As the first cases of coronavirus arrive in the state, Colorado health and social services officials say they are striving to make sure lower-income residents and people of color are not disproportionately impacted by the illness and potential economic disruption.
As of the afternoon of March 6, Colorado had reported eight coronavirus cases, most in patients who had recently traveled to highly infected areas. So far, no so-called “community” transmissions are reported, but public health officials expect they will show up. It’s too early to tell the extent to which Coloradans will be impacted.
National and international studies of past pandemics have revealed inequities by race, ethnicity and income groups in everything from the level of exposure to the pathogen, to health care outcomes during and resulting from treatment, to loss of income and vulnerability to emergency health expenses. A study of the 2009 H1N1 virus outbreak published in the American Journal of Public Health documented major gaps in complications and hospitalization rates among Blacks, Hispanics, Indigenous people and whites, in areas as widespread as Boston, Chicago and Oklahoma.
While Colorado as a whole scores well in experts’ national rankings of public health emergency preparedness (more on that shortly), past experience in addressing broad health challenges shows there will be pockets of the state facing extra health and daily living threats, said Glen Mays, chair of the Department of Health Systems, Management and Policy in the Colorado School of Public Health. Lower-income communities with fewer public resources and higher uninsured rates, or immigrants of color who fear contact with authorities because of documentation issues, are two examples.
“It boils down to these communities being less protected, with fewer resources to be deployed to screen and identify a threat,” Mays said. “When a new thing happens, you have to make choices every day. Ultimately, that means someone’s not going to get served.”
Potential school closures alone raise troubling equity issues, acknowledged Dr. Mark Wallace, public health director for Weld County and board chair of Sunrise federally qualified health clinics in northern Colorado. Around the world, at least 300 million children are now missing school because of coronavirus lockouts.
“We have to be aware that we’re going to leave a bunch of children out in the cold where they won’t get an education, they won’t get food, and they won’t have access to school health centers. It ripples through very quickly,” Wallace said.
“One thing is very clear: we are pretty far from the goal of equal protection when it comes to protecting people from large-scale disease outbreaks, like what coronavirus could become,” Mays said. “Where you live determines to a strong degree how protected you are from hazardous events like novel coronavirus.”
In addition to his position at Colorado School of Public Health, Mays directs the National Health Security Preparedness Index, created by the U.S. Centers for Disease Control and Prevention and supported by the Robert Wood Johnson Foundation. The index tracks multiple measures of states’ preparedness for public health threats, and ratings show how states vary from each other and improve or decline over time.
Read more at ColoradoSun.com.