COVID-19 becomes a magnifying glass for health disparities


The daily email update on COVID-19 affecting our hospital system is a glaring reflection of the health disparities amongst those in marginalized groups. The farther south you go, generally in San Diego, the higher the number of socioeconomically disadvantaged persons, and that tends to include a disproportionate number of persons of color.  These populations may be unable to physically distance due to living conditions and job conditions.  Perhaps there is a higher number of persons living together per household, in a smaller space, along with the inability to work from home.  And the mortality rates of those from COVID-19 amongst these persons is higher than white counterparts. Sometimes there is an inherent distrust in the medical system.  COVID-19 and racism intersect. However, this is not a unique situation in health care—many chronic illnesses portend worse outcomes for those in marginalized groups.  Marginalization means just that: glaringly apparent in health outcomes and socioeconomic disparities.

There is a recognition that racism is woven into the fabric of modern-day medicine.  How does one unravel this? How does one come to terms with this? Education about the past yes, implicit bias, and diversity training, of course, but more importantly, a call upon health care professionals to show up with an intention for those they are serving, especially those in marginalized groups with authenticity and compassion.  Beyond health care, racism is interwoven into the fabric of life in the U.S. Can we all learn to show up with compassion, for ourselves, our fellow human brothers and sisters?  We need this now more than ever.

The murder of George Floyd has been a galvanizing catalyst for anti-racism.  Why is that? His breath, a necessary function of the human body for life, was brutally taken from him, using a method that was dehumanizing. It was an example of the injustice occurring time and time again all over the U.S., for too long. No wonder the rage, the disappointment, the desire to change the way things are. When there is no breath, there is no life.  “There’s more right with you than wrong with you if you are breathing,” said Jon Kabat-Zinn. What about “There’s more right with you than wrong with you, if you are living.” Because sadly, the breath can be taken, even if you are otherwise healthy.  The breath can be taken if you contract COVID-19.  The breath can be taken from you if you are black.  The breath can be taken from you because you are not white.

COVID-19, the virus itself is neutral. However, because of racism interwoven into the U.S., COVID-19 becomes a magnifying glass, highlighting disparities, a thief of the breath, disproportionately affecting groups that are most affected by racism.  COVID-19 and racism together remove the breath of marginalized groups.  Breath that is freely given, to all humans, from the first moment of life.  Sometimes we are unable to control which diseases afflict us.  We cannot control the actions or thoughts of others, however hard we try.  We can only hope to influence, but others’ actions and thoughts are ultimately theirs. However, we can own our actions, own our responses when caring for those from marginalized groups:  notice, listen, pay attention, without judgment, with curiosity, to choose responses that can be intentionally anti-racist, not despite COVID-19, but particularly during COVID-19 and beyond.  Instead of choosing to be color blind, COVID-19 is an opportunity for us to develop Professor Rhonda Magee’s ColorInsight. From her new book, The Inner Work of Racial Justice: Healing Ourselves and Transforming Our Communities Through Mindfulness:

First, we ground our efforts in the desire, the will, and the courage to turn toward, rather than away from, race and racism to examine its role in all our lives. Second, we work to develop a deeper and more nuanced capacity to perceive and to understand how race and racism operate in our own lives and in those of others. Third, we deepen our ability to be with others as they reflect on these aspects of their experiences- to listen without judgment and with compassion, and to work together with them toward mutually healing personal and interpersonal transformation. And finally, we commit to looking for ways to act in favor of liberation that touches on the collective and the systemic, thereby opening the door for transformation that benefits us all.

How can we start to do this? We can start by noticing the breath.

Ni-Cheng Liang is a pulmonary physician and founder, the Mindful Healthcare Collective.

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