On Wednesday, May 27, 2020, the House Ways and Means Committee conducted a virtual hearing on the Disproportionate Impact of COVID-19 on Communities of Color. Chairman Richard Neal (D-MA), said: “While the factors driving these inequities are complex and multifaceted, their impact on health outcomes have been clearly documented.”
His opening comments highlighted: Indigenous and Black pregnant women die at three times the rate of white women in this country; Black Americans are 30 percent more likely to die from heart disease than White Americans. Latinx populations in America have lower rates of health insurance coverage than other ethnic groups.
Neal pointed out that 22 percent of counties across the country are disproportionately black, but they account for 52 percent of COVID-19 diagnoses and 58 percent of COVID-19 deaths nationally. He also said that “In Los Angeles County, the death rate for Pacific Islanders is 12 times higher than it is for whites. And the infection rate among the Navajo Nation has now surpassed the state of New York, the center of the pandemic in the United States – reaching 2,680 cases per 100,000 people.”
Ranking Member Congressman Kevin Brady (R-TX) said, “For more than 120 years, America has struggled with health disparities found in communities of color, first revealed by University of Pennsylvania scholar W.E.B. DuBois in his historic 1899 book ‘The Philadelphia Negro,’ and followed by Booker T. Washington, who in 1915 convened the ‘Conference on Improvement of Health Conditions’ of African Americans at Tuskegee, Alabama.”
He said that the pandemic was not a time to be playing politics since racial disparities predate the pandemic saying, “People of color, and this nation, deserve serious solutions, not sound bites. Especially from those that purely hate President Trump—who was taking decisive action to fight this virus and limit travel from China while Democrats were still focused on impeachment.”
Brady was critical of Medicaid, saying that, “Medicaid dollars are supposed to help low-income families and workers, but the Affordable Care Act rewards states for shifting their focus away from those who need it most.” He was also critical of how current pandemic relief funds are not getting too small and rural communities.
The witness included Dr. Ibram X. Kendi, Ph.D., Founding Director, The Antiracist Research & Policy Center at American University, Dr. Raynald Samoa, MD, Endocrinologist, City of Hope, Los Angeles, CA, Dr. Thomas Dean Sequist, MD, MPH, Chief Patient Experience and Equity Officer at Mass General Brigham, Dr. Alicia Fernandez, MD, Professor of Medicine at University of California San Francisco, Dr. James Hildreth, Ph.D., MD, President, and Chief Executive Officer, Meharry Medical College, Dr. Douglas Holtz-Eakin, Ph.D., President, The American Action Forum.
Dr. Kendi said, “In April, many Americans were choosing the racist explanation; saying people of color were not taking the virus as seriously as White people—until challenged by survey data and majority White demonstrations to reopen states….according to the Foundation for AIDS Research, employment, access to health insurance and medical care, as well as neighborhood pollution are more predictive of Black infections and deaths than underlying illnesses like heart disease and diabetes.” He said we need to stop blaming people of color for disparities and instead focus on pushing policy that leads to equity and justice.
Dr. Samoa focused on the impact that COVID-19 has had on Native Hawaiian and Pacific Islanders. He said that Native Hawaiian and Pacific Islanders have the highest rate of confirmed Covid-19 cases in California, King County in Washington state, Clark County, Nevada, and the second-highest rates in Utah, Oregon, Arkansas, and Colorado.
He recommended two actions, allot funding for an evidence-based community-driven comprehensive initiative to fight Covid-19 in Pacific Islander communities and to fix a legislative oversight that led to inequitable access to health care for thousands of Pacific Islanders in the United States. With the passage of the 1996 TANF law, people residing in the U.S. under the Compacts of Free Association (COFA) have been categorically ineligible for Medicaid.
Dr. Sequest focused on Native American and Hispanic populations and focused on the Navajo Nation and Chelsea, Massachusetts. The Navajo Nation having nearly 4,500 cases, with an infection rate of nearly 2,500 per 100,000 residents surpasses New York. In Chelsea, approximately 70 percent of the population is Hispanic, and there have been 2,500 cases of COVID infection, for an astonishing rate of over 6,000 cases per 100,000 residents that is among the highest in the nation. He called for funding programs at the interface of health care delivery, public health and community health to address social risk factors such as food and housing insecurity; increasing funding of the Indian Health Service and fund infrastructure improvements in Native communities and; supporting training and financial incentive programs to increase health care provider supply in communities of color.
Dr. Fernandez highlighted the pandemic’s impact on Latinos. His recommendations: higher testing and monitor disparities and the targeting of public health interventions by race, ethnicity, and language and expansion of testing and contact tracing; protect industries, small businesses, and their workers and families including industries such as food processing and agriculture; extending CARES act paid sick and family leave economic provisions; and expansion and improvement within health care systems to improve quality and equitable and equal access treatment.
Dr. Hildreth from Meharry represented the largest historically black medical school in the nation. He called for greater testing, contact tracing, and safe social distancing and raised the need for more diversity of the health care workforce. He specifically called for funding of $5 billion for the Consortium of Black Medical Schools (CBMS) to assist these schools in expanding testing, contact tracing, surveillance, the training of front line workers, and promotion of the recruitment of a more diverse healthcare workforce.
Douglas Holtz -Eakin, the President American Action Forum, focused on the economic impact. He highlighted the devastating and long-term economic impact and then stated that “The COVID-19 pandemic will have significantly disparate health and economic impacts on various populations. …The pandemic is not creating these disparities but rather highlighting and exacerbating existing disparities.” Specific factors that were contributing to these high rates include living environments with people of color living in areas of a higher concentration, nutrition issues with higher levels of food insecurity, barriers to adequate diets and education factors including barriers such as limited access to technology for distance learning and traditional challenges such as “the summer slide” that allows for children to lose some of the educational gains they have made over the school year.