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Head and Neck Surgery

COVID-19, Disparities, and Opportunities for Equity in Otolaryngology—Unequal America

Educational Objective
To understand how COVID-19 is highlighting disparities and opportunities for equity in Otolaryngology

1 Credit CME

JAMA Otolaryngology–Head & Neck Surgery

Published Online: September 10, 2020

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Article Information and Disclosures

Ciersten A. Burks, MD^1,2;

Gezzer Ortega, MD, MPH^1,3;

Regan W. Bergmark, MD^1,2

Author Affiliations

¹Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
²Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
³Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts

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The coronavirus disease 2019 (COVID-19) pandemic has laid bare health disparities in the US. Black and Latinx people have been disproportionately affected by COVID-19. In New York City, reported death rates through April 8, 2020, for Latinx and Black people were 22 per 100 000 and 20 per 100 000, respectively—more than twice the mortality rate of 10 per 100 000 for White individuals.¹ The disproportionate burden of hospitalization and deaths in the predominantly minority borough of the Bronx was subsequently confirmed.² Michigan, Louisiana, and Illinois also report high mortality rates among Black and other minority residents relative to White residents. Crowded housing preventing social distancing, unavoidable occupational exposure, necessary use of public transportation, and delays in access to medical care are thought to be some of the underlying causal mechanisms. Racial and ethnic minority patients also experience a greater burden of comorbidities, which are associated with increased risk of death from COVID-19. These comorbidities also are direct effects of system-based, societal problems that perpetuate worse overall health for minority patients. The aftermath of the COVID-19 pandemic will continue to reveal the inequality in America’s health care system and societal structure; therefore, we, as otolaryngologists, must act.

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Article Information

Corresponding Author: Regan W. Bergmark, MD, Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Center for Surgery and Public Health, Brigham and Women’s Hospital, 45 Francis St, Boston, MA 02114 (rbergmark@bwh.harvard.edu).

Published Online: September 10, 2020. doi:10.1001/jamaoto.2020.2874

Conflict of Interest Disclosures: Dr Bergmark reported support from the Brigham and Women’s Department of Surgery for the submitted work and a grant from the American Board of Medical Specialties outside the submitted work. No other disclosures were reported.

Funding/Support: This work was supported by the Department of Surgery at Brigham and Women’s Hospital.

Role of the Funder/Sponsor: The Department of Surgery at Brigham and Women’s Hospital had no role in the preparation, review, or approval of the manuscript and decision to submit the manuscript for publication.

References

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Deschler DG . Head and neck cancer compared with other cancers—does the great equalizer equalize equally? JAMA Otolaryngol Head Neck Surg. 2019;145(3):249-250. doi:10.1001/jamaoto.2018.4072 PubMed Google Scholar Crossref

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Centers for Medicare & Medicaid Services. CMS adult elective surgery and procedures recommendations. Accessed March 24, 2020. https://www.cms.gov/files/document/cms-non-emergent-elective-medical-recommendations.pdf

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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.