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My Health Can’t Wait for Communities of Color
Delayed Care in the Time of COVID-19
At the height of the COVID-19 pandemic, as waves of virus-stricken patients...
flooded hospitals across the U.S., many normally busy doctors’ offices sat vacant. Calm hallways and empty doctors’ outpatient schedules became the norm. That was in part because people across the country delayed necessary healthcare ̶ from routine appointments to necessary screenings and important elective surgeries ̶ due to the fear of contracting COVID-19 in a healthcare setting1. Some even avoided care for emergent conditions, such as acute heart attack and stroke.
We are now facing a second, hidden pandemic following COVID-19. Of particular concern, research suggests that delays in screening, diagnosis and treatment for diseases like cancer, heart disease and diabetes nationally have already resulted in thousands of excess deaths2,3. In addition to the human toll, the long-term financial costs of untreated or late detection of serious diseases could be substantial for patients and the healthcare system4.
What is more, research shows that people of color are more likely to delay health care than other groups5, demonstrating yet another facet of the systemic inequities harshly spotlighted by the pandemic. In fact, in one survey conducted by the Society for Cardiovascular Angiography and Interventions, when respondents identifying as Black or Hispanic were asked about their willingness to visit a doctor during the pandemic, only about 1 in 4 people said they were comfortable scheduling a medical procedure, compared to almost half of the general population6.
That’s why Johnson & Johnson Medical Devices Companies launched My Health Can’t Wait, an educational effort and resource hub designed to inspire people to prioritize their health and reach out to their healthcare professionals about how and when to seek needed care. In addition to the national effort, the company has also launched My Health Can’t Wait Illinois, a state-based effort to help patients in Illinois feel more confident about prioritizing their health, particularly Black and Hispanic patients in Chicago.
While the COVID-19 pandemic has exacerbated delayed care among communities of color, inequities in our healthcare system have persisted for generations. “There are a lot of reasons why people don't seek care,” says Dr. Monica Peek, an Associate Professor of Medicine at the University of Chicago hospital system where she focuses on internal medicine and preventive healthcare. She also studies implicit bias in the healthcare setting7. She sees the problems that people of color face on a daily basis. Dr. Peek explains, “It's already a challenge when people are racialized minorities, because this group is disproportionately lower income and less likely to be insured, among other factors. Because of that, they are disproportionately saddled with these extra burdens in access to care, and that's just their baseline experience.”
In Illinois specifically, COVID-19 has only worsened the historical health inequities in the state, and particularly among communities of color. In Chicago, for example, where almost two-thirds of residents are Black or Hispanic8, these Chicagoans are significantly more likely to die from cancer, heart disease and diabetes than their white counterparts9.
"So much during this pandemic has been a function of where you live..."
-Dr. Monica Peek
“Chicago is a bit of a unique city, because we’re a very large and a very segregated city,” says Dr. Peek. “There are some sections of the city that are highly resourced and some that are very poorly resourced—that has had implications for a lot of things during the pandemic: which hospitals had the capacity to provide complex ICU care, where pharmacies were available, which pharmacies had early access to vaccine supplies… So much during this pandemic has been a function of where you live, and so that makes Chicago particularly unique, because the poor and the racial and ethnic minorities have been geographically clustered together with less access to the resources they need.”
What can be done address this alarming trend? Johnson & Johnson Medical Devices Companies believes one of the keys to reversing it lies in tools, resources and communication between patients and healthcare professionals, like My Health Can’t Wait Illinois. Additionally, Dr. Peek feels the best way to encourage people to get back into doctors’ offices, hospitals and clinics is “a public health campaign championed by Chicago leaders and elected officials.” To date, the My Health Can’t Wait Illinois effort has been amplified by many state policymakers, including by Illinois House Speaker Rep. Chris Welch, Illinois House Black Caucus Chair Rep. Kam Buckner, Rep. Greg Harris, Rep. Theresa Ma, Rep. Ann Williams, Rep. Lindsey LaPointe, Rep. Will Davis, Sen. Julie Morrison, Sen. Sara Feigenholtz, Sen. Omar Aquino, Sen. Elgie Sims, and Sen. Robert Martwick.
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- Johnson & Johnson Medical Devices Companies Elective Surgery Survey. About the Survey: This survey was conducted online within the United States by The Harris Poll on behalf of DePuy Synthes, part of the Johnson & Johnson Family of Companies, from July 9-13, 2020 among 2,016 U.S. adults ages 18 and older. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated.
- Lai AG, Pasea L, Banerjee A, Hall G, Denaxas S, et al. Estimated impact of the COVID-19 pandemic on cancer services and excess 1-year mortality in people with cancer and multimorbidity: near real-time data on cancer care, cancer deaths and a population-based cohort study. BMJ Open. 2020 Nov 17;10(11):e043828. doi: 10.1136/bmjopen-2020-043828. PMID: 33203640; PMCID: PMC7674020.
- Woolf SH, Chapman DA, Sabo RT, Weinberger DM, Hill L. Excess Deaths From COVID-19 and Other Causes, March-April 2020. JAMA. 2020;324(5):510–513. doi:10.1001/jama.2020.11787.
- McKinsey & Company. Understanding the hidden costs of COVID-19’s potential impact on US healthcare.
- Dulce Gonzalez, Michael Karpman, Genevieve M. Kenney, Stephen Zuckerman. Urban Institute. Delayed and Forgone Health Care for Nonelderly Adults during the COVID-19 Pandemic.
- Society for Cardiovascular Angiography and Interventions (SCAI). New Data Confirms Alarming Trend: Covid-19 Fears Are Causing Americans to Avoid the Doctor’s Office and Delay Routine Care.
- Goddu AP, O’Conor KJ, Lanzkron S, Saheed MO, Saha S, Peek ME, Haywood C, Beach MC. Do words matter? Stigmatizing language and the transmission of bias in the medical record. Journal of general internal medicine. 2018;33(5):685-91.
- United States Census.
- Chicago Health Atlas.