'Pandemics do not cause inequities, they unmask them:' American Kidney Fund Congressional Briefing on COVID-19 Impact on Communities of Color Tackles Social Determinants of Health

ROCKVILLE, Md. (September 25, 2020) — Bringing together an all-star panel of health and policy experts, the American Kidney Fund's (AKF) Sept. 16 Congressional briefing focused on factors that have contributed to the disproportionate impact of COVID-19 on communities of color. The briefing — COVID-19, Health Disparities and the Social Determinants of Health — explored the dramatically higher rates of coronavirus infections, hospitalizations and deaths among people of color and those with end-stage renal disease (ESRD, or kidney failure), and how addressing the social determinants of health is part of the solution to tackle these health disparities.

"Unfortunately, the health disparities that we see in kidney disease are mirrored in what we now see happening with COVID-19," said LaVarne Burton, AKF president and CEO. "The impact of COVID-19 on minority populations and ESRD patients is not unexpected given the higher rates of hypertension and diabetes in our communities as well as heart disease and other multiple chronic conditions that make a person more vulnerable to COVID-19 complications, hospitalizations, and, sadly, even death."

U.S. Rep. Nanette Diaz Barragán (D-CA-44) discussed the social determinants of health that contribute to poor health outcomes in communities of color. Earlier this year, she introduced H.R. 6561, Improving Social Determinants of Health Act of 2020.

"We must examine the social, economic, and environmental factors that drive this inequality, such as poor housing conditions, food insecurity, fewer transportation options, and lack of educational opportunities," Rep. Barragán said. "Scenarios like these are also some of the reasons why we see a lack of access to care, and are some of the reasons why we have health disparities between underserved communities and more affluent areas."

Moderated by former Congresswoman and current AKF Trustee Dr. Donna Christensen (D-VI), the panel focused on the many non-medical factors that contribute to poor health in communities of color. Dr. Christensen noted that racial and ethnic minorities tend to be concentrated in high-poverty areas with substandard investment in education, which she noted is the best way out of poverty.

"One of the ways to address health disparities is to have more health care providers that speak and look like the people that they are taking care of, and we're not doing much to correct that," Dr. Christensen said. "Even today, we are seeing racial bias influencing health care and health outcomes for people of color."

 Dr. Eduardo Sanchez, chief medical officer for prevention for the American Heart Association, discussed the underlying conditions that put people at increased risk of severe COVID-19. "COVID-19 is affecting people in the United States in very unequal ways," said Dr. Sanchez. "Chronic kidney disease is at the top of the risk factors, and then conditions that are related to, live with and are associated with chronic kidney disease — obesity, serious heart conditions, type 2 diabetes." The disproportionately high rates of these diseases among racial and ethnic minorities may be compounded by their similarly disproportionate representation in "essential" jobs that cannot be done from home during the pandemic, living in crowded housing conditions, lacking health insurance or being underinsured, and living in the U.S. without proper documentation. These factors present clear barriers to medical care.

Noting that CDC data clearly shows the rate of both COVID-19 hospitalizations and deaths among Blacks and Latinos are dramatically higher than for white Americans, Dr. Oliver Brooks, immediate past president of the National Medical Association and chief medical officer of Watts Healthcare, noted that factors like health insurance, living in neighborhoods with more pollution and less access to healthy food, and jobs that cannot be done from home make racial and ethnic minorities more vulnerable during a public health emergency.

"Pandemics do not cause inequities, they unmask them," Dr. Brooks said. "The three reasons are social determinants of health, racism, and preexisting, or underlying conditions. There is a thread that connects all of them."

In hot spot counties with the most cases of COVID-19, the Latino community is the largest minority group with a disparity in cases identified, said Sindy Benavides, CEO of the League of United Latin American Citizens (LULAC).

"When we look at work and unemployment, we know that 5 out of 6 Latinos have to leave the house every single day to work and get paid," Benavides said. "We are the essential workers of America. Latinos are over one-quarter of all grocery store workers, we are over 40% of meat packing workers, and we are over 85% of all farm workers."

Patrick Gee, who is an AKF Ambassador and a kidney transplant recipient, received a sudden diagnosis of kidney failure. "In underserved, undervalued and disenfranchised communities, there are no educational materials being circulated," he said. "Everybody wants to live healthy, but how can you live healthy when you aren't given any opportunities to do so?"

The entire briefing is available for viewing on YouTube.

The Congressional briefing was part of AKF's Kidney Action Week, a first-of-its-kind event in the COVID-19 era, focusing on kidney health, kidney disease awareness and prevention, and the link to COVID-19.