To date, the relentless COVID-19 pandemic has cost the lives of approximately 400,000 Americans when indirect deaths are factored in, according to Centers for Disease Control and Prevention data. The virus has altered virtually every aspect of our way of life.
In its wake, the pandemic places a harsh spotlight on a hard truth: Structural racism in America causes fatal inequities in healthcare outcomes. We see this unfold as COVID-19 continues to kill, or leave chronically ill, African-Americans, Hispanics and other minority populations at statistically significant higher rates than whites.
Sadly, COVID puts a fine point on a larger problem. More than ever in our lifetimes we are reminded that racial discrimination principally explains social determinants of health that include educational attainment, employment status and wages, housing, and an array of environmental factors. The cumulative physical and psychological effects on minority communities and the poor leaves them substantially compromised both physically and psychologically. It is well-documented that African-Americans and other minorities disproportionately experience heart disease, diabetes and mental health conditions that can be traced to the wear and tear from long-term exposure to chronic stress.
It is unsurprising that studies among hospitalized COVID-19 patients show a high prevalence of stroke, as well as heart, kidney and liver disease, asthma, diabetes, high blood pressure and obesity. It is tragic that these conditions both disproportionately affect minority populations and substantially explain the excess number of COVID-19-related deaths among minority populations. What makes these realities worse is that healthcare in this country does not, on balance, proactively address social determinants of health. We are simply left trying, largely inadequately and at great expense, to lessen the impact of these patients' conditions.
As has been noted frequently over the past several months, racism is truly a public health issue, the results of which we witness every day, all day. It would be spectacularly naive to believe its effects do not harm us all. As leaders of two major not-for-profit healthcare systems, we are both passionately committed to transforming the U.S. healthcare system, and society, in a way that ensures equal health outcomes for all members of our communities.
It is way past time to get real.
A crisis of this magnitude requires us to marshal all of our experience and resources to design and implement healthcare policy that provides universal coverage and access to high-quality healthcare. Among other things, this also must mean implementing policies that address social determinants of health and the disparities that result.
We propose the establishment of a congressionally created, time-limited, national commission made up of healthcare industry leaders, business leaders, public health experts and providers. The commission would make requisite policy recommendations to Congress and provide the healthcare industry an opportunity to coalesce around, and publicly advocate for, necessary healthcare reforms. The commission could also guide Congress in meeting its commitment to provide optimal healthcare coverage via the Medicare and Medicaid programs.
As healthcare CEOs who are joined by myriad colleagues advocating for this commission, we believe it is time for healthcare to be more socially responsible and rediscover its inextricable connectedness to public health. The nation rightly expects us to take a role in improving the social and personal determinants of health and to lead the way in lifting up public health so that the health and well-being of all can be attained.
Let's not ignore the lessons learned from the COVID-19 pandemic. We cannot legitimately claim to provide healthcare in this country when we cannot successfully care for the most vulnerable.
Let's work to eliminate the conditions that prevent quality healthcare and work to create those that help achieve health equity.
Let's do more than we are paid to do. As a nation—indeed as human beings—let us work together to do what our conscience calls us to do.