Call To Change: Ending Racial Health Disparities

By:  ERICA E. TAYLOR M.D.|

We are inundated daily with updates about the continued spread of COVID-19, which has left the nation uncertain of the vaccine’s authentic effectiveness. While information regarding treatment and prevention of COVID-19 is constantly evolving, hesitation about the vaccine remains. And with fair reason for some segments of the population.

A historical distrust of the government and healthcare system emanates from a marred past of injustices inflicted by individuals who have taken the oath to do no harm.  Black people continue to be ravaged by COVID-19, as well as by underlying chronic diseases like hypertension, diabetes, obesity, and heart disease. Despite advances in treatment, the Black community continues to die at a higher rate even when a condition is preventable. The lack of equitable medical treatment is pervasive in our society, and the most insurmountable obstacle we face is that of structural racism which reared its ugly head during the COVID-19 pandemic. Vaccine hesitancy is a significant barrier to Black people being vaccinated, but that distrust is not anything new. It comes from years of oppressive tactics against Black people by the federal government and health care system.

Take the well-known “Tuskegee Study of Untreated Syphilis in the Negro Male”. The study enrolled 699 Black men in order to better understand the natural progression of syphilis. The men were enrolled in the study from 1932-1972 under the pretense of being treated for “bad blood”.  The men received free medical exams, free meals, and burial insurance in exchange for their participation. Researchers failed to provide treatment despite identifying a cure for syphilis in 1943. For decades, Black people were stripped of their human rights and subjected to inhumane experiments conducted by the U.S. government. Due to the Tuskegee Study, informed consent is now a requirement prior to enrollment in clinical trials. Black people voluntarily participated in the COVID-19 vaccine trials and were involved in the vaccines’ development.

Historically, Black people are underrepresented in clinical trials, however, the COVID-19 vaccine trial included more racial and ethnic diversity. Representation is important in instilling trust in the vaccine, however the fact that a Black woman, Dr. Kizzmekia Corbett was pivotal in the development of the vaccine does not outweigh the underlying structural racism for some individuals.

The structural racism highlighted during the pandemic is an age-old issue. Blacks are dying at an alarming rate. Despite the lives lost as a result of COVID-19 infection, the vaccination rates in the Black community continue to lag behind their white counterparts. The current vaccine uptake in the Chicago Black community is 60.9% for the first dose and just over half of the population has completed the vaccine series at 54.7 %. According to USA Facts, over 252M first doses have been administered in the U.S. with an estimate of 64.5% of the country being fully vaccinated. However, to put in more context for the Black community, only 41% of the population is fully vaccinated.  The impact is that those experiencing severe outcomes, such as hospitalizations and even death are among the unvaccinated.  Cities nationwide are taking significant steps to ensure vaccine equity— and Chicago is no exception. The Protect Chicago Plus program ensures the City’s vaccine distribution reaches the individuals and communities most impacted by COVID-19, especially Black and Latinx residents. The program works with community stakeholders to identify settings and groups where vaccine access will decrease COVID-19 transmission risk quickly.

A multi-faceted approach is necessary to overcome structural racism and increase vaccine uptake in Black Chicagoans. The conversation must shift from being one-sided to one in which there is a mutual exchange of ideas in an inclusive and respectful manner. The social determinants of health which impact the optimal health of the community must also be addressed. The concept of optimal health has been amplified in the Black community as a potential solution to fighting infection.  There has been a paucity of information on the benefit of vaccines coupled with sustaining a healthy lifestyle to combat the COVID-19 virus. I encourage people to get the vaccine and supplement it with a healthy and active lifestyle. The body needs to be equipped to fight against the virus by consuming nutritious foods, staying hydrated, being physically active, and sleeping 6-8 hours per night.

The reality is that we must address the racial health equity gap which predisposes Black people to more severe outcomes if they are infected with COVID-19. Underlying health conditions coupled with low vaccine uptake have led to higher death and hospitalization rates in Blacks. When I think back to January of 2021, I was initially reticent about receiving the vaccine. However, after arming myself with information from trusted colleagues and seeing the ever-increasing lives lost, I made the decision to protect myself and my loved ones.  If you are on the fence regarding vaccination, I implore you to follow the science, seek out a trusted healthcare professional with whom you feel you can openly discuss your concerns, and have your questions answered. Ultimately, the choice to receive the vaccines lies with you. I encourage you to arm yourself with good information as you make your decision.

 

About Dr. Erica E. Taylor

Dr. Erica E. Taylor is the Medical Director for Congregate Settings at the Chicago Department of Public Health (CDPH). She is passionate about advocacy, international health, and eliminating the persistent health care chasm that exists in marginalized communities. Dr. Taylor received her Bachelor of Arts in Pre-Medicine and Biology from Augustana College in Rock Island, IL. She is an alum of the Indiana University of School of Medicine and completed her residency in Obstetrics and Gynecology at Mercy Hospital and Medical Center in Chicago. Dr. Taylor is Board Certified in Obstetrics and Gynecology and holds a Master of Science degree in Preventive Medicine with an emphasis in Epidemiology from the University of Iowa.

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