COVID-19 as a mirror: Reflecting the pandemic of racism and the historical roots of health inequities

Historically, the attribution of biology to race has shaped societies and manifested in innumerable disparities and irreparable harm, especially in communities of color. From the earliest days of the United States to the present day, the dehumanization and “othering” of African Americans have caused deep racial inequities that have been perpetuated and embedded in American culture. The early months of the COVID-19 pandemic underscored the deep racial inequalities in the US, especially in health outcomes for communities of color. Structural racism has played a critical role in exacerbating disparities, with Black, Hispanic, Latinx, and Indigenous populations experiencing higher rates of severe disease and mortality. The interconnectedness of racism with the social determinants of health, concomitant with higher rates of chronic illnesses like diabetes and hypertension, increases vulnerability to severe COVID-19. Health disparities are compounded by implicit biases in the medical field, a lack of diversity among healthcare providers, and historical medical mistrust among marginalized groups. Underrepresentation in the medical field, biomedical sciences, and academia hinders efforts to address health disparities effectively. This essay seeks to raise awareness of how the concepts of race and racism have resulted in racial hierarchies that perpetuate systems of oppression and impede efforts toward racial and health equity. Specifically, this essay covers time periods in American history, including slavery, the Jim Crow Era, the Civil Rights Movement, and the COVID-19 pandemic, and discusses how addressing race and racism and the achievement of racial health equity require targeted efforts to increase diversity in healthcare and biomedical fields, improve cultural competence, and foster trust between medical professionals and communities of color. (author abstract)