01 Oct Minority COVID-19 Patients Had More Co-Morbidities Including Obesity, Heart Disease and Diabetes
MedicalResearch.com Interview with:
Dr. Madhur Garg, MD MBA
Clinical director, Radiation Oncology
Montefiore Health System and Professor
Departments of Otorhinolaryngology – Head & Neck Surgery – and Urology
Albert Einstein College of Medicine
MedicalResearch.com: What is the background for this study?
Response: The Bronx was hit particularly hard with Covid-19 – making up one of the highest per capita cases and deaths in the country. Montefiore Health System and Albert Einstein College of Medicine, care for a large population of ethnic minorities (non-Hispanic Black and Hispanic individuals make up 65% of our patient population).
MedicalResearch.com: What are the main findings?
Response: In this study of 5,902 patients treated for Covid-19 at our academic medical center, there were two main findings:
- Blacks and Hispanic patients presented with a higher proportion of pre-existing conditions, such as obesity, diabetes, heart disease, kidney disease, dementia and had higher rates of Covid-19 infections and related hospitalizations.
- Blacks and Hispanic patients had similar survival rates as compared to white patients, when adjusting for pre-existing conditions, age, sex and socio-economic status.
MedicalResearch.com: What should readers take away from your report?
Response: Ethnic minorities have higher rates of Covid-19 infections and are sicker at presentation, however with equitable access to the services available in comprehensive healthcare environments, discrepancies in outcomes based on race and ethnicity can be mitigated.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Non-Hispanic Black and Hispanic patients had lower socioeconomic scores and had a higher proportion of more than two medical co-morbidities or pre-existing conditions. Therefore, it is so important to focus efforts on enabling better access to primary care, and education about preventing and effectively managing chronic diseases, including obesity, cardiovascular disease, diabetes, renal disease, and dementia.
MedicalResearch.com: Is there anything else you would like to add?
Response: Community spread resulting from crowded living conditions and increased exposure due to occupation in ethnic minorities (frontline and essential workers) account for high infection rates. In addition, ethnic minorities, and people with lower socioeconomic status (SES) have a higher likelihood for comorbidities, such as obesity, heart disease, diabetes, and kidney disease. Access to care, health awareness/education and economic stability are social determinant of health.
Earlier reports indicated worse outcomes in Black and Hispanic patients, but these reports did not account for differences in access to care, socioeconomic diversity, and the prevalence of other medical comorbidities. Montefiore has been on the forefront of addressing healthcare disparities related to social determinants of health. We are consistently working with our community stakeholders in developing and implementing screening tools to better understand social needs at the neighborhood level, outside the confines of the hospital. Only by tackling gaps in our current healthcare system, investing in population health, and continuing to partner with our community – with special attention to underserved populations – can we begin to curb pre-COVID care disparities and heal COVID’s aftermath.
Kabarriti R, Brodin NP, Maron MI, et al. Association of Race and Ethnicity With Comorbidities and Survival Among Patients With COVID-19 at an Urban Medical Center in New York. JAMA Netw Open. 2020;3(9):e2019795. doi:10.1001/jamanetworkopen.2020.19795
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