Victoria Nichols

A Covid-19 Response Rooted in Health Equity


Significant change is on the horizon for the US government in 2021. A new President will enter the White House and a new class of representatives will take their place in the House and Senate. These leaders will have the opportunity to influence and enact policies to advance the healthcare system and address the greatest public health crisis of the past century. As the new administration and legislature begin this important work, their top priority should be to develop and implement a Covid-19 response plan that is rooted in principles of health equity. Principles of health equity focus on ensuring opportunities for everyone to attain their highest level of health, regardless of socioeconomic status. A health equity approach is critical to comprehensively address the COVID-19 pandemic, as this global health crisis has revealed long standing racial and income inequities that can no longer be ignored.  


Covid-19 cases and deaths in the US have been disproportionately higher in communities with larger Black and Latinx populations. A variety of factors contribute to these outcomes, including but not limited to inadequate access to health care, racial bias, disproportionate representation of Black and Latinx populations in front-line occupations and a history of well-earned mistrust for the healthcare system. Many of these factors are within healthcare’s sphere of influence and should be critically assessed and comprehensively addressed in the incoming administrations’ Covid-19 response plan. 


Applying health equity principles to respond to Covid-19 and addressing factors contributing to disproportionate mortality rates among certain racial demographics can take a variety of forms and the new administration should work in partnership with Congress to explore innovative solutions that have promise for bipartisan support. As an initial step, the administration should explore ways to improve equitable access to healthcare services by building a robust local network of health institutions backed by Medicaid to bring services to people in medically under-resourced neighborhoods. Additionally, policymakers should work to enact laws that expand telemedicine to ensure that remote care is accessible to diverse, low-income patients but does not further exacerbate disparities. These policy ideas have promise both for gaining broader bipartisan support and advancing equity in US health care delivery and access. 


Whether the new administration pursues change through the regulatory or legislative processes, it will be well positioned to prioritize health equity in their pandemic response plan as President-elect Joe Biden has chosen Dr. Marcella Nunez-Smith, an expert in health care inequity, as one of three advisors to co-lead the Covid-19 Transition Advisory Board. She has emphasized the importance of addressing the issues of inequity in the US head-on in order to control the pandemic. 


Prioritizing equity in the Covid-19 response will initially benefit those disproportionately impacted by the virus, however by addressing structural gaps in the overarching healthcare infrastructure, equity-based solutions ultimately benefit everyone. Especially during times of global crisis, it is imperative to think more holistically about systems of care and push beyond the status quo to address challenges that make everyone vulnerable and put some at increased risk of harm.