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More than 18 million Americans, most of whom are minorities and low-income individuals, are uninsured or underinsured while also being at increased risk of developing severe cases of COVID-19, a new study by researchers at Harvard Medical School and CUNY’s Hunter College has shown.
“Our study shows that minority communities face double jeopardy from COVID: on the one hand, they are at higher risk of severe complications from coronavirus, and on the other hand, they are more likely to be uninsured and underinsured, and hence to avoid care or to face potentially ruinous medical bills,” Dr. Adam Gaffney, the study’s lead author who is a pulmonary and critical care physician at the Cambridge Health Alliance and Harvard Medical School, told Newsweek.
“Our dysfunctional health care financing is one important contributing factor behind pernicious racial health inequities in American society,” Gaffney said.
The study, which was published Wednesday in the Journal of General Internal Medicine, used data compiled by the Centers for Disease Control and Prevention regarding age, race and health risks. It looked specifically at health issues—such as asthma, diabetes, kidney disease, heart disease and severe obesity—that increase the risk of an individual developing a severe case of COVID-19. The researchers then analyzed this data in connection to whether the individuals had adequate insurance.
When the data was reviewed, the results showed that minorities, with the exception of Asians, and low income individuals were more likely to have underlying health issues that can increase the severity of a new coronavirus infection. Additionally, this higher-risk group, which is estimated to be about 18.2 million people, was more likely to be uninsured or underinsured.
These issues were compounded further in states that have not permitted Medicaid expansion under the Affordable Care Act, which would allow more people to access government-run health insurance. The research showed that black Americans were 42 percent more likely to be at risk for severe COVID-19 while they were also 51 percent more likely to have inadequate health care coverage than high-risk non-Hispanic whites. With Native Americans, the disparity was even greater, as they were 90 percent more likely to be at high risk for severe COVID-19, and 53 percent more likely to have inadequate health care coverage.
Gaffney acknowledged that steps have been taken by the government and insurance companies to address some of the problems with inadequate insurance coverage amid the coronavirus pandemic. However, he said this was not enough, while pointing out that the large uninsured and underinsured population creates an additional public health risk.
“To control this pandemic on an ongoing basis, people have to be unafraid to obtain care when they need it, whether for testing or treatment. But a Gallup poll in May found that 14 percent of Americans would avoid health care because of costs even if they had symptoms consistent with COVID. If people stay home with symptoms because they’re afraid of a giant bill, they put their own health at risk,” the doctor said.
“This also could impede efforts to reduce viral spread. This pandemic is laying bare the weaknesses, the gaps, and the inequities of the U.S. health care system,” he said.
The study used data that was compiled prior to millions of Americans losing their jobs due to the economic fallout caused by the pandemic. Gaffney noted that many more people have now lost their employer-sponsored health insurance as millions have filed for unemployment.
“These trends will only exacerbate the inequities we identified in our study,” he said.
Dr. Steffie Woolhandler, a co-author of the study who is a distinguished professor of public health at CUNY’s Hunter College and a lecturer in medicine at Harvard Medical School, said that the issue with health care coverage goes beyond the coronavirus pandemic.
“It’s not just COVID care that’s unaffordable,” Woolhandler said in a statement emailed to Newsweek. “Patients with heart disease, asthma and diabetes need protection too. Medicare for All is the long-term answer,” she said.
Although data has not been fully collected and compiled, numerous reports across the country have revealed that minority and low-income communities have been disproportionately affected by the pandemic. Experts have pointed to economic inequalities as well as a higher prevalence of some pre-existing health conditions, which aligns with new Harvard/CUNY study.
Minorities are also disproportionately represented in many professions deemed essential as stay-at-home orders were implemented across the country. This means they were more likely to continue going to work and interact with a wider range of individuals during lockdowns, potentially exposing them to a greater risk of contracting the virus.