What does the COVID-19 pandemic reveal about our society’s inequities, and what we can learn from it to ensure a healthier and more equitable society?
In a new episode of the Prevention Institute’s “Moving Upstream” podcast, four women health leaders share firsthand experiences from the perspectives of public health, academia, and clinical care. The podcast is hosted by Dr. Karen Remley, former health commissioner of Virginia and former CEO of the American Academy of Pediatrics (and former de Beaumont Senior Fellow), who discusses early observations about the pandemic with three other leaders in health:
- Rachel Davis, executive director of the Prevention Institute;
- Dr. Shari Barkin, chief of general pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt and a community researcher; and
- Dr. Jewel Mullen, associate dean for health equity at the Dell Medical School of the University of Texas at Austin and former public health commissioner of Connecticut.
So much remains to be learned about COVID-19. But as we navigate this global pandemic, these health leaders offer important insights about what’s happening now and how it will affect Americans’ physical and mental health over time.
Place Trust in Public Health Institutions
When emergencies arise, information comes from many sources — some less credible than others. Davis recommends cutting out the noise and turning your attention, and trust, toward the leaders who are driven by evidence-based policy and decision-making.
“It’s really important, particularly in a situation like this, for people to be able to trust their government,” Davis said. She said that while there is historic distrust of government, “I’ve been strongly encouraging folks we work with to be able to look to their local health department to get the kind of information they need that can help them be safe and keep their family safe and their community safe.”
Mullen added that the voices of leaders in health are particularly important, although many are missing during this crisis. “I long for the voices of the colleagues I know who are still working so hard on behalf of all of us nationally and globally to make this be a pandemic that is shorter rather than longer,” she said. Because these voices are not being heard, “we’re not benefiting from the reassurance of their knowledge, their dedication, and their primary focus on population health and well-being and equity.”
Recognize Longstanding Inequities
As is typical in a crisis, the COVID-19 pandemic has widened the gap in disparities among communities who are historically underserved and experiencing poor health. “Good health is the foundation of what we’re able to do,” Davis said, “and right now, what we see is [the pandemic] hampering social, economic, and educational opportunities.”
She added, “What we really need is a system for prevention, health equity, and racial justice which recognizes all of these multifaceted contributors to health and to understand that even in the context of a pandemic, prevention matters.” Davis noted that the people at greatest risk of adverse outcomes from COVID-19 are those who already have chronic illnesses, many of which can be prevented by addressing social determinants of health.
The inequities underscored by the COVID-19 pandemic have long existed, and we must continue raising our voices about them, Mullen said. “The inequities that we’re talking about are so encased in the systems and policies that we are expecting people to thrive in when instead the increasing [share] of humanity is just subsisting.”
Maintain Social Connections
Even as people practice social distancing to keep their communities safe, we can still work to maintain our connections with friends, family, and neighbors. “Feeling connected and being connected is a really important part of health and safety and well-being,” Davis said. “It’s really important for people to not feel isolated, and that can particularly be true in a time of crisis.”
While heeding public health guidance, we should consider “how can we also make sure that people don’t feel isolated, that people feel connected, and that we’re reaching out and keeping communities connected and cohesive through really this very challenging, confusing, frightening time?”
We may need to reevaluate the term “social distancing,” which implies disconnection, and instead use the more appropriate term “physical distancing,” Barkin said. “It’s up to us to make sure that [disconnection] is not what we intend, nor is that what we implement,” she said. “Physical distancing still allows us to care for our neighbors and care for our communities.”
Strive to Work Together
In times of distress, people may pull away from one another when they need to come together. The multifaceted public health response to COVID-19 means that coordination is key, even if we don’t know exactly what that entails.
“Coordinating activities in a time of uncertainty feels like a Herculean task,” Barkin said. “Not to say that we aren’t up for it, it means that people have to feel okay swimming in uncertainty and reaching out for each other to identify the best way to coordinate our actions so we can be most efficient and effective together.”
Public health is often considered a team sport. The COVID-19 pandemic has taken that expression to new levels, reminding us that we all have a responsibility work toward solutions. “A virus doesn’t care where we live or what job we have,” Barkin said. “And it also sheds light on the very clear understanding that public health is the bedrock of a healthy, functioning society, so that not only do we need to take care of what is right in front of us, we have to learn from this time and plan forward together.”
Listen to the podcast: “Coronavirus: From the Urgency of Reaction to the Importance of Long-Term Action.”
