Obesity, diabetes, hypertension, and other chronic conditions have plagued American society far before COVID-19. Almost 50% of the U.S. suffers from at least one type of chronic disease, with the chance of developing a disease being twice as high for marginalized communities, and about 50% of all Black adults in the U.S. are obese.
This trend of marginalized communities suffering from chronic illnesses at much higher rates, is extremely dangerous as chronic conditions have been linked to causing severe cases of COVID-19, though research is still ongoing. Because chronic conditions are more prevalent in BIPOC, these communities face greater consequences of COVID-19 — such as hospitalizations, rigorous intensive care, and even death. This explains the overwhelming trend of BIPOC communities being disproportionately affected by COVID-19.
Moreover, multimorbidity — having more than one chronic condition — is even more dangerous for COVID-19 patients. Obesity, for example, increases the likelihood of developing additional debilitating conditions such as Type 2 diabetes, heart disease, and stroke, which can exacerbate the symptoms of COVID-19.
“If a patient [has] diabetes, [they] have about an 80% chance of being obese,” Dr. Jay Jorge said. Dr. Jorge is a general surgeon and trained bariatric surgeon, performing weight loss procedures.
Chronic conditions have been shown to lengthen a patient’s recovery time with COVID-19 and worsen the virus’ long-term consequences.
“80 to 90% of my patients are ethnic minorities,” Dr. Jorge said. “African Americans and Latinx individuals are affected [the most] when it comes to [high] obesity rates; and, other medical conditions such as hypertension, dyslipidemia, and sleep apnea [are products of] being obese.”
Pre-existing conditions, such as obesity, are often caused by unhealthy eating habits, which can result from individuals’ low socioeconomic status. Because of factors such as food insecurity, limited access to healthy foods, and social environment, marginalized communities are more likely to consume low-nutrient foods that foster unhealthy diets.
Food insecurity leads to stress, as parents struggle to provide meals for their families. The resulting stress can negatively impact the mental health of family members, which research shows can be associated with emotional eating and less frequent physical activity. Having stress has been found to correlate with severer COVID-19 cases.
Food apartheid — a term referring to the systemic barriers restricting access to nutritious foods — also impacts a community’s access to healthy diets, as it is more likely to occur in regions concentrated with BIPOC communities. Supermarkets in these areas stock less whole grains and fresh produce, causing a disparity in what foods different communities are able to consume. These regions are also likely to have a higher density of fast food chains, which can become the only economically feasible choice for families.
Food apartheid — a term referring to the systemic barriers restricting access to nutritious foods — also impacts a community’s access to healthy diets, as it is more likely to occur in regions concentrated with BIPOC communities.
Food deserts, localized areas experiencing food apartheid, are seen in cities all across the U.S. A study by the University of Illinois, for example, found that food deserts in Chicago are primarily located in low-income, Black neighborhoods; and, out of 22 Chicago communities without large grocery stores or supermarkets, 15 communities were predominantly Black.
Low income, marginalized neighborhoods also tend to lack adequate environments that encourage physical activity, such as recreational facilities and parks. A University of North Carolina study found that low-income BIPOC neighborhoods have less access to gyms and, that greater access to these facilities correlates with reduced chances of being overweight or obese. Furthermore, green spaces, which are proven to provide mental stability and foster physical activity, are more sparse in BIPOC neighborhoods.
“High income neighborhoods are generally more aesthetically pleasing, have more access to walking and biking opportunities, and feel safer than lower income neighborhoods,” the study stated. As physical activity is a regularly used method to release stress, these communities may suffer from worse mental health and chronic illnesses because of a lack of resources.
In obese patients, acute respiratory distress syndrome (ARDS) has been hypothesized to be the main cause of COVID-19 related deaths. Obese patients are more prone to developing the syndrome as they have restrained respiratory function, due to increased adipose tissue volume and compression of the lungs.
“It [could] be possible that there is an underlying genetic predisposition or because obesity patients don’t have as good of a reserve,” said Dr. Jorge. “So physiologically when [obese patients] get infected they can’t handle it as much as someone healthier.”
Multimorbidity is on the rise in the U.S. and its disproportionate impact on BIPOC communities will continue to spike rates of mortality and illness unless more equitable healthcare and community standards are established.
Last updated 10/1/20
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