Black patients died more frequently from COVID-19 because of inferior hospitals

Health Care Equity

Why did proportionately more black people die of COVID than their white counterparts? Was it a lifestyle issue, were there chronic health problems or did it have to do with the treatment these patients received? Are the facilities in certain neighborhoods inferior to those in other neighborhoods?

Black patients admitted to hospitals with COVID-19 were 11 percent more likely to die than their white counterparts after adjusting for patient and clinical characteristics, according to a recent study in JAMA Network Open, reported Samantha Liss in Healthcare Dive. These patients were more likely to die largely because of where they received care — at hospitals that performed less effectively than those that treated white patients, according to the study that analyzed more than 44,000 Medicare Advantage admissions to more than 1,180 hospitals across 41 states.

The JAMA study highlights that where people live influences where they receive care, because people are likely to seek care close to home. Black Americans have not been able to live in certain neighborhoods, which led to segregation in cities and unequal access to resources, according to the study.

Liss said, “As the COVID-19 pandemic gripped the U.S., it was clear last year that black Americans were bearing the brunt of the deadly virus. Black Americans were more likely to get sick, hospitalized and die than White patients.”

Thus far, more than 600,000 people in the United States have died as a result of the pandemic, which has infected more than 178 million around the world. The JAMA study attempted to examine what role, if any, the hospitals where black patients were admitted influenced their deaths. According to the authors,  people tend to wrongly assume that death rates are higher because of chronic health problems among certain populations.

According to David Asch, one of the study's authors and the executive director of Penn Medicine's Center for Health Care Innovation, "It's intolerable that we live in a society where black patients are more likely to go to hospitals where death is also more likely." 

The coronavirus got to the U.S. at a time of racial strife. Then the pandemic showed the inequities in the U.S. as people of color were more likely to die as a result of the virus, according to the report. The authors claimed that this latest study illustrates the "long shadow" unequal policies continue to have in the U.S., pointing toward housing policy that ultimately segregated neighborhoods, leaving black people with unequal access to resources, opportunities and housing. The JAMA study also ran simulations and determined that if those same black patients were admitted to the same hospitals as white patients, the health outcomes would be more equal.

Sherita Golden, M.D., M.H.S., a specialist in endocrinology, diabetes and metabolism, and chief diversity officer at Johns Hopkins Medicine, also provided insight into this complex issue. “While much of the focus has been on African Americans disproportionately contracting and dying from COVID-19, other minority populations are also adversely affected, including Latinx/Hispanic and Native American communities,” she said.