It would be foolish to respond to COVID by focusing on the coronavirus that caused it, because the virus alone cannot determine the catastrophic impact. For example, in the United States, the disease initially hit the urban population severely.But the virus has spread to more Rural areas over time, The impact has recently been transferred to the southern states. In these areas, People under 70 Compared with other places, the frequency of death from COVID is higher.These same states have Fewer people Get vaccinated and protected.Mortality trends and increase the burden Among cardiovascular and metabolic diseases in the southern United States, this disease has existed before the virus hits, but has made its impact worse.Difficulty in accessing health care is also a factor in these sad southern figures, as many of these same states refuse Expansion of Medicaid According to the Affordable Care Act.Even before the pandemic, states that expanded Medicaid showed Improve health; those who refuse to expand do notWith the COVID epidemic, states with expanded Medicaid are better able to strengthen testing and tracking, and provide medical insurance for people who suddenly lose their jobs.
The bigger lesson of COVID is that social and biological risks are deeply entangled. Viruses can cause personal illnesses, but epidemics can occur in people. Like previous epidemics, this disease reflects political, economic and social conditions. One way to understand these dynamics is through the concept of Syndemics.
the term Syndrome Refers SynchronizeEnergy between extensionscivilian. This idea involves three propositions. First, political and economic forces with historical depth have led to deep-rooted social, economic, and power inequality. Second, these inequalities affect the distribution of health risks and resources, leading to the concentration of diseases in specific populations. Third, due to biological interactions, some overlapping diseases can make each other worse.
COVID is not inherently comorbid. Syndemics is not a characteristic of a disease, but a characteristic of the system. Syndemics reminds us that although we can understand viruses in the laboratory, the distribution of diseases depends on the complex, real-world interactions between the political and economic structure, the ecological environment, and human biology. in other words, Context is important. Local Influence of history and power structure Where do the conditions gather, how they interact and why some people suffer more.
In the U.S, The conditions for comorbidity are ripe. A sort of Deep history of Systemic racism with White supremacy There are two direct consequences in the country. First of all, factors such as racial segregation, the racialized structure of the labor force, and the racial inequality in the prison system mean that blacks, aborigines and other people of color are more likely to be exposed to SARS-CoV-2, the virus that causes COVID . In contrast, the accumulated advantage of whites means that whites are more likely to engage in occupations that allow them to work from home, thereby reducing exposure. Secondly, due to the same political, economic and social inequality, blacks and browns have disproportionately suffered from poor health conditions such as high blood pressure and diabetes.Have Biological interaction There are differences between these conditions and COVID. For example, when the chronic inflammation caused by diabetes is exacerbated by the acute inflammation caused by SARS-CoV-2, it will cause a strong immune response and damage multiple organs.
This comprehensive interaction may be a reason worldwide Excess death The number of deaths in 2020 far exceeds the shocking number of deaths directly attributed to COVID that year.These conditions make the U.S. federal government’s response to the disease even weaker in 2020 fatal. By continuously downplaying threats and reopening crowded businesses while infections are still accelerating, the Trump administration Allow the virus to spread Along the fault line of society.and Pre-existing inequalities in health and living conditions This means that the worst-hit communities have suffered from concentrated poverty, substandard housing, reduced access to health care, disproportionate police surveillance and imprisonment, greater exposure to air pollution, fewer access to healthy food, and cardiometabolism. The problem of higher disease incidence. The pandemic has made many of these conditions worse.For example, Unequal Influence Economic impact throughout 2020 and the current economic recovery continue Many black communities and other communities of color are left behind.Earlier this year, the failure to prioritize the fairness of vaccine distribution has made Inequality growing up.
It doesn’t have to be this way. Take New Zealand as an example.There are many differences between the country and the United States, but they share a common history of European settler colonialism and persistent social, economic, and health inequalities among white, Asian and Pacific islanders And aboriginals. New Zealand once and now has a background of developing syndromes. But when COVID swept its coast, Prime Minister Jacinda Ardern shut down the country. In the nearly five-week lockdown that was implemented in March 2020, she embodied her “work hard, act early” approach, focusing on protecting her “5 million team.” She also urged New Zealanders to care for each other and be compassionate. The country has achieved great success in controlling COVID. Drawing on a long-term pandemic preparedness plan, Ardern adopted basic public health principles to stop the disease in this small, low-density population.
Many other countries responded with strong public health leadership, quickly implementing lockdowns and controlling the disease.For example, the government of Rwanda closed everything and strictly controlled the spread of COVID in 2020, in part by establishing Believe Within the system and what Agnes Binagwaho, the country’s former Minister of Health said, “Compassionate lead”In 2020 International Journal of Health Policy and Management Paper. One week after the first confirmed case, a nationwide lockdown was implemented, followed by extensive contact tracing and testing.Today Rwanda is struggling with a new peak of cases Promote vaccination As many citizens as possible, but it is difficult to get enough vaccines because Global inequality in immunization.
Inequality takes lives.Demographer Elizabeth Wrigley-Field recently showed that black Americans Experiencing premature deaths on a pandemic scale Per year. Just like the flu pandemic a century ago, COVID immediately caused shocking losses Reduce life expectancy More than a year in the United States. However, even if the life expectancy of white Americans has decreased, it is still higher than that of black Americans, and the life expectancy of black and Latino populations is expected to decrease three to four times that of whites.
When a new type of coronavirus is introduced into this unequal environment and allowed to spread, it is a disaster-not only for the target of racial oppression, but also for everyone. Another recent study estimated that if the U.S. government pays compensation to the descendants of enslaved persons—an important step in achieving freedom and justice for all—then the overall transmission rate of the virus, regardless of race or ethnic background, Will be 31% to 68% lower Than the original. Everyone will have a better life.
If the pandemic begins to subside, we hope that the world will not return to a “normal” state that is not suitable for everyone. COVID will not be the last pandemic threat we face. In order to reduce the pain of the next time, we must reduce the pain people experience now. The bigger lesson of Syndemics is that a more equal society is also a healthier society.