Racism and COVID-19; Nurses in Politics; Combat Social Determinants
Institutional Racism Influences Coronavirus Pandemic, Fauci Says
A multitude of factors influenced by institutional inequality (https://thehill.com/homenews/state-watch/491518-black-latino-communities-suffering-disproportionately-from-coronavirus), such as underlying health conditions and employment opportunities (https://www.ons.org/podcasts/episode-107-social-determinants-lead-unequal-access-health-care), are to blame for the COVID-19 coronavirus’s disproportional effects on African Americans, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said. His remarks were part of a June 23, 2020, testimony before the House Energy and Commerce Committee.
“Because of economic and other considerations, the jobs that the majority of them would find themselves in does not allow them to protect themselves by looking into a computer and doing telework," Fauci said. “Complications and death relate very strongly to the prevalence and incidence of underlying comorbid conditions, which are clearly more expressed in the African American population than the rest of the population.”
Black Medicare patients were four times more likely to be hospitalized with COVID-19 than their white counterparts, NPR reported on June 22, 2020 (https://www.npr.org/sections/health-shots/2020/06/22/881886733/black-medicare-patients-with-covid-19-nearly-4-times-as-likely-to-end-up-in-hosp). Hispanics were twice as likely to test positive for the virus, and Asian Americans were about 50% more likely.
"We need to recognize the urgency in this moment to expand how we think about health care's role in promoting health," Marcella Nunez-Smith, MD, MHS, director of the Equity Research and Innovation Center at Yale School of Medicine, said (https://www.npr.org/sections/health-shots/2020/06/22/881886733/black-medicare-patients-with-covid-19-nearly-4-times-as-likely-to-end-up-in-hosp). "As physicians and healthcare delivery systems, we need to prioritize addressing our patient's health-related social needs such as food and housing."
ONS condemns racism (https://www.ons.org/ons-condemns-racism) and urged healthcare professionals and legislators to acknowledge the connection between systematic racism and health disparities. Learn more about how you can support and advocate for (https://voice.ons.org/topic/patient-advocacy) patients of all backgrounds.
Nurses Assimilate Into Politics, Promote Healthcare Advocacy
Nurses need to stand up and be counted—or better yet lead (https://voice.ons.org/news-and-views/every-year-is-the-year-of-the-nurse?utm_source=hl&utm_medium=email&utm_content=Advocacy_Health_policy&utm_campaign=articles_of_interest)—in both the policy and political worlds. And some nurses across the country (https://www.elle.com/culture/a32934526/nurses-running-for-office-phara-souffrant-forrest-lori-feagan/) are doing just that: taking their expertise and their oath to the public environment. They are putting their names on the dotted line and announcing their candidacy. First, they save lives, but now they have the potential to save America. We all can model their example and take action in our own communities.
- Rep. Lauren Underwood (https://underwood.house.gov/) (D-IL), an RN, was elected to Congress in 2018.
- Phara Souffrant Forrest (https://pharaforassembly.com/), a maternal child health nurse, is running for state assembly in Brooklyn.
- Jennifer Holm (http://www.mankatoclinic.com/jennifer-holm-aprn-cnp), APRN, CNP, a neonatal intensive care unit (ICU) nurse and California Nurses Association board member, sits on her local school board.
- Lori Feagan (https://www.spokesman.com/stories/2019/dec/18/nurse-practitioner-lori-feagan-running-as-democrat/), ARNP, a nurse practitioner and former ICU nurse, is running for state legislature in eastern Washington State.
“Nurses are uniquely suited to tackle healthcare policy—something voters say is their top concern in poll (https://thehill.com/hilltv/rising/474327-voters-name-health-care-as-top-issue-going-into-2020) after poll (https://www.politico.com/news/2020/02/19/poll-health-care-election-115866),” Rebecca Nelson reported (https://www.elle.com/culture/a32934526/nurses-running-for-office-phara-souffrant-forrest-lori-feagan/).
Only two nurses currently serve in U.S. Congress: Underwood and Rep. Eddie Bernice Johnson (D-TX), who was the first RN elected to the body in 1992.
“A nurse is a trained public advocate,” Forrest said (https://www.elle.com/culture/a32934526/nurses-running-for-office-phara-souffrant-forrest-lori-feagan/). “If I see something wrong with the patient, or the house that the patient lives in, or the school, or the community, or the state that the patient lives in (https://www.ons.org/podcasts/episode-107-social-determinants-lead-unequal-access-health-care), that’s all in the scope of my practice.”
Learn more about how you can secure the future of oncology care (https://voice.ons.org/news-and-views/the-future-of-oncology-care-depends-on-you?utm_source=hl&utm_medium=email&utm_content=Advocacy_Health_policy&utm_campaign=articles_of_interest) and promote health policy reform through the ONS Center for Advocacy and Health Policy (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy?ref=RO).
Solidarity Is Key to Eliminate Social Determinants of Health
Nurses know social determinants of health affect cancer outcomes (https://voice.ons.org/advocacy/nurse-explains-how-socioeconomics-may-influence-cancer-outcomes?utm_source=hl&utm_medium=email&utm_content=Advocacy_Health_policy&utm_campaign=articles_of_interest). However, as Donald Berwick, MD, MPP, wrote (https://jamanetwork.com/journals/jama/fullarticle/2767353), Americans need to shift their morals before the country can make any sustainable progress in addressing inequal access to health care.
Berwick pointed out two simple solutions to the systematic racism in U.S. health care:
- Raise taxes to allow governments to improve social determinants.
- Move a substantial fraction of health expenditures to focus on addressing social determinants.
“Either is logically possible, but neither is politically possible, at least not so far,” Berwick said. Therefore, “the power of these societal factors is enormous compared with the power of health care to counteract them.”
Americans can succeed in this shift only if the nation embraces moral determinants of health, such as solidarity.
“‘Solidarity’ would mean that individuals in the United States legitimately and properly can depend on each other for helping to secure the basic circumstances of healthy lives, no less than they depend legitimately on each other to secure the nation’s defense,” Berwick said. “If that were the moral imperative, government—the primary expression of shared responsibility—would defend and improve health just as energetically as it defends territorial integrity.”
ONS offers an array of resources on social determinants of health. Listen to a recent podcast (https://www.ons.org/podcasts/episode-107-social-determinants-lead-unequal-access-health-care?utm_source=hl&utm_medium=email&utm_content=Advocacy_Health_policy&utm_campaign=articles_of_interest) episode, review ONS Voice articles on cancer health disparities (https://voice.ons.org/topic/cancer-health-disparities), and get involved (https://voice.ons.org/advocacy/get-involved) with ONS’s advocacy efforts.