COVID-19 Pandemic Increased Racial Disparities in Medical Care

Danielle J. Johnson, MD, FAPA, chief medical officer, Linder Center of Hope, Mason, Ohio, answers questions about her session at the 2021 Psych Congress titled "Diversity and Cultural Competence: The Impact of “Dual Pandemics” on Women’s Mental Health". Her session explored the ways the COVID-19 pandemic and structural racism "have brought health care disparities to the forefront".

Dr Johnson, who is also an assistant clinical professor at the University of Cincinnati College of Medicine Department of Psychiatry and Behavioral Neurosciences, Ohio, says that medical mistrust has played a part in the disparities during the pandemic.

Question: In what key ways has the COVID-19 pandemic disproportionately affected people of color? ​

Answer: There are higher rates of cases, hospitalizations, and deaths in many communities. People of color are more impacted by job loss or loss of income, less likely to have jobs that allow working from home so are more exposed to COVID-19, and more likely to live in housing situations that do not allow for social distancing and quarantining. There is an increased rate of being underinsured or uninsured so access to care is limited.

Q: In what key ways has the COVID-19 pandemic impacted women of color’s access to medical care?

A: Similarly, there is an increased likelihood of job loss and decreased income, lack of access to medical care and depending on where one lives, decreased proximity to care.

Q: What is medical mistrust and how has it played a part in the disparities during the COVID-19 pandemic?

A: Medical mistrust is patient mistrust in health care professionals, institutions, and systems; this often exists in communities of color due to a history of discrimination, bias, and mistreatment.  It has played a part in disparities during the pandemic because communities that are disproportionately impacted by COVID-19 are less likely to seek and receive care.

Q: In your session, you discuss maternal and infant health disparities among women and children of color. How can clinicians be a part of the solution to this ongoing issue?

A: Awareness is the most important part.  It's important to be aware of any potential biases in treatment - do you offer different treatment options/protocols to women of different races, with different co-morbidities, socioeconomic statuses, insurance coverage status, etc.  Patients should feel heard, understood, and educated throughout their pregnancy and postpartum.​

Q: What can clinicians start doing now that will allow them​ to better serve patients of color?

A. Ensure everyone on the treatment is educated about implicit bias and cultural competence.  Be willing to learn more about your patient's fears, worries, concerns about their medical care, and about aspects of their racial/ethnic/cultural background that could impact their care.

Danielle J. Johnson, MD, FAPA is Chief Medical Officer at Lindner Center of HOPE in Mason, Ohios, and an assistant clinical professor in the University of Cincinnati College of Medicine Department of Psychiatry and Behavioral Neurosciences. Dr Johnson is Chair of the Ethics Committee of the Ohio Psychiatric Physicians Association and a Fellow of the American Psychiatric Association. She is on the Board of Directors of the International Society of Reproductive Psychiatry and a member of the Ohio Pregnancy-Associated Mortality Review committee.