Opinion: Here's how we reduce COVID-19 racial disparities and help African Americans

Posted: April 28, 2020

The below op-ed was written by Lovoria Williams is a UK College of Nursing faculty member and president of the Lexington Chapter of the National Black Nurses Association, and Alona H. Pack is president of the KYANNA Black Nurses Association of Louisville.

In response to the COVID-19 pandemic, journalists have documented the alarming statistics of disparate mortality among black people. According to a recent editorial in the Chicago Sun-Times, “health outcomes in the United States have never been fair and equal, not in Chicago or anywhere else.  And there has never been health care equity.  Black folks have always suffered from higher rates of dangerous medical conditions such as hypertension and diabetes, that correlate with lower incomes and poorer health.”

The Los Angeles Times weighed in by telling its readers that “because of poverty and other barriers, African Americans are less likely to have access to medical care and they’re more likely to live in neighborhoods where markets selling fresh, nutritious food are scarce.”

Not to be outdone by larger markets, The Courier Journal, the Herald-Leader and myriad of television and radio stations have detailed the problem here in the commonwealth citing many of the same social determinants of health listed above.

As two African American nurse leaders, we are glad that the news media is reporting about disparities in the incidents and consequences of COVID-19, and we are encouraged that our governor was among the first to report the race of COVID-19 victims. However, we need more.

These disparities were predictable and a more proactive public health approach to ensure that messaging and resources were strategically directed to vulnerable populations, such as blacks who suffer a disproportionate burden of poor health, is called for. Now is the time for nurse leaders trained to identify problems to advocate for culturally appropriate evidence-based solutions to prevent further COVID-19 disparities.

We applaud Gov. Beshear’s quick and decisive action to enforce social distancing measures to protect the health of Kentuckians. However, we urge Kentucky’s nurses to view these measures through a culturally sensitive lens. African American culture is strongly grounded in faith, family and fellowship — all of which are currently restricted to protect public health.

As restrictions are encouraged, we urge Kentucky nurses to recognize that while compliance is a challenge for everyone, the cultural context of compliance are varied, and we caution nurses to avoid perpetuating a narrative that seems to blame black people for dying. For instance, consider compliance with instructions to remain home and to wash our hands for individuals who may be homeless or to avoid attending worship for individuals whose only social outlet and source of strength may be the church community. We as nurses are well aware that masks are in short supply. So let’s consider that many among us, including individuals from lower socioeconomic status, do not have access or means to obtain masks.

So, when we see African Americans and others congregating on a nice spring day, let’s consider the many reasons that this may occur. While many populations laud the heroic efforts of health care professionals, note that because of the history of denied access and mistreatment inflicted by the health care system, many black Americans have a deep mistrust of the profession.

Recall also that it has only been in recent days that reporters began to highlight racial disparities among COVID-19 victims and that the faces of early COVID-19 victims and of those reporting the dire numbers did not reflect the diverse images of the populations suffering from infection. The early representation of the impact of the virus may have perpetuated a myth among some populations that COVID-19 did not affect people of color when in fact the opposite is true — people of color are the most likely among us to die from this virus.

As such, let’s promote culturally appropriate strategies — let’s urge African Americans to protect themselves by following the CDC and Gov. Beshear, (kycovid19.ky.gov). Let’s urge our Kentucky nurse colleagues to provide culturally sensitive messaging and care and to advocate for appropriate messaging and priority access to COVID-19 testing for America’s most vulnerable populations. As we move beyond the current health crisis, let us revisit efforts that address the root cause of social iniquities.

Now is the time!