Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Physical Medicine and Rehabilitation


Tom Colletti, DHSc, MPAS, PA-C, DFAAPA



Examining increased morbidity and mortality in racial and ethnic minorities during the COVID-19 pandemic is essential to understanding health inequity, inequality, and injustice in our current healthcare system. Asian, Black, Latinx, American Indian, Alaskan Native, Native Hawaiian, and Other Pacific Islanders were disproportionately affected by the COVID-19 pandemic resulting in an increased incidence of infection, hospitalization, and death. Social determinants of health, including socioeconomic status, profoundly affected racial and ethnic minorities, resulting in the inability to social distance due to multigenerational living and without the opportunity to work remotely. The service industry during the pandemic was disproportionately constructed of racial and ethnic minorities, resulting in a larger percentage of those populations losing employment when the hospitality industry temporarily closed (due to halted travel). A significant number of racial and ethnic minorities were employed as essential workers such as nurse’s aides, public transportation drivers, sanitation workers, retail sales, and in the meatpacking industry. Others were employed in an environment where unpaid sick leave was the norm and absenteeism could result in loss of employment. Long-standing systems such as structural racism continue to perpetuate discriminatory practices affecting, employment, education, housing, and access to health care resulting in poorer mental and physical health outcomes. Social determinants of health and structural racism are the legacy of United States (US) Settler Colonialism, established upon indigenous elimination, racism, and immigrant exploitation.


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