ABSTRACT
We at the W. Montague Cobb/NMA Health Institute share growing concern regarding prisons and immigrant detention as structural determinants of Coronavirus disparities for our most vulnerable and underserved populations. Black or African American adults represent 12% of the U.S. adult population but 33% of the sentenced prison population, with nearly six times the imprisonment rate for whites. Interestingly, but not surprisingly, immigrants who are also Black may be at higher risk for being detained compared to their non-Black immigrant counterparts because of racial profiling. Whereas Black immigrants account for 20 percent of immigrants facing deportation on criminal grounds and three out the last thirteen deaths in detention due to COVID-19, they comprise only 7 percent of the immigrant population. Wallace et al.’s recent Morbidity and Mortality Weekly (MMWR) Report noted 4,893 cases and 88 deaths among incarcerated or detained residents, 2,778 cases and 15 deaths among staff members, and at least one confirmed case among 420 facilities and representing 86% of the 37 of 54 jurisdictions reporting. Although the epidemiologic data on Coronavirus within these settings remains incomplete, we do know that crowded conditions and other factors that propagate pathogen transmission are common. Furthermore, these transient settings likely posit risk for local social networks, and the general population. In light of the burgeoning pandemic, guided decarceration and accompanying social support programs should be public health priorities as well as the adoption of national clinical management standards with additional focus on suicide prevention and mental health. Coordinated CDC-led tracking of relevant epidemiologic data including race-ethnicity and demographics of residents and staff may also be warranted. Along with protecting incarcerated or detained persons and their basic human rights, staff, and the communities to which they return, urging control measures should be the elimination of racial and ethnic disparities in health and healthcare.
ABSTRACT
[Formula presented] Despite the challenging nature of the pandemic that made all events virtual, the 15th Annual W. Montague Cobb Symposium and Scientific Lectureship held as part of the 125th National Medical Association (NMA) Convention continued as a treasured event. Titled “The Role of HBCU Medical Schools in Driving Research Excellence in the Wake of COVID-19,” with the Cobb Lecturer as noted pediatrician Dr. Deborah Prothrow-Stith who defined youth violence as a health problem, this year’s Symposium featured the Consortium of all four medical institutions of historically black colleges and universities (HBCUs) including Charles R. Drew University of Medicine and Science, Howard University College of Medicine, Meharry Medical College, and Morehouse School of Medicine. Cobb Lecturer Prothrow-Stith touched on the context of the pandemic and traumatic murder of George Floyd for the enhanced attention to longstanding issues, and framed their Consortium efforts as “powerful together.” Beyond navigating community testing and intervention as well as vaccine strategies toward tackling Coronavirus-related disparities, their implemented measures around the undergirding social determinants of health are highly innovative. With Morehouse’s National COVID-19 Resiliency Network (NCRN) currently funded at $40 million under a three-year cooperative agreement with the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) likely to prove transformational, renowned immunologist and physician Dr. James Hildreth urged keeping our institutions at the forefront of vaccine development and public health ambassadorship. Even with limited funding for efforts undertaken at a national level, and intervening where majority institutions often struggle, this Consortium holding a long legacy of trusted commitment to the underserved continues undeterred. We hope that their collaborative value is felt and that expanded, sustained funding to HBCU institutions from HHS and its Agencies and Offices for health-related research and development not only transcends this pandemic but is accelerated.