COVID-19—The Historical Lessons of the Pandemic Reinforce Systemic Flaws and Exacerbate Inequity

• Published in: American journal of public health (1971) Vol. 111; no. S3; pp. S176 - S178
• Main Author: Freeman, Lori Tremmel
• Format: Journal Article
• Language: English
• Published: Washington American Public Health Association 01.10.2021
• Subjects: Accreditation; Chief executive officers; Containment; Coronavirus Aid Relief & Economic Security Act 2020-US; Coronaviruses; COVID-19; COVID-19 diagnostic tests; COVID-19 vaccines; Departments; Disease control; Ethnicity; Funding; Health disparities; Immunization; Infectious diseases; Infrastructure; Intervention; Jurisdiction; Leadership; Minority & ethnic groups; Neighborhoods; Opinions, Ideas, & Practice; Other Race/Ethnicity; Pandemics; Public health; Public Health Practice; Race; Racism; Sexual behavior; Social classes; Social interactions; Social status; SUBJECT CODES: COVID-19; Systemic racism; United States > US; New York City New York
• ISSN: 0090-0036; 1541-0048; 1541-0048
• DOI: 10.2105/AJPH.2021.306543

The COVID-19 pandemic demonstrates the complex layers of public health practice associated with widespread infectious disease strategies, including containment, mitigation, and medical countermeasures. Through each of these stages of disease intervention, the pandemic exposed deep chasms in our country's ability to ensure that the opportunity to be healthy is an inalienable right for everyone at the highest level of our existence-as a human being-and without regard for one's race, ethnicity, sexual orientation, or economic or social status. I address some of the many examples of how the pandemic further deepened health inequities in our country, how current public health systems failed to address systemic and structural racism rooted in social determinants of health, and how the Public Health 3.0 framework was inadequate in addressing these issues.Inequities in COVID-19 testing emerged early in the pandemic: during containment efforts. Studies confirmed that Black and Hispanic populations had disproportionately higher rates of hospitalization and death from COVID-19 than did Whites.1 In New York City, New York, for example, efforts were undertaken to study testing across the jurisdiction by race/ethnicity and neighborhood, showing that more tests were done in geographic areas with concentrations of White people although non-White areas had more positive tests.