The COVID-19 pandemic laid bare the social, racial, health and economic inequities entrenched in our systems and institutions. Communities of color, immigrants, low-income, and undocumented people suffered disproportionately: they got sick and died from COVID-19 at significantly higher rates than whites. This did not come as a surprise to three Cal Wellness grantees—California Pan-Ethnic Health Network, Public Health Advocates and Prevention Institute—who have been sounding the alarm on racial injustice and health inequity in our state for decades. Now, these grantees are doing everything in their power to make sure that we heed the lessons we learned the hard way over the last three years. You can read their stories at the bottom of this page.
"I frequently pose this question to people. If I were to take you back to 2018 and say to you, 'In a couple of years we're going to have a pandemic, and it's going to be an infectious disease that devastates the world. Who do you think will be most impacted?’” said Dr. Flojaune Cofer, senior director of policy at Public Health Advocates. “Without knowing what the disease was, most people who pay attention to the world around them could have predicted that people most harmed by this pandemic were going to be low-income folks, people of color, people who worked lower-wage jobs. Most people could have predicted that people who are immune compromised or older were going to be at highest risk for getting the disease and succumbing to it.”
Cofer continued: "That means that there are patterns to how our society is set up that were already in place and that were knowable. And that means that there were opportunities for prevention that we didn't take advantage of."
At Cal Wellness, we believe that our health and wellness are directly affected by our race, class, gender and disability. By our zip code. By our family history. By our immigration status and past involvement with the criminal justice system. In public health, there is a term for this: social determinants of health.
"The social determinants of health ended up being predictive of who would get COVID-19 and who would suffer the worst consequences from it and death,” said Juliet Sims, associate program director at Prevention Institute.
“For example, are you uninsured or under-insured? Do you have access to housing? If you do, is it crowded conditions? Are you able to shelter in place? Or do you have to leave your house and go to work in order to not lose your home? Do you have access to green spaces and parks where you can safely be active and connect with others? Are you a resident who is undocumented? Because our fellow Californians who are undocumented didn't receive federal checks and they didn't automatically have access to emergency healthcare," explained Sims.
The disproportionate health and economic impacts we witnessed during the pandemic are a result of history of inequity in our state and country. We've known about these differences in health status and lived experiences and we could have remedied them, but we didn't.
If we want to see a different outcome in the future, we must address the social determinants of health in ways that promote health and health equity. And to do that, we need a paradigm shift in how our government and our public health system work.