HJAR Nov/Dec 2020

22 NOV / DEC 2020  I  HEALTHCARE JOURNAL OF ARKANSAS COVID-19 HEALTH DISPARITIES COVID-19: Educational Attainment, Economic Mobility & Health Disparities Like millions of others over the last six months, I have focused on adhering to federal, state and local guidelines and recom- mendations surrounding public healthcare measures aimed at slowing the spread of COVID-19. Based on national and state data, the number of cases continues to increase and is directly correlated with events (such as national holidays) and activities (such as reopening schools) in which social distancing, wearing a face mask and gathering in small groups have been either poorly adhered to or totally discarded. As summer winds down, fall creeps in and we struggle to reopen our educational system, the number of deaths continues to climb with a disproportionate number occurring in over-65-year-old people, in- dividuals with multiple comorbidities, institutionalized (nursing homes, prisons) people, people of color (African-American, Hispanic, American Indian/Alaska Native, Native Hawaiian/Pacific Islanders) and other marginalized populations (LGBTQ and homeless people). Although the total number of cases in Arkansas has followed national trends, Arkansas has not experienced the mid to late summer downward trend observed nationally.1 Arkansas, along with several other states, is now experiencing a gradual increase in the daily number of COVID-19 cases ranging from a low of 485 on Aug. 20, 2020, to 786 on Sept. 20, 2020. Although the number of cases (79,049 as of Sept. 24, 2020) and deaths (1,246 as of Sept. 24, 2020) are lower than some surrounding states, Arkansas, like many states, has a disproportionate number of deaths in communities of color. This mirrors national mortality rates based on race and ethnicity. Nationwide, Black Americans and Latino Americans have experienced 21.5 percent and 20.9 percent of all deaths of known races but represent only 12.4 percent and 18 percent of the U.S. population, respectively. 1,2 Mortality Rates in Arkansas InArkansas, age-adjusted mortality rates are 24 Whites per 100,000 White popula- tion; 70 Blacks per 100,000 Black popula- tion; 117 Latinos per 100,00 Latino popula- tion; and 2,179 Pacific Islanders per 100,000 Pacific Islander population. This translates into age-adjusted mortality rates inAfrican- Americans/Blacks, Latinos and Hawaiian/ Pacific Islanders that are 3, 4.9 and 90 times of that in theWhite population, respectively. Arkansas has its highest COVID-19 mortal- ity rate among Pacific Islander residents. Forty-three Pacific Islanders are known to have died of the virus. There are fewer than 10,000 Pacific Islanders living in Arkansas (0.4 percent of the population). Based on projections, population density and deaths per 100,000 population, Hawaiians/Pacific Islanders are experiencing an extremely high age-adjusted mortality rate that is 90 times higher than the White population. Nation- ally, about 82 Indigenous people/100,000 Indigenous population have died from the coronavirus, a mortality rate 3.5 times higher than theWhite population. There have been 2 Indigenous people who have died fromCO- VID-19 inArkansas (all data is based on state reporting of at least 15 deaths of residents due to COIVD-19). 1 In Arkansas, the total number of deaths (1,246 as of Sept. 24, 2020) by race is as fol- lows: Black orAfrican-American (15.7 percent of the state population) – 241 deaths, 19.3 per- cent of total deaths; Latino (7.8 percent of the state population) – 80 deaths, 6.4 percent of total deaths; American Indian, Alaska Na- tive (1 percent of the state population) – 2 deaths, 0.2 percent of total deaths; White (72 percent of the state population) – 712 deaths, 57.1 percent of total deaths; Asian (1.7 percent of the state population) – 13 deaths, 1 percent of total deaths; multi-race (2.2 percent of the state population) – 7 deaths, 0.6 percent of total deaths; Native Hawaiian/Pacific Island- er (0.4 percent of the state population) – 43 deaths, 3.5 percent of total deaths; unknown races account for 174 deaths and 14 percent of total deaths. 1,3