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Protecting the vulnerable: Addressing social determinants of health will save lives during COVID-19 pandemic

In this time of global health crisis, urgent action is needed to protect the most vulnerable members of our community.
(Photo: OSUCCC – James)

Sponsored: OSUCCC – James

In this time of global health crisis, urgent action is needed to protect the most vulnerable members of our community.

“The global COVID-19 pandemic shines a harsh light on a stark truth: The most vulnerable among us are at greatest risk of dying, and for many that is by virtue of their societal status—their social determinants of health,” says Electra Paskett, PhD, MSPH, associate director for Populations Sciences and co-director of the Cancer Control Research Program at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).

Social determinants of health are defined as the conditions in which people live, work, play and pray, and by the broader social structures that influence these conditions. Population-based studies have shown definitively that these factors influence overall health and well-being, and in times of crisis they are exponentially impactful, experts say.

“Time and again the same people are hit the hardest: the poor, the elderly, those with language barriers or limited social support, limited access to health care or food—the list is vast. This results in many in our community feeling marginalized, devalued and left behind,” says Paskett. “To flatten the COVID-19 curve and reduce the risk imposed on people and health care systems, we must ensure that all people are afforded equal access to information, testing and care.”

Paskett and colleagues Darrell Gray II, MD, MPH, and Chasity Washington say taking these measures now is key during this time of global health pandemic and beyond:

  1. Focus on health and testing at the neighborhood level. Expand criteria for qualifying for Centers for Disease Control Priority 1- or 2-level COVID-19 testing to include those who live in zip codes and census tracts with overlapping economic depravity, food insecurity and high burden of chronic disease. Allow earlier access to testing and informational resources by providing them at places frequented by those at risk, such as food banks.
  2. Expand neighborhood watches and engage community voices to share health information. Community health workers and patient navigators can help identify those who are in need of basic necessities and health care in vulnerable neighborhoods while maintaining social distancing requirements to provide intervention and support.

“Patient navigators and community health workers are trusted members of the communities they serve, and we should engage these individuals in a concerted, united way to do screenings, check-ins and self-care education with patients in at-risk areas,” says Washington, director of the Center for Cancer Health Equity at the OSUCCC – James

  1. Give people tools to track and mitigate spread. Connect at-risk individuals to resources that help abate in-home and community spread (contact tracing), address financial challenges, fulfill caregiver duties, and safely acquire food and medicine.
  2. Address language barriers. Screen for the need for translator and interpreter services. Allow a visitor to accompany patients who do not speak English, and make all materials available in common languages.
  3. Help people get back to their routine care. Patient navigators can help individuals understand why important medical procedures have been postponed and when they will be rescheduled. This will help patients resume normal medical care and adhere to rescheduled visits once the pandemic restrictions have been lifted.
  4. Provide support and resources to help people re-enter the workforce. When restrictions are lifted and people can transition back into the workforce, employees and business owners will need support. The need spans from access to masks for business owners and their employees, to assisting with planning and implementation for small businesses to adhere with public health guidelines for operating a business during COVID-19.

“COVID-19 has forced the world to a tipping point. As a society, we have the power to change this picture if we make small changes that have lasting impacts on how we care for the most vulnerable among us,” says Gray, deputy director of the Center for Cancer Health Equity at the OSUCCC – James. “We cannot continue the practices that have contributed to disparities for decades, ignoring the needs of those who need our help the most.”

To learn more about COVID-19 and cancer, visit cancer.osu.edu/coronavirus.