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2020 ; 173
(6
): 474-481
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Historical Insights on Coronavirus Disease 2019 (COVID-19), the 1918 Influenza
Pandemic, and Racial Disparities: Illuminating a Path Forward
#MMPMID32501754
Krishnan L
; Ogunwole SM
; Cooper LA
Ann Intern Med
2020[Sep]; 173
(6
): 474-481
PMID32501754
show ga
The coronavirus disease 2019 (COVID-19) pandemic is exacting a disproportionate
toll on ethnic minority communities and magnifying existing disparities in health
care access and treatment. To understand this crisis, physicians and public
health researchers have searched history for insights, especially from a great
outbreak approximately a century ago: the 1918 influenza pandemic. However, of
the accounts examining the 1918 influenza pandemic and COVID-19, only a notable
few discuss race. Yet, a rich, broader scholarship on race and epidemic disease
as a "sampling device for social analysis" exists. This commentary examines the
historical arc of the 1918 influenza pandemic, focusing on black Americans and
showing the complex and sometimes surprising ways it operated, triggering
particular responses both within a minority community and in wider racial,
sociopolitical, and public health structures. This analysis reveals that critical
structural inequities and health care gaps have historically contributed to and
continue to compound disparate health outcomes among communities of color.
Shifting from this context to the present, this article frames a discussion of
racial health disparities through a resilience approach rather than a deficit
approach and offers a blueprint for approaching the COVID-19 crisis and its
afterlives through the lens of health equity.
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