Data on racial and ethnic patterns of the pandemic paints an alarming picture. Biases and discriminatory practices in health care contribute to stark inequities, but physicians and other health professionals can help make a change to better reach and care for Black patients.
Tochukwu M. Okwuosa, MD, director of cardio-oncology services and associate professor of internal medicine and cardiology at Rush University Medical Center in Chicago, shares how physicians and health professionals can improve the physical and mental health of Black patients during the pandemic and beyond.
While Dr. Okwuosa did not always eat healthfully, as she made her way through her residency and cardiology fellowship, she realized, “I’m talking to my patients about these things, but I should start with me. I should make the change in myself first so that then it can be related to my patients.”
“It’s so much easier to talk to patients and share what I’ve been through with my journey,” she said.
This is especially true during the pandemic when many patients say, “because of COVID-19 I’ve just been locked up in the house.”
“I have to encourage them and say, ‘We’re trying to have you be safe, but you can walk. You can walk outside,’” said Dr. Okwuosa, adding that even though the gyms are reopening, she does not recommend going yet because her patients fall into the higher-risk category.
“Walking and exercising are important because it’s good to help you relieve stress. It’s also good to help you breathe fresh air and, of course, there are the cardiovascular benefits that come from exercise,” she said, adding that even without a treadmill, patients should “put on their mask and sneakers and just walk outdoors.”
Learn more about strengthening long-distance care for chronic disease patients.
Remaining up to date on important information and addressing the concerns of patients is key to fighting misinformation and maintaining trust.
“COVID-19 has been very scary for a lot of people, including the physicians,” said Dr. Okwuosa. “Then, of course, our patients. There was initially this misconception in the Black community that COVID-19 was probably not affecting Blacks because of all the press that we had about ACE receptors in the beginning.”
“Then we all began to realize that this was not the case and that Black people were definitely prone to COVID-19 infections,” she said. “They are even more prone to it. Probably more than any other population to any other race in the United States and more likely to die from it.”
“A lot of studies are coming out that are suggesting that this is all social economics more than anything else,” said Dr. Okwuosa.
Learn more with the AMA about the importance of science in an era of distrust and misinformation.
With COVID-19 information—and misinformation—flooding the news channels and social media, physicians have a critical role to play in helping their Black patients prevent further spread of the disease.
For example, at the pandemic’s peak in Chicago Dr. Okwuosa had an older couple come into her clinic for routine care even though she was offering telehealth and phone visits. As they were talking, the couple mentioned that they had seen their daughter, who had a fever and wanted to go to the hospital.
“Now these are elderly patients—both of them were in their 70s,” so Dr. Okwuosa was very alarmed. She proceeded to reinforce the risks of going to see their grandkids and daughter because of the husband’s heart disease and cancer.
“I was so grateful that he mentioned it in passing,” said Dr. Okwuosa. “I was able to spend 10 minutes or more talking to them about COVID-19, explaining what the disease was all about and why they have to be scared about even trying to go near those landscapes.”
“This is what I mean about education, which was lacking in the community” in the pandemic’s early days, she said. “It is better now because my patients that I am seeing are better educated in this sort of situation, but it was scary at that time.”
“The Black Lives Matter movement is also another issue,” said Dr. Okwuosa, adding that “we have two major epidemics going on and my Black patients want to talk about it.”
“I talk to my patients about cardiovascular issues, but I’m also concerned about my patients’ social and psychological well-being,” she said. “That’s the other aspect of it.
“Overall, how is this affecting their psychological well-being and what sorts of help can we offer our Black patients knowing that they are dealing with two major issues out of proportion to every other race in the country,” said Dr. Okwuosa.
While many physicians can be strapped for time, it is still important to check in with patients at every visit.
“We don’t have enough time, but even just asking how they are and just hearing how their family is doing helps,” said Dr. Okwuosa. “A lot of my patients have kids or grandkids, so I ask, ‘How’s your child doing? How’s this person doing? How are things going?’”
“A lot of Black patients, knowing they’re dealing with a Black physician, usually open up and they’ll say something and just having us listening is important,” she said. “For one reason or another, just make sure that they are OK.”
“Make sure that everything is being taken care of. That is very important to me, especially for elderly patients who are by themselves. That’s become even more important now,” said Dr. Okwuosa.
Dr. Okwuosa finds that while she sees “a diverse population of patients,” when she treats a Black patient, they look at her and “get so excited.”
“A lot of my African American patients love to come and see me, particularly because they see this cardiologist who’s female, who’s African American and who they can identify with,” she said.
“It makes it easier to talk to them, to relate to them on a level that we both can understand each other,” she said, adding that it helps patients make needed changes to improve their health and well-being.
Learn more about the racial health inequities that are rampant in hypertension.
The AMA continues to compile critical COVID-19 health equity resources to shine a light on the structural issues that contribute to and could exacerbate already existing inequities. Physicians can also access the AMA’s COVID-19 FAQs about health equity in a pandemic.
Essential Tools & Resources
Read AMA policies on health equity
Explore health equity on JAMA Network™️
Read the latest on health equity from AMA Journal of Ethics®️
Learn more about health disparities on AMA Ed Hub™️
COVID-19 Q&A: health equity in pandemic
Release the Pressure: Heart health equity with Essence