COVID-19: The Health Inequity Magnifier

本周,BMC肾脏病社论顾问Deidra Crews博士讨论了美国的Covid-19-19如何在该人群中对长期健康不平等的看法放大了。

The COVID-19 pandemic and efforts to mitigate its spread have affected people across the entire world—but not equally. Many of the same groups of individuals known to suffer a disproportionate burden of poor health outcomes are faring especially poorly during this pandemic. In many ways, the disparate outcomes being documented in COVID-19 are simply offering a magnified view of longstanding health inequities.

TheRobert Wood Johnson Foundationstated that “健康公平意味着每个人都有公平而公正的健康“. To achieve health equity, obstacles to health must be removed. Socially disadvantaged people, who have been historically marginalized and/or disfavored by social and political institutions, have faced significant obstacles to health equity in the midst of COVID-19.

To achieve health equity, obstacles to health must be removed.

Social distancing, a key recommendation for preventing the spread of COVID-19, has proven to be very difficult for socially disadvantaged persons. Housing insecurity and homelessness are established risk factors for chronic health conditions, includingkidney disease。在Covid-19的环境中,这些挑战意味着许多人不能可行地维持与他人的建议物理距离。此外,对于需要他们每天与公众互动的服务专业人士,他们的社交距离能力也受到了挑战。在此类职业中,种族和少数民族和低收入人士的人数过多,这增加了他们的共同风险。

For people who have sought testing for COVID-19, inequities in health care access and services have been on full display.One report指出,与具有相同症状相同的白人相比,具有COVID-19的潜在症状(例如咳嗽和发烧)的非裔美国人患者不太可能接受Covid-19测试。这种偏见的保健服务可以导致稍后出现的社会弱势个人(例如,住院),症状严重甚至death。As vaccines and treatments for COVID-19 are developed and disseminated, individuals who have directly, or vicariously, experienced bias in the health care setting may be reticent to seek these options, out of fear of inequitable treatment.

COVID-19 mitigation efforts have led to shortages of food in many communities due to store closures as well as bulk purchases by individuals who can afford to do so. Low-income communities have been particularly affected. A consequence of structural inequities including residential segregation, food access isknown to varyby community demographics. In this pandemic, diet-sensitive health conditions such as diabetes, hypertension and kidney disease, may be exacerbated, particularly for persons facingfood insecurity

解决方案for addressing the inequities magnified by COVID-19 have been offered and include expanding access to testing and health care, and providing social services to keep vulnerable groups safe. People with kidney diseases are particularly vulnerable to COVID-19 infection, hospitalization anddeath。Because many are alsosocially disadvantaged,评估和扩展提供的服务,包括满足社会需求的服务将非常重要。

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