First Reflections—Health Equity in the United States: Furthering the Dialogue

This is the time of year when many of you will be asked to renew your AHLA membership and will also receive appeals from AHLA as part of our annual fundraising activities. You are all well familiar with the many educational offerings and networking opportunities that AHLA uses these funds to provide. I want to take this opportunity to highlight AHLA’s broader activities in the public interest. AHLA consistently seeks to advance health law education by leveraging its unique ability to encourage constructive information exchange and dialogue on complex health law, policy, and public health issues among affected members of the health law community. Past examples of this include conveners on the use of artificial intelligence in health care in November 2020 and the opioid crisis in September 2018.

In this vein, AHLA continues to use its role as a health care thought leader to further the dialogue on the issue of health equity in the United States. Issues of health equity and social determinants of health have long been with us and the COVID-19 pandemic has brought them into sharp and troubling focus. Recently updated statistics and other information contained on the Centers for Disease Control and Prevention (CDC) website show the staggering disparate impact that COVID-19 has had on racial and ethnic minority groups in the United States.¹ According to CDC statistics, Black Americans are 3.4 times more likely to be hospitalized for COVID-19 than White Americans. For Native Americans, the rate is 3.7. For Hispanic and Latino Americans, the rate rises to 3.8. The statistics are even more stark regarding COVID-19-related deaths. Using age-adjusted data, Black Americans make up almost 24% of COVID-19-related deaths, while only constituting roughly 13% of the U.S. population. Hispanic and Latino Americans make up roughly 38% of COVID-19-related deaths, while constituting only approximately 19% of the U.S. population. Native Americans constitute .7% of the population but comprise 2.9% of COVID-19 related deaths.

The CDC website notes various factors that disproportionately affect racial and ethnic minority groups that increase the risk of exposure to COVID-19. These include crowded living conditions, as well as disproportionate representation in a variety of essential work settings, such as health care facilities, food processing, factories, and retail services. According to the CDC, the disparate hospitalization and death rates may at least partially be explained by common underlying conditions, including diabetes, high blood pressure, obesity, chronic kidney disease, and congestive heart failure. The CDC notes that many of the same social determinants of health that increase the risk of illness from COVID-19 also increase the risk of health conditions such as obesity, high blood pressure, and diabetes. These include education, economic stability, physical environment, insurance coverage, and access to care.

AHLA’s recent activities have included the podcast “Racial Disparities in Health Care” in August 2020² and the webinar “Health Equity in Clinical Trials” in February 2021.³ AHLA will host a one-day virtual convener on April 12, 2021 where a panel of recognized thought leaders will discuss all aspects of health disparities and equity in health care, social determinants of health, the impact of law on these issues, and what can be done to address these issues now and in the future.

In addition, the Editorial Board of the Journal of Health and Life Sciences Law is publishing a special issue in December 2021 with a focus on “Emerging Issues in Health Equity in the United States: Legal, Legislative, and Policy Perspectives.” The issue will seek to advance public discourse on this topic for the benefit of AHLA members, the academic community, and decision makers in both the legislative and executive branches of government. The articles will identify the history and reasons why the U.S. health care system has reached the current state of affairs of health inequity as well as workable, effective strategies for meaningful, positive changes in our health care system, during a time of widespread disruption propelled by racial, social, political, environmental, and economic turmoil and inequity exacerbated by a pandemic. This effort is being headed by AHLA Fellows Almeta Cooper and Harvey Tettlebaum and is actively seeking authors to contribute.

Finally, please visit our new Hub on the AHLA website called “Diversity, Equity, and Inclusion in Health Care,” which gathers all AHLA content on this subject at a single, easy-to-use point of access.⁴

Stay safe.