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One of the tragedies of the COVID-19 pandemic is the high impact of the coronavirus on minority communities. News agencies and medical researchers report elevated levels of death in the African American and Latinx communities. These populations may have higher levels of exposure to the virus (perhaps due to circumstances such as job type), and many from these populations do not do as well fighting the virus as do others.
What can be done to help achieve health equity for persons in these at-risk groups? Long-term solutions may include improving access to healthcare for minorities and assuring protections against the virus in the workplace. However, those actions, which may help minorities with prevention of the virus and appropriate diagnosis and treatment of COVID-19, will only occur when substantial societal changes take place. What can we do in the meantime?
For one, we need to beef up support for minorities at risk. The idea that social support affects health outcomes has become accepted by many in the medical community, yet there are still skeptics. Psychosocial factors contribute to health, but their effects are difficult to tease out in a clinical or medical trial. If an individual has a high level of support, that individual also might have optimism—social support and optimism may overlap—and it is difficult for researchers to discern which ultimately affects the health outcome.
Nevertheless, in the last 40 to 50 years, clinicians and researchers have come to accept that certain psychosocial factors affect disease. For instance, it is now common knowledge that Type A behavior influences cardiovascular disease. Since the 1970s, researchers have assessed the influence of social support, another psychosocial factor, on health behaviors and on health outcomes. More support typically equates to better health.
Social support comes in many fashions, and it is difficult to delineate which type of support actually influences health. It may be the combination of supports that help an individual. Typical types of social support are the following: (a) emotional support (provision of a listening ear); (b) instrumental support (provision of resources); (c) appraisal support (feedback); and (d) informational support (advice and information).
Fortunately, Latinx communities are good at supporting one another. We should applaud and help these efforts. For example, a program aimed at using Promotoras called Mujeres en Accion por Su Salud (Women in Action for Their Health) assists women in decreasing their cardiovascular risk factors by encouraging regular walking. Promotoras, or peer counselors, provide needed emotional and informational support to help Latina women exercise. The program offers instrumental support by supplying pedometers and community walking maps. Appraisal support occurs when the Promotoras give feedback to the Latinas about their exercise goals. Similarly, many Latina women enjoy relatively good pregnancy outcomes in part because their communities support them during and after their pregnancies. They support one another at the time of birth, giving emotional and instrumental support.
Can local governments fund social support programs during this time of COVID-19? Certainly. Public health departments are training contact tracers to play detective and find where disease transmission occurs. Such trainings can include modules on teaching empathy and active listening so that the contact tracers can provide social support at the same time they are working on tracking COVID-19. In addition, social workers can be part of contact tracing teams to aid persons exposed to the virus in getting resources, such as Supplemental Nutrition Assistance Program benefits. Even these small efforts will help decrease bad health outcomes with COVID-19.
In African American communities, support can come via health ministries at churches. Pastors generally appreciate such ministries as they “feel strongly about the intersection of health, religion and spirituality.” Parishioners are accustomed to outreach about health issues, so at this time of COVID-19, faith-based organizations could encourage their health ministry teams to reach out to church members. Many such church members are isolated and lonely during this pandemic—a recent study noted that those who are socially isolated will have higher overall and cardiovascular disease mortality.
Since many minorities have been devastated by the pandemic, government grants to minority communities should include requirements for community leaders to increase social support in their communities. One study showed that minority women with high levels of emotional support had “thriving health.” Faith-based organizations should ask their donors to contribute to health ministry teams. Ministry teams should greatly increase outreach and support to persons in their areas vulnerable to COVID-19.
Media and governmental entities have been putting forth the phrase “we are in this together.” But are we? Only by doing everything possible to decrease the morbidity and mortality in minority populations will we show that we are “in this together.” One simple but effective way is to take actions that increase social support.
