NYC Comes to Terms with Racial Inequities in COVID Hospitalizations

A recent report from the New York City Department of Health and Mental Hygiene (a founding member of the Big Cities Health Coalition) shows that the COVID-19 hospitalization rate was more than two times greater among Black New Yorkers compared to White New Yorkers during the omicron wave. Understanding why the dramatic inequities experienced by Black New Yorkers throughout the COVID-19 pandemic became worse during this most recent surge requires a deeper analysis and cannot be explained by simple factors. Their white paper traces the cascade of factors that ultimately result in these inequities and lays out a roadmap for action.

The analysis shows that anti-Black structural racism contributed to this inequity in multiple ways, including:

• inequitable access to safe community and work environments
• fewer Black New Yorkers working from home
• delays in primary series vaccination and lower rates of booster doses among Black New Yorkers
• longer delays to diagnosis among Black New Yorkers, caused in part by structural barriers such as decreased access to COVID-19 testing or time off work to seek testing
• inequities in access to effective outpatient COVID-19 treatment
• higher rates of chronic disease, putting Black New Yorkers at greater risk of severe COVID-19 illness

The NYC Department of Health and Mental Hygiene has called on their partner city agencies, health plans, clinical providers, and community-based organizations to work with them toward a shared vision of reducing racial health inequities in the COVID-19 pandemic and beyond. These actions encompass investment in priority neighborhoods; improved access to care, including vaccination and COVID-19 treatments; and community engagement with cultural humility.