LITTLE ROCK, Ark. -- COVID-19 is disproportionately affecting black and brown communities. Looking at states that have released coronavirus data by race, researchers at Johns Hopkins University found even with limited numbers, Black Americans accounted for 34% of total COVID-19 deaths - despite only representing about 13% of the nation's population.
According to analysis from APM Research Labs, African-Americans in Arkansas are three times more likely to die of the virus than whites.
Uche Blackstock is a physician and founder of the group Advancing Health Equity. She said longstanding social and economic policies are driving the higher infection and death rates.
"And so when we talk about which communities carry the highest chronic disease burden - so diabetes, high blood pressure - these communities carry that high burden because of lack of access to, not just health care, but quality health care," Blackstock said.
She said COVID-19 is only exacerbating what poverty and systemic inequalities in access to clean air and fresh food have created for decades; noting that African-African, Latinx and Native American individuals are more likely to die from chronic health conditions than their white peers.
Blackstock said in the early stages of the pandemic, racial and socioeconomic biases were embedded in factors used to determine who had access to testing, such as if a person had traveled internationally. She said she believes many people who may have been exposed to the virus while working in jobs such as transportation and food production likely went undiagnosed.
"Because they did not fulfill that very strict criteria," she said.
Experts say accurate and publicly available racial data will help inform policies to help the most vulnerable, such as providing alternative housing in hotel rooms or dorms to help people quarantine who may not be able to safely do so at home, as well as providing paid sick leave for workers and improving access to affordable health care.
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Recent research shows approximately half of people who die by suicide had contact with a health care professional within the month prior to their death.
However, a recent study shows only 8% of hospitals are currently implementing all four recommended suicide prevention practices: safety planning, warm handoffs to outpatient care, patient follow-up and lethal means counseling.
Melissa Tolstyka, director of Behavioral Health Services for Trinity Health Ann Arbor, said a seamless transition from inpatient to outpatient care is critical. At Ann Arbor, she saw a 46% increase in compliance with comprehensive suicide risk assessments and patients discharged on the suicide care pathway now receive a safety plan, which she sees as progress.
"We continue to see a need for really robust programming," Tolstyka explained. "Not just within the behavioral health world, but in the medical world as well. Our organization really wanted to focus on bringing the behavioral health and the medical services together to enhance our safer suicide care practices for our patients."
The initiative is being piloted across various units at Trinity Hospitals in Ann Arbor and Grand Rapids including the emergency department, psychiatric medical and inpatient nursing units. If you or anyone you know is struggling or in crisis, help is available 24 hours a day, seven days a week, by calling or texting 988, the Suicide and Crisis Lifeline.
Casie Sultana, clinical nurse leader for Trinity Health Grand Rapids, prioritizes patient well-being, emphasizing support and improvement over solely managing risks within the facility.
"We want to be someplace that people feel welcome to come to who are dealing with suicide," Sultana emphasized. "You feel so alone. It's a very lonely journey and we want people to come seek help and feel welcomed when they do that."
Susan Burchardt, clinical services manager at Trinity Grand Rapids, advised other hospitals considering a similar program to learn from organizations already using it.
Support for this reporting was provided by The Pew Charitable Trusts.
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Access to reduced-price medication is a necessity for many rural Missourians with low income.
Rep. Cindy O'Laughlin, R-Shelbina, the Senate Floor Leader, said Big Pharma is trying to confuse legislators with unrelated hot-button topics such as abortion access and illegal immigration in a last-ditch effort to stop the state from joining a program to force drugmakers to sell medicines at a discount.
"Appealing to nuclear topics, which really do not apply in this situation, is a disingenuous way to try to defeat a bill that is actually good for Missouri," O'Laughlin asserted.
O'Laughlin pointed out the program is transparent, and uses the tax money saved to help low-income families deal with chronic conditions such as diabetes.
The drugmakers object to the government forcing them to give significant discounts, arguing hospitals' and for-profit pharmacies' bottom lines, particularly those owned by pharmacy benefits managers, are being exploited. Nationally, 46% of contract pharmacy agreements involve pharmacies linked to the three largest benefits managers.
Rep. Tara Peters, R-Rolla, introduced the 340B contract pharmacy access billand said the lobbying is absurd.
"Federally, 340B program does not allow for abortion drugs," Peters stressed. "Why would any legislation that we're trying to pass in the state allow for that? I mean, the thought of that even being in existence is absolutely ludicrous."
The Missouri Senate passed the bill 27-3 on Monday and it now goes to the House.
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Alabama is running out of time to tackle Medicaid expansion this legislative session.
More than 230 people gathered earlier this month with the group Alabama Arise, urging state lawmakers to prioritize the issue. Their message: Access to health care isn't just a matter of policy, it can be a matter of life and death.
Debbie Smith, Cover Alabama campaign director for Alabama Arise, said as the session winds down, the group will continue to echo the call for increased access to health coverage. She thinks it would not only save lives but revitalize communities across the state.
"Over 80% of our rural hospitals are operating in the red," Smith pointed out. "Not a great stat. About 19 rural hospitals are at immediate risk of closure, and those are the lifeblood of those communities. They're on life support."
Smith emphasized hospitals at financial risk also put their workforce at risk. Those who are against Medicaid expansion believe it is ultimately unaffordable for the state. However, Smith argued it could save the state nearly $400 million over the next six years. According to the Public Affairs Research Council of Alabama, those savings would be enough to cover the cost.
The council's study also showed Medicaid expansion would generate nearly $2 billion of economic growth. Beyond economic benefits, Smith pointed to the stark disparities in maternal and infant mortality rates in Alabama.
She stressed Medicaid expansion would do more than provide health care coverage during pregnancy or postpartum, it is about ensuring comprehensive coverage.
"We've been lucky enough to expand Medicaid coverage up to 12 months postpartum but we still need to figure out how to cover people before they even get pregnant," Smith asserted. "It's really important for people to have health coverage so they can address any kind of issues they might have, like if they have diabetes or high blood pressure that might affect their pregnancy in the future."
With limited time left in the legislative session, she noted one option could be Gov. Kay Ivey's executive authority to enact Medicaid expansion. Smith added using the power could be the simplest path forward, backed by the promise of additional funding from the American Rescue Plan.
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