[Skip to Content]
[Skip to Content Landing]

Responding to the COVID-19 PandemicThe Need for a Structurally Competent Health Care System

Educational Objective
To understand the structural changes needed to ensure a competent health care system in the post-COVID-19 world
1 Credit CME

The coronavirus disease 2019 (COVID-19) pandemic has exposed the consequences of inequality in the US. Even though all US residents are likely equally susceptible to infection with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the virus that causes COVID-19 disease, the resulting illness and the distribution of deaths reinforces systems of discriminatory housing, education, employment, earnings, health care, and criminal justice.1,2 The patterns of COVID-19 illuminate centuries of support systems that the US did not build and investments it did not make.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Jonathan M. Metzl, MD, PhD, Department of Medicine, Health, and Society, Vanderbilt University, 300 Calhoun Hall, Nashville, TN 37235 (jonathan.metzl@vanderbilt.edu).

Published Online: June 4, 2020. doi:10.1001/jama.2020.9289

Conflict of Interest Disclosures: None reported.

References
1.
Bailey  ZD , Krieger  N , Agénor  M ,  et al.  Structural racism and health inequities in the USA: evidence and interventions.   Lancet. 2017;389(10077):1453-1463. doi:10.1016/S0140-6736(17)30569-XPubMedGoogle ScholarCrossref
2.
Williams  DR , Cooper  LA .  COVID-19 and health equity—a new kind of “herd immunity”.   JAMA. Published online May 11, 2020. doi:10.1001/jama.2020.8051PubMedGoogle Scholar
3.
Waldstein  D . As Georgia reopens, virus study shows Black residents may bear brunt. New York Times. Accessed May 11, 2020. https://www.nytimes.com/2020/04/30/health/coronavirus-georgia-african-americans.html
4.
Wadhera  RK , Wadhera  P , Gaba  P ,  et al.  Variation in COVID-19 hospitalizations and deaths across New York City boroughs.   JAMA. Published online April 30, 2020. doi:10.1001/jama.2020.7197PubMedGoogle Scholar
5.
Hauck  G , Nichols  M , Marini  M , Pantazi  A . Coronavirus spares one neighborhood but ravages the next. Race and class spell the difference. USA Today. Accessed May 11, 2020. https://www.usatoday.com/in-depth/news/nation/2020/05/02/coronavirus-impact-black-minority-white-neighborhoods-chicago-detroit/3042630001/
6.
Pirtle  WNL .  Racial capitalism: a fundamental cause of novel coronavirus (COVID-19) pandemic inequities in the United States.   Health Educ Behav. Published online April 26, 2020. doi:10.1177/1090198120922942Google Scholar
7.
Metzl  JM , Hansen  H .  Structural competency: theorizing a new medical engagement with stigma and inequality.   Soc Sci Med. 2014;103:126-133. doi:10.1016/j.socscimed.2013.06.032PubMedGoogle ScholarCrossref
8.
Metzl  JM , Petty  J , Olowojoba  OV .  Using a structural competency framework to teach structural racism in pre-health education.   Soc Sci Med. 2018;199:189-201. doi:10.1016/j.socscimed.2017.06.029PubMedGoogle ScholarCrossref
9.
Bourgois  P , Holmes  SM , Sue  K , Quesada  J .  Structural vulnerability: operationalizing the concept to address health disparities in clinical care.   Acad Med. 2017;92(3):299-307. doi:10.1097/ACM.0000000000001294PubMedGoogle ScholarCrossref
10.
Yancy  CW .  COVID-19 and African Americans.   JAMA. Published online April 16, 2020. doi:10.1001/jama.2020.6548PubMedGoogle Scholar
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close
Close

Lookup An Activity

or

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close