Why Social Justice Is Central to Treating COVID-19

Racism and classism create conditions where people of color, those living in poverty, and other marginalized groups have limited access to resources that affect health

Recent data shows that Black, Latino, indigenous, and immigrant communities are , in large part because of the persistent legacy of structural racism鈥攑ractices and policies that systematically benefit White people and harm people of color.

From , to the , to the and of New Orleans, Detroit, and Oakland, California, the message is clear: COVID-19 highlights our societal failures at the intersections of public health, health care, and social justice. If health inequities weren鈥檛 severe and oppressive enough, add the layer of on a . No matter where we look, our system has continually devalued Black bodies and lives.

As an interdisciplinary team of , , medical students, and critical race scholars, we believe that an important piece of the solution lies in physician training and knowledge of how societal factors affect health. Clinicians in training need to be grounded in the social determinants of health and critical race theory to prepare them for an ethical and effective pandemic response. We鈥檒l explain why social justice is so crucial to medical education and the care of marginalized communities.

Public health, social justice and medicine

Public health promotes and protects the health of people and the communities where they live, learn, work, and play. Traditionally, physicians study purely biological factors that only make up a of an individual鈥檚 risk of disease. Public health professionals study the 鈥攆actors beyond our bodies that affect health. These include insurance status, access to health care, reliable access to food, safe housing, transportation, education, safety, and equal protection under the law.

. This is because research has shown that health disparities are created by social inequities. Public health experts understand that oppressive systems dictate which people have access to key resources that determine health. Racism and classism create conditions where people of color, those living in poverty, and other marginalized groups have limited access to resources that affect health鈥�.

The social practices that created these gaps in health include , a practice where lenders denied mortgages to eligible buyers solely because of their race. Therefore, Black people and other people of color were denied the right of homeownership and upward economic mobility that millions of White people enjoyed. Redlining, now banned, was succeeded by , whereby middle-class White people come into urban areas and displace Black people who have lived in a neighborhood for years.

Both redlining and gentrification perpetuate poverty in communities of color in America鈥檚 cities. As such, many live in communities where clean water for good hand hygiene isn鈥檛 guaranteed, and social distancing is nearly impossible in crowded homes. In this way, redlining and gentrification affect the racial inequities seen in COVID-19.

By improving social determinants of health, health care leaders can transform our systems toward adequate COVID-19 prevention, testing and treatment for marginalized communities. But without a critical race lens, experts will still . They still might assume that racial and ethnic disparities exist because they believe that race is biological鈥�. Rather, they must confront how is a root cause of health inequity.

A strong example of social justice-oriented care is the work of pediatrician , who helped link toxic lead levels in Flint, Michigan, drinking water with the high lead levels in sick children鈥檚 blood from Flint. Hanna-Attisha helped ring the alarm on the , which sparked efforts to clean Flint鈥檚 drinking water. We believe a similar social justice approach is necessary for beating COVID-19.

COVID makes the case clear

Social justice and human rights are at the center of COVID-19. Therefore, they must be centered in clinician training. Courses on inequity and social justice are still optional in many medicals schools. Most of these efforts are , , or assigned to .

COVID-19 has revealed how looking at differences in health through biology alone is limited. It is not sufficient in addressing this pandemic. If people perceive inequities as inevitable, they resign marginalized communities to poor health outcomes. When health providers and the health system take accountability for our inequitable health care system, they can better serve patients and communities.

As practitioners, scholars, and people from communities that are most affected by COVID-19, we see human rights as being at the core of our work. Social justice demands us to see people with their full humanity to ensure equity in and beyond a pandemic. Because so many affected by COVID-19 are navigating poverty, food insecurity, lack of housing, child care, and insurance issues, physicians must develop a deep understanding and compassion towards all elements that undergird people鈥檚 health and well-being.

Editor鈥檚 Note: , , and contributed to this article.

This article was originally published by . It has been published here with permission.

Zo毛 Julian is an obstetrician gynecologist, educator, and researcher committed to sexual, reproductive, and perinatal healthy equity through authentic and equitable community partnership.

Rachel R. Hardeman is a tenured associate professor in the division of Health Policy & Management at the University of Minnesota.

Ryan Huerto is a family medicine physician and health services researcher dedicated to health justice, workforce diversity, chronic non-communicable disease management, disease prevention, medical education, and mentorship.