The coronavirus 新冠肺炎疫情正在全球范围内产生影响，但在美国出现了明显的令人不安的趋势.S.: People of color, particularly African Americans, 比白人更严重的疾病和死亡.

Why is this happening? Sherita Golden, M.D., M.H.S., a specialist in endocrinology, diabetes and metabolism, and chief diversity officer at Johns Hopkins Medicine, provides insight into this complex issue.

Disproportionate Rates of COVID-19 Illness and Death in Black Communities

According to media reports, in Chicago, where African Americans comprise a third of the city’s population, 他们占冠状病毒检测呈阳性的人数的一半, and almost three-quarters of COVID-19 deaths.

Likewise, in Milwaukee County, Wisconsin, African Americans make up 70% of deaths due to the coronavirus, but just 26% of the county’s population.

这些例子并不例外，而且这种趋势并不局限于非裔美国人. Golden says, “虽然大部分焦点都集中在非裔美国人不成比例地感染和死于COVID-19, other minority populations are also adversely affected, including Latinx/Hispanic and Native American communities.”

Coronavirus Risk Factors and People of Color

“These communities share common social and economic factors, already in place before the pandemic, that increase their risk for COVID-19,” Golden says. Those factors include:

Living in crowded housing conditions. “拥挤的居住环境是一项艰巨的挑战，这是长期的种族居住隔离和先前的红线政策的结果,” Golden says. “10个人住在一套三室公寓里很难保持适当的身体距离.她说，倡导这些更广泛的政策问题可以帮助防止未来疾病结果的差异.

Working in essential fields. Golden notes that people working in environmental services, food services, the transportation sector and home health care cannot work from home. These positions put workers in close contact with others.

Inconsistent access to health care due to lack of insurance or underinsurance. Being able to afford doctors’ visits, 治疗慢性病的药物和设备对于降低COVID-19和其他疾病导致的死亡风险至关重要. For instance, 由于治疗不一致，糖尿病或哮喘控制不佳的患者更有可能出现严重的疾病, even deadly, coronavirus infection.

Chronic health conditions. 戈尔登指出，有色人种在与COVID-19的不良结果相关的慢性健康状况方面负担更重, including diabetes, heart disease and lung disease. In a study cited by the U.S. Centers for Disease Control and Prevention (CDC), 约90%因严重COVID-19住院的患者至少有其中一种 underlying medical conditions.

Stress and immunity. 研究证明，压力对人体抵御疾病的能力有生理影响. Income inequality, discrimination, 暴力和制度性种族主义会给有色人种造成慢性压力，从而削弱他们的免疫力, making them more vulnerable to infectious disease.

How to Fight Racial Disparity in the COVID-19 Pandemic

Instituting fair housing policies, 改善就业机会和采取其他措施减轻经济不平等，将使有色人种在下一次卫生紧急情况中受益, 但戈尔登表示，现在有办法减少弱势群体的疾病和死亡率.

Targeted COVID-19 Messaging

“因为目前还没有针对COVID-19的疫苗或抗病毒治疗方法, physical distancing, 洗手和戴口罩是预防疾病向这些脆弱人群传播的关键公共卫生干预措施,” Golden says. 这个信息很直接，但传递的方式却很重要.

“We need to use some novel approaches to promoting physical distancing messages through social media campaigns. 保持身体距离的信息应以文化敏感的方式翻译成多种语言, 在一个识字水平上，让所有处于危险中的人都能理解这些信息,” Golden says. (戈尔登推动约翰霍普金斯大学与语言服务机构合作，将冠状病毒材料翻译成西班牙语.)

她补充说，信息传递应该解决并阻止与COVID-19相关的耻辱, 她说，这阻止了有症状的人在病情严重之前寻求医疗救助.

“移民社区特别关注的是这样一种说法，即寻求医疗服务将使人们在未来更难获得绿卡. 这是不正确的，这个信息需要沟通，”戈登说.

Coronavirus Testing for People of Color

“我们需要确保所有有症状的人都接受COVID-19检测, particularly African American, Latinx/Hispanic and Native American individuals,” Golden says.

她说，坊间数据表明，出现COVID-19症状的弱势群体可能不会像白人那样频繁地被转诊进行检测. 缺乏检测可能意味着进一步的传播，更多的患者在病情严重之前不会寻求医疗帮助.

“任何认为自己有COVID症状但尚未被转诊进行检测的人都应该倡导并坚持进行检测,” Golden says.

为那些没有初级保健医生或交通工具的人提供COVID-19检测是必须的. “这项工作将涉及组织公共卫生方法，为现有的检测地点提供交通工具, 直接在社区热点地区设立检测点，对有症状的个体及其接触者进行检测,” Golden says.

At the state and federal level, 像戈尔登这样的领导者正在揭示种族健康差异背后的更多因素, and in the COVID-19 pandemic in particular. 提高公平的一个关键是收集更准确的种族、民族和社区特定数据. 了解谁受到了冠状病毒的影响，谁承担了最大的负担，对于解决检测和治疗方面的不平衡至关重要.