Report illuminates health and socioeconomic disparities in the District of Columbia

Approximately three quarters of the deaths associated with COVID-19 in the nation's capital have been among the African American community. A new Georgetown University report illuminates entrenched health and socioeconomic disparities that explain one reason this is occurring.

Health Disparities in the Black Community: An Imperative for Racial Equity in the District of Columbia is a publication of the School of Nursing & Health Studies (NHS) at Georgetown University Medical Center. Christopher J. King, PhD, FACHE, chair of the Department of Health Systems Administration at NHS, is its lead author.

The rate of death from COVID-19 in the Black community is a "trifecta of high risk day-to-day survival needs, pre-existing illnesses, and limited access to timely, high-quality healthcare," says King.

Black residents in our city face a disproportionate burden of disease, such as cancer, diabetes, heart and respiratory diseases, and obesity. These health disparities result from long-standing injustices and makes the African American community much more vulnerable to a highly infectious virus like COVID-19."

Christopher J. King, PhD, FACHE, chair of the Department of Health Systems Administration at NHS

The newly issued report builds on the 2016 publication, The Health of the African Community in the District of Columbia: Disparities and Recommendations, which King led at the request of the D.C. Commission on African American Affairs. Maurice Jackson, PhD, associate professor of history at Georgetown and former commission chair, co-authored the new report's opening letter with King.

'Racial inequity is a public health issue'

"COVID-19 transmission methods are a reminder that racial inequity is a public health issue," Jackson and King write. "The pandemic serves as yet another reminder to course correct and dismantle racial injustice for the sake of humanity. In that spirit, we will continue to monitor the health and well-being of the District's Black community – particularly as the city rapidly changes. Findings of this report will inform policymaking, advocacy agendas, appropriation of equitable resources, and education for the general public."

The report, which provides pre-COVID-19 figures, delves into topics ranging from disease burden and education to economic status. Some of the stark data:

• There is a 15-year difference in the life expectancy between residents in Ward 3 (87) and Ward 8 (72);
• Residents from Wards with higher volumes of Black residents (5, 7, and 8) represent the majority of those hospitalized for preventable health conditions;
• The number of Black residents who are obese is 3 times higher than White residents;
• The number of Black residents living with diabetes is 7 times higher than White residents;
• The number of Black residents who die from heart disease is 2.5 times higher than White residents;
• Compared with all racial and ethnic groups, the median household income for Blacks is lowest ($43,546) – three times less than Whites ($135,263); and
• Compared with all racial and ethnic groups, Blacks have the lowest percentage of bachelor degree attainment.

Progress and recommendations

In addition to its synthesis and analysis of more recent data, the report highlights progress that has been made since 2016 in terms of local government initiatives, philanthropic opportunities, and health care innovation.

The publication also lists a series of 18 recommendations in two categories, "social, economic and environmental" and "clinical care and health systems."

"One sector cannot fix the problem," the report's authors write. "The journey to racial equity requires an explicit and cross-sector approach to eliminate social, economic, and environmental conditions that stymie upward mobility and compromise well-being across the lifespan. As the city continues to experience growth and economic progress, proactive efforts are needed to address policies, practices, and norms that perpetuate segregation and inequitable distribution of resources."

King authored the report with Patricia Cloonan, PhD, RN, associate professor of health systems administration, and students (graduate and undergraduate) Grace Keegan, Amelia Bedri, Edward Kasper, Xerxeser Kayode, Phebean Sheriff, and Jonathan Wagner.

The work complements various related efforts on Georgetown's campus, including the Health Justice Alliance, the Institute for Racial Justice, and the Georgetown Initiative to Reduce Health Disparities.