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Addressing the Health Equity Gap

Does COVID-19 discriminate against race or social class? Because of a variety of circumstances, an individual’s situation can impact susceptibility to lung disease. What can we do to address this health gap?

The stories are alarming. A large inner-city hospital reported the overwhelming majority of patients who died from COVID-19 were African American. A suburban hospital that is part of a large regional healthcare system noted high COVID-19 cases and deaths among Hispanic laborers. A small community in the Southeast where many residents live below the federal poverty line reported more than 30 deaths among African Americans in a two-week span.

These stories highlight the continuing healthcare disparities in the United States. COVID-19, asthma, and other lung diseases are far more common among African American, Hispanic/Latino, and Native American communities, especially those in urban areas.

Why gaps exist

Many factors impact health disparities — from income level and lack of health insurance to increased exposure to environmental allergens and irritants. People living in medically underserved communities also are more likely to miss doctor appointments, delay their care or forego treatment, leading to poorer health outcomes.

In Atlanta, pediatric pulmonologist LeRoy Graham, M.D., recognized the persistent health disparities in communities of color. He also saw barriers keeping people from receiving the treatment they need. For example, many African Americans with undiagnosed asthma do not realize they have a problem with their lungs because they do not see a doctor very often or do not understand their symptoms.

Breaking through those barriers

Dr. Graham saw an opportunity to better engage African Americans by going where many of them gather on a regular basis: churches and other faith-based settings. He started a nonprofit called Not One More Life that sends doctors, nurses, asthma educators, and respiratory therapists to predominantly Black churches and schools to host free asthma screenings, referrals, and patient education.

“Places of worship were the social safety net before there was even a social safety net,” Dr. Graham says. “We went into African American community churches and built a foundation of trust that carries over into healthcare. We had people fill out asthma questionnaires and undergo screenings. Most importantly, we got them referrals and provided patient education so they can better make informed, evidence-based decisions about their health.”

The success of Not One More Life

Not One More Life, which merged with Allergy & Asthma Network in 2019, proved successful. In September 2020, Allergy & Asthma Network launched the Not One More Life Trusted Messengers program, providing free COVID-19, asthma, and COPD screenings at two predominantly Black churches in the Atlanta region. The program is a public-private partnership supported by Sanofi-Genzyme and numerous other partners at the local, regional, and national level. Up to 90 percent of participants in Not One More Life’s asthma screenings reported seeing a doctor afterward.

Expanding access to care and encouraging underserved communities to participate in research are key in achieving health equity.

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