs about biological differences between blacks and whites still inform medical judgments including tolerance for pain. 

Leah Mayo, Coordinator of the Center for Healthy Communities at UNCW, says change will require a team-based approach and asking the patient the right questions. 

"So, diabetes, for example, if you’re just meeting with the physician, they may wonder well, why can’t you manage your diabetes?  And it’s because they’re not asking those questions – like, do you have housing?  Do you have food? 

"But if you have a social worker or public health person in that space, they could potentially field those questions and help connect that person to resources."

The novel Coronavirus does not target people of color because of any genetic predisposition.  It’s social determinants of health -- housing and food insecurity, lack of quality health care, and these implicit biases -- among other factors that make minorities more vulnerable.


North Carolina Social Determinants of Health by Region