Page 13 - SFHN Dec 2020

2020: A Year in Review... 2020: A Year in Review... 2020: A Year in Review...

Cover Story: How 2020 Revealed Health Inequities in the Midst of a Pandemic

Continued from page 1
and inequities, including in the number I recognize that I am not the same Minority Groups” updated July 24, 2020. intensity by minority patients can be a
of COVID-19 deaths impacting every- physician that I was a year ago - before It addresses factors that contribute to significant barrier to effectively manag-
one, and yet racial and ethnic groups dis- the pandemic, before feeling the weight increased risk; discrimination in systems ing pain. This information is itself
proportionately. To say 2020 has been of responsibility for critical decisions in (i.e. healthcare, housing, education, “painful” and illustrates the importance
quite the year is an understatement! the face of ambiguity, and before George criminal justice, and finance), healthcare of cultural competency in medicine and
Imprinted on me in the last few Floyd’s death. I have adapted by develop- access and utilization impacted by dis- the need for intervention strategies to
months are the courageous faces of ing a keener awareness for deciphering trust that exists for the government and reduce health disparities with a goal of
healthcare providers from across the what I can directly shape and influence healthcare systems with known histori- health equity for everyone.
country, who have given so much of and by focusing my energy there, while cal events of inequities, occupational Palliative providers are by sheer nature
themselves despite fears and uncertainty. not obsessing unproductively over what exposure, gaps in education, income, strong advocates, lending a voice to
Many were confronted early in the pan- I cannot. and wealth, and housing conditions. whole person-centered care. If this last
demic by a shortage of PPE and limited COVID-19 continues to spread across When looking at health inequities year hasn’t forced us to look deeply with-
knowledge of the virus yet showed up to our country and the globe, and it is a beyond a COVID-19 lens, strong evi- in, then I don’t know what will. Perhaps
work as always and delivered on a sworn dangerous and deadly virus that has dence confirms that compared to whites, more than ever we need to better under-
oath to provide compassionate care, pan- taken a tremendous toll on our commu- ethnic minorities experience greater dif- stand one another to form and sustain
demic or not. From necessity, we are nity and on our healthcare system. On ficulty with access to health care servic- meaningful connections.
increasingly more adept in using virtual November 22, 2020, the CDC website, es, higher rates of mortality, shorter life Increasing awareness, education,
platforms for many interactions - patient www.cdc.gov, informs the United States expectancy, higher rates of chronic dis- resources, and evolving practices will
visits, events, meetings, conferences, and having 11,843,490 total COVID-19 ease, lower rates of cancer screening, and help us to promote fair access to health-
socializing. cases, with 49.8 cases in the last 7 days higher rates of having a more advanced care. 2020 has tested our resiliency, and
Dare I say we are now reliant on virtual per 100k, and total deaths of 253,600 as stage of cancer at the time of diagnosis as we are stronger for it. Maya Angelou
communication. Despite the virtual con- reported since January 21, 2020. described in “Cultural Relevance in End- said, “You can’t really know where you
straints, 6 feet buffer zones, facemasks, When reviewing data, it is also evident of-Life Care” by Phyllis R. Coolen fea- are going until you know where you have
plexiglass shields, and unintentional that people from racial and ethnic minor- tured in Ethnomed in May 2012. Coolen been.”
biases and fears, decency prevails, and ity groups are at increased risk from get- shares information on disparities in the If we examine the past with a thought-
heroes have emerged. ting sick from COVID-19 and dying. treatment and management of pain at ful appreciation of the history and with
As a provider of palliative and hospice When compared to White, Non-Hispanic end-of-life for ethnically diverse patients. awareness and presence in our daily
services at Catholic Palliative Care Persons, CDC surveillance data updated Factors like limited access to care, to interactions, then we can enthusiastical-
Services and Catholic Hospice, I am on August 18, 2020 demonstrates that analgesics and opioids, to pain special- ly look forward to a collaborative spirit
incredibly proud to be associated with Black or African American, ists, and language barriers all contribute in 2021 that connects and enriches us all
such devoted and compassionate staff. Non- Hispanic persons have 4.7x high- to disparities. In examining the cancer in consequential ways.
We faced 2020 challenges as a team to er hospitalizations with 2.1x higher pain experience, miscommunication While 2020 revealed health inequities in
meet the needs of our community. deaths, Hispanic or Latino persons have between the provider and the patient the midst of a pandemic, it also revealed
Countless times our employees served as 4.6x higher hospitalization with 1.1x regarding the patient’s perception and what can be accomplished against tough
a conduit for loved ones to interact, higher deaths, American Indian or expression of pain can impact ethnic obstacles. We are equipped with dedicated
sometimes for the last time, when face to Alaska Native, Non-Hispanic persons groups disproportionately. healthcare professionals and leaders who
face visitation was limited. This was an have 5.3x higher hospitalization and For African American and Hispanic can advance health equity initiatives to
unimaginable notion a mere few months 1.4x higher deaths, and Asian, Non- patients with recurrent and advanced ensure all people have the opportunity for
ago. Hispanic persons have 1.3x higher hos- cancer, pain severity may be significantly long, healthy lives. The diligent and delib-
Forming a hospice isolation unit, a pitalization and no increase in deaths. S underestimated by providers as shown in erate actions we take united, the healthier
place for those with COVID-19 to receive ocial determinates of health, those studies cited by Coolen. we will all be.
exceptional end of life care while provid- conditions in where we live, work, learn, Other findings have also demonstrated
ing safe access to loved ones in the last play, and worship, have historically pre- that minorities were more likely not to Dr. Tracy Romanello is Medical Director,
hours of life meant so much to those we vented people of color from having “fair receive pain medication or would receive Catholic Palliative Care Services and
served and for our staff too. When battle opportunities for economic, physical, a lower dose of an analgesic, even if the Catholic Hospice. For additional informa-
tested, our team delivered time and time and emotional health” per the CDC patient had advanced cancer or was tion, contact Catholic Palliative Care
again, and when we lost one of our own, COVID-19 feature “Health Equity receiving end-of-life care. Services at (305) 351-7086 or
it hurt deeply. Considerations and Racial and Ethnic Additionally, underreporting of pain palliativecare@catholichospice.org.

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