Lessons from the Pandemic: What COVID-19 Is Teaching Us About Health Equity

By Dr. Myechia Minter-Jordan, President and CEO, DentaQuest Partnership for Oral Health Advancement and Catalyst Institute, Inc. 

The inequities in our health care system have existed for decades, as people of color have long experienced significant differences in care access, treatment and quality. Now, as these same communities suffer from COVID-19 at disproportionately higher rates, the country is waking up to this disturbing reality.  

So, what has COVID-19 taught us about health equity?   

Racism Is a Public Health Crisis 

Recognizing that racism is a public health crisis — as many cities and states have officially done in recent months — is the first step to addressing the impact of systemic racism on health care. It’s certainly not the last. In fact, there are many more steps to take and barriers to overcome as we aim to improve the system that will deliver better outcomes for all Americans.  

As a member of the COVID-19 Health Inequities Task Force, I’m spending time with some pretty alarming data about the state of Massachusetts:  

  • People of color are two times more likely to live in areas impacted by COVID-19 than their white counterparts. 

  • Statewide data showed that nine of the ten cities and towns with the highest rates of infection are communities where more than half of residents identified as people of color. 

  • Those cities and towns are also experiencing higher mortality rates.  

Sadly, we have seen similar trends across the country. 

What do we do about this? If we’re going to call racism a public health crisis, then we need to treat it like one. A combination of testing, tracking and data-driven analyses has enabled public health officials to direct resources to the communities most impacted by COVID-19 and slow the spread. We can use similar data-driven tactics to invest health resources in communities that have been most impacted by systemic racism beyond the pandemic.  

There Is an Unacceptable Gap in Access to Oral Health  

We cannot address the deep inequities in health care without addressing the unacceptable gap in access to health care, including oral health. We know that oral health is directly linked to overall health — in particular many of the chronic diseases that put people at high risk for COVID-19, such as asthma, diabetes and cardiovascular disease.  

Currently, over 74 million Americans lack access to dental coverage — three times the number of people without medical insurance. Of these 74 million people, Black and Brown Americans disproportionately suffer from lack of care. Four in ten live in an area where non-emergency dental care is not covered by Medicaid. And Black adults are 68% more likely to have unmet dental needs compared to their white counterparts. 

We already knew access was a problem. But now we also know how this problem manifests during a global pandemic. At a time when Emergency Department (ED) capacity is a precious resource, reducing preventable dental-related emergencies is as important as ever. The current system and ED use trends reflect major social and geographic disparities in accessing health care. And it costs us — in lives, unnecessary suffering and billions of dollars. Instead, let’s find ways to put those funds to preventive care, dental treatment and oral health education through expanded access to Medicaid dental benefits, as a starting point.  

We Need a Stronger Safety Net 

The pandemic has made it abundantly clear that the current safety net has failed too many Americans. How can we improve it? We need to ensure comprehensive access to oral health care through public benefit programs. Oral health directly connects to overall health, so making sure programs like Medicaid and Medicare include an adult dental benefit is crucial to improving access and equity. 

At a time when state budgets are in crisis, we need to protect the progress we’ve made in expanding adult dental benefits. Any cuts right now would be shortsighted and have devastating effects for millions of patients and providers.  

In a recent DentaQuest Partnership survey of predominantly Medicaid providers, we heard that the providers were concerned about their ability to secure PPE and implement the necessary infection control protocols. This reflects the challenging economic realities that Medicaid dental providers are facing and has serious implications for the more vulnerable patients they serve.  

There is no doubt that the pandemic has exposed and exacerbated many failings in our health care system and our society. Fortunately, there are proven solutions we can start using today to begin closing these gaps. By focusing on data and innovation, investing resources in the communities that need them most and expanding benefits, we can build a stronger safety net and a more equitable system that prioritizes the health of all Americans. 

Learn more about health equity.