key: cord-290523-pqah68j8
authors: Waite, Roberta; Nardi, Deena
title: Effects of COVID-19 on the Mental Health of Black and Brown Racialized Populations in the U.S
date: 2020-10-22
journal: Arch Psychiatr Nurs
DOI: 10.1016/j.apnu.2020.10.010
sha: 
doc_id: 290523
cord_uid: pqah68j8

nan

although this group comprises 13% of the U.S. population; this is contrasted with the white population, who make up 76% of the U.S. yet accounted for 45% of these hospitalizations (Aubrey, 2020) . The Hispanic and Latino communities are also harder hit by the outbreak. For instance, in New York City, 34% of the New Yorkers who have died of COVID-19 are Latino, despite making up 29% of its total population (Mays & Newman, 2020) . This alarming disparity in COVID-19 mortality rates cannot be surprising considering that chronic health conditions, such as heart failure, asthma, hypertension, diabetes mellitus and HIV, are at much higher rates, begin earlier and are treated later in the black population community than in the white population (Williams et al., 2010) .

Native Americans, especially those who live in rural areas and reservations such as the Navajo Nation, have been especially hard hit from pandemics: NBC News calls the Navajo Nation's health services, managed by the U.S. Indian Health Services (IHS), "limited,"(Abou-Sabe et al., 2020, para. 1). A quarter, or 25% of the Diné population died from the "Spanish flu" of 1918; During the swine flu epidemic, Dinė or Navajo people, died from that flu at a rate "4-5 times higher than other Americans"; currently, the Nation's COVID-19 infection rate is "ten times higher per capita than its neighboring state, Arizona" (Lange, 2020, para. 4) home, it serves as a safety net for its patients and many community members. Like many other health care organizations, it experiences delays in receiving needed testing supplies for COVID-19 however this testing is currently underway. Clinical services however quickly transitioned to enable access to care for patients. Telehealth for clinical services for primary care, dental and behavioral health were rolled out after its partner, FPCN obtained the necessary approvals from insurance companies and department of state, bureau of professional and occupational affairs licensing boards. Specifically, psychiatric services in primary care including integrated behavioral health consultants and the psychiatric nurse practitioner were able to maintain their transdisciplinary team orientation with all providers in primary care to attend to the needs of patients across the lifespan. Likewise, the larger behavioral health department shifted to operating at full capacity using telehealth including HIPPA compliant Zoom. On average, 95% of sessions are now virtual, therefore, routine van services were placed on hold; however increased delivery drivers were hired for the health centers pharmacy which delivers medications for free within a 2-hour time frame to any patient living in Philadelphia. Similarly, its mind-body services for both patients, community members and staff were all converted to virtual sessions including programming for fitness, yoga, and mindfulness meditation. Additionally, Zumba and Pound classes were offered to staff. These services are integral to mitigating and managing stress and promote engagement with others. Social services have also enhanced their work at the health The goal is to develop "hyperlocal" (neighborhood level) strategies to slow the spread of coronavirus and improve health outcomes for residents of those communities hardest hit by this crisis. These communities have struggled with limited access to healthcare services and insufficient primary care providers, long standing unemployment, a dearth of businesses in the community, chronic illnesses, and a panoply of health risks and stressors that contribute to the pronounced lifespan gap between white and black Chicago residents (Pratt, 2020) The panel consists of not only the usual business leaders and healthcare experts, but a representative from NAMI and community advocates such as Mr. Anton Seals Jr., whose words are quoted at the beginning of this piece. As Mayor Lightfoot said, "This cannot be temporary scaffolding. It's got to be laying a foundation for a permanent fix to many of the problems that for too long we have ignored or said, they are too big to solve" (Pratt, 2020, p. 4) .

We will be watching what happens to the Chicago panel and its work after the pandemic is over. We hope the work of the panel and these other models will be used as best practice guides to change the economic maps and social injustices that foster these health disparities still, especially for the black and brown racialized populations in this country. The new normal they can create should include better distribution of resources, such as clean water, more primary care providers, telehealth and telecounseling services, to people who need them…wherever they live.

This should not be a matter of "if you pay, then you can play", but a best practices model of incorporating the major social determinants of health into assessment and treatment services for all needing health services, now during the pandemic and afterward.

Inequities in health are fueled by cultural and societal norms based on racism and racist practices in the United States particularly during the COVID-19 pandemic, and will be evident in J o u r n a l P r e -p r o o f its aftermath. Health equity, a process which assures conditions of optimal health for all peoples, requires needed attention to the social determinants of health: economic stability, education, community services and safety, healthcare, respectful communications, and affordable decent housing, for all populations. Racial diversity has greatly increased in the U.S., and the needs of our diverse population should inform health care practices and policy making in order to preclude disparities in these determinants, as well as the healthcare inequities that persist most pointedly along racial lines. But knowing this is not enough: doing is what is called for.

Navajo Nation braces for a surge of coronavirus cases

American inequality meets covid-19. (n.d.). The Economist

COVID-19 Racial Disparity: African Americans May End Up In Hospital More Often : Coronavirus Live Updates : NPR

Black People Are Dying Of COVID-19 At

Virus Is Twice as Deadly for Black and Latino People Than Whites in N.Y.C. The New York Times

Mayor creates response teams for hard-hit neighborhoods. 1. Social Determinants of Health

Race, socioeconomic status, and health: Complexities, ongoing challenges, and research opportunities