EAU CLAIRE — As the number of Americans dead from COVID-19 reached 200,000 this week, the past several months have shown that disparities exist regarding health outcomes.
According to the Centers for Disease Control and Prevention, as of Aug. 18, Black Americans were 2.1 times more likely to die from COVID-19 than white Americans. That is not because of genetic differences, but rather because of social determinants of health. Those factors include income, living conditions, housing insecurity, access to health care and jobs requiring in-person work.
To address those issues, Dr. Mark Wieland, a Mayo Clinic internal medicine physician, discussed his recent work and answered questions during a media availability Tuesday afternoon. Wieland talked about inequitable health outcomes he’s seen, how to communicate with vulnerable groups and the opportunity the country has to combat systemic racism.
Communication plays a role in decreasing COVID-19 inequities.
Wieland, who is based in Rochester, Minnesota. is involved with a program that provides accurate and timely COVID-19 information to people in underserved groups such as non-English speakers. The Rochester Community Health Partnership has over 25 community leaders communicating COVID-19 updates in six languages to people in Minnesota while also asking community members what is happening where they live.
Wieland said those two directions of communication are crucial. There are several similar programs around the country, including in Mississippi and Florida, and he believes the program can be done anywhere.
“We think it’s a scalable model,” Wieland said.
He said the RHCP works because community leaders are trusted by the people with whom they communicate. The most important aspect involves personal interaction and gaining trust before a health emergency like COVID-19 occurs, so that when problems occur there are trusted people to communicate what to do next. Communication can occur via social media, phone call, email, text message or video.
In addition to consistent and reliable messaging from trusted people, Wieland said hopeful and empathetic messages work better than fear-inducing talking points.
“It’s fundamentally a human experience, and it’s based on interactions that are entirely human,” Wieland said. “Trust is based around that and empathy ties in with that. Without hope and empathy, we just become one more series of talking heads.”
Wieland said COVID-19 information seemingly “changes by the minute” so it is crucial to send accurate, timely updates. It can be tough to match “the frenetic pace of the facts on the ground,” which is why consistent messaging from a trusted human is vital.
Combatting false or misleading information is important as well, Wieland said. Examples of misinformation include supposed home remedies that deal with COVID-19 and conspiracies about the origin of the virus.
In recent months, the most common questions from underserved groups that work with RHCP have addressed a potential vaccine. Wieland said some people have expressed potential hesitation to take a vaccine because of undue political influence.
“There is some reticence relative to, ‘I don’t want to be the guinea pig. This vaccine is being rushed and politically motivated and so I don’t want to be any part of that,’” Wieland said.
Wieland said structural racism has contributed to COVID-19 inequities. The coronavirus has similar outcomes to long-term health issues like diabetes and hypertension but has occurred on a quicker, larger level.
“Structural racism is foundational to the disparities that we’re seeing,” Wieland said. “This is a highly concentrated example of that playing out, so it really lays bare the structural inequities that were put in place by design.”
Short-term solutions to address these issues involve more comprehensive testing and contact tracing. Wieland said putting resources in lower-income neighborhoods to gain a better sense of infection and death rates can help. In the long term, Wieland hopes there will be an equitable distribution when a vaccine is available on a wide scale.
Despite all the work that’s being done, Wieland worries that COVID-19 inequities will become worse as time continues.
“Because it’s such a fast-moving shift and at such a great scale, I worry that it’s not enough,” Wieland said.
To work toward fewer health inequities happening in the future, Wieland said it is crucial to address “upstream factors” like the legacy of housing disparities through redlining.
“The COVID crisis provides an opportunity to collectively act on the root causes of these fundamental inequities that have been demonstrated by the pandemic,” Wieland said.