Earlier this month, many were shocked by the news that COVID-19 is the third leading cause of death in St. Louis County. A report from the St. Louis County Health department stated this fact along with the grim news that as the virus surges, health disparities in African American communities increase negative health outcomes.
Kendra Holmes, senior vice president and chief operating officer of Affinia Healthcare, was not shocked by the news.
“It’s not simply a health disparity issue…it’s a racism issue.”-Kendra Holmes, senior vice president and chief operating officer of Affinia Healthcare
“We knew from the beginning that black people would be disproportionately impacted by COVID because they are disproportionately impacted by diabetes, cardiovascular disease, cancer and other diseases. It’s so much more complicated than just COVID,” Holmes said, adding, “COVID is just another example of why we don’t live as long as white people.”
Holmes’ frustration is palpable but understandable. She has received countless awards and recognition (including the St. Louis American Foundation’s 2021 “Stellar Performer” in Healthcare Award) for Affinia’s frontline approach to battling the pandemic, especially in underserved communities in the city and county.
According to a report last month from the Peterson Center on Healthcare and Kaiser Family Foundation, COVID-19 was not only the third leading cause of death across the country in 2020 but in early 2021, it briefly became the number one leading cause of death, far surpassing even cancer and heart disease deaths.
Amid these dire statistics, African Americans, who make up 13% of the U.S. population, constitute 23 percent of COVID-19 deaths. Although the pandemic may have been unavoidable, the disparities, according to Holmes, are not.
“These (disparities) are man-made,” she said. “They are the creation of barriers and obstacles to health care that have been placed on black people.”
As an example, Holmes noted how long it took to get COVID-19 testing sites in communities of color in the region last year.
“Look where the testing sites were initially set up by the hospital systems,” she said. “They are not going to like me saying this but, facts are the facts. They were not set up in black communities. Affinia Health Care was the first testing sites in north and south St. Louis.”
It’s hard to argue that the initial low number of testing sites in black communities didn’t contribute to the rapid spread of the virus in those areas and the disproportionate number of black deaths. Holmes stresses this is inexcusable.
“We already know that black people have more chronic illnesses but, again, not because of genetic defects,” she said. “It’s because of all these man-made obstacles that they put in place for us where we cannot have access to quality health care. We knew that if people were tested, we could identify who would get COVID and would have been able to get those individuals in hospitals.”
Another example Holmes shared has to do with Monoclonal antibody treatments. This was the remedy given to President Donald Trump when he was diagnosed with COVID in 2020. Through a partnership with the state and city health departments, Holmes said Affinia was able to open a Monoclonal antibody treatment clinic in north St. Louis, but, she added, the actual treatments were slow to arrive.
“This treatment absolutely works, but we were one of the last clinics to receive it and provide it to the underserved people who are disproportionately impacted…and we had to fight for it,” she said. “So, when people are wondering why we have these health disparities, we should ask ‘well, why did you wait so long to put therapies in our communities that you know work?’”
The coronavirus exposed an already existing problem in America’s healthcare systems: Implicit bias. Before the pandemic, academic studies illustrated how biases and stereotypes have led to over-or-under-diagnosis of certain conditions, lack of proper pain management, insufficient or inadequate emergency care, increased health risks and the reality that black women are three to four times more likely to die from pregnancy-related causes than white women in the U.S.
According to the County Public Health report, majority black north St. Louis County had the highest COVID-19 mortality rates.Spring Schmidt, deputy director of St. Louis County Public Health Department, reiterated health disparities increased the negative health outcomes of African American County residents. She listed several contributing factors such as general access to care, Blacks who work essential jobs, which exposed them to the virus, and “institutionalized racism.”
Schmidt called for a “community approach” to address the root causes of housing, transportation and other social determinants that contribute to disproportionate illnesses and deaths in communities of color. Earlier this year, President Joe Biden invoked an executive order aimed at addressing COVID-19 disparities.
Holmes said she wonders if these actions will really get to the root cause of unequal healthcare:
“OK, we’re going to talk about transportation and jobs…Great! But how long have they been addressing this? There has never been a period in the history of the United States when people of color received the same quality of healthcare as white people…period,” she said. “Eighteen months of COVID is not going to change that.”
The pandemic, Holmes added, has increased her resolve to provide “quality healthcare” to marginalized communities, but it’s also made her more determined to challenge the system.
“It’s not simply a health disparity issue, it’s a racial disparity issue,” she said. “It’s a racism issue that drives all these disparities. It’s a thought process rooted in white supremacy that will take decades to dismantle and we need to call this out.”
Sylvester Brown Jr. is The St. Louis American’s inaugural Deaconess Fellow.
