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Over the past 100 years, we have made incredible advances in healthcare that would have been considered miraculous for any previous generation. To give an example, the life expectancy in the United States in 1950 it was 68.2 years. We have since added 10 years to that average. Social programs have helped young and old, two of the most vulnerable to health populations, to receive unprecedented levels of care and attention. And telemedicine has separated the health support and monitoring of many Americans from physical hospitals, expanding access to care.

And yet, despite these advances and despite spend more than other OECD nations on health care , the United States maintains huge health disparities. As James Madara, CEO and Executive Vice President of the American Medical Association, wrote on the organization’s website: “The US healthcare system that exists today is a hodgepodge of ideas, programs and regulations that is both extraordinarily expensive and highly inefficient. And despite its size and technological advances, our healthcare system is plagued by huge gaps and inequalities that favor some groups while unfairly disadvantages others. “

Our current situation has its origins in socio-historical tectonic forces that have displaced and fractured the healthcare landscape. For those at the top, access to superior care, education, resources and social networks serves to protect their health. For those who are in the canyons, the terrain continues to withstand every past and ongoing crisis: consider, for example, the disproportionate fallout from the dissolution of the Mental Health Systems Act .

Then came COVID-19.

COVID-19 deepens US health disparities

Communities on the pernicious side of America’s health disparities have their own unique histories, environments, and social structures. They are popular in the United States, but they all have one thing in common.

“There is a common divide in American communities, and that is poverty,” he said Debbie Salas-Lopez, MD, MPH , senior vice president of community and population health at Northwell Health. “This is the undercurrent that manifests ill health, poor health outcomes, or poor health prognoses for future well-being.”

Social determinants have far-reaching effects on health, and poor communities have unfavorable social determinants. To choose one of the many examples, food insecurity reduces access to quality food, leading to poor health and common endemics of chronic medical conditions. The U.S. Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and type 2 diabetes, as an increased risk of developing a severe case of the coronavirus.

The pandemic did not create poverty or food insecurity, but it exacerbated both, and the results were catastrophic. A study published this summer in Journal of General Internal Medicine he suggested that “social factors such as income inequality may explain why some parts of the United States are hit harder by the COVID-19 pandemic than others.”

This is not to say that families in the United States are in better conditions have not been harmed. A document from the Center for Economic Policy Research noted that households in counties with higher median incomes have suffered adjustment costs associated with the pandemic, for example, by reducing earnings interactions to align with social distancing policies. However, the paper found that the costs of social distancing were much greater for the poorest families, who cannot easily change their living conditions, which often includes more individuals living in a home and a dependence on mass transportation. to get to work and grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and healthcare, where keeping physical distance can be next to impossible.

The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. “Our interpretation is that the poorest people are less able to protect themselves, which leads them to different choices: they face a sharper compromise between their health and their economic well-being in the context of the threats posed by COVID-19” , the authors wrote.

“There are so many pandemics that this pandemic has exacerbated,” noted Dr. Salas-Lopez.

An example is the gap between health and wealth. The mental stressors of maintaining low socioeconomic status, especially in the face of extreme wealth, can have a physically degrading impact on health. Writing about this gap , Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and impair the prefrontal cortex and other brain functions through anxiety. depression and cognitive load.

“Thus, from the macro level of entire body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear,” Sapolsky writes. “It is outrageous that if children are born into the wrong family, they will be predisposed to ill health by the time they start learning the alphabet.”

Research on the economic and mental fallout of COVID-19 is showing two things: that unemployment is affecting low-income and young Americans more during the pandemic, potentially widening the health-wealth gap even further; and that the pandemic is not only exacerbating mental health stressors, but is doing so at clinically relevant levels. As they wrote the authors of a review , The effects of the pandemic on mental health are in themselves an international public health priority.

We need to find ways to unify this country because we are all human beings. We are all equal and we believe that health is one of those important rights.