ABSTRACT
In the United States, the coronavirus disease-2019 (COVID-19) pandemic has disproportionally affected Black, Latinx, and Indigenous populations, immigrants, and economically disadvantaged individuals. Such historically marginalized groups are more often employed in low-wage jobs without health insurance and have higher rates of infection, hospitalization, and death from COVID-19 than non-Latinx White individuals. Mistrust in the health care system, language barriers, and limited health literacy have hindered vaccination rates in minorities, further exacerbating health disparities rooted in structural, institutional, and socioeconomic inequities. In this article, we discuss the lessons learned over the last 2 years and how to mitigate health disparities moving forward.
Subject(s)
COVID-19 , Health Inequities , Health Services Accessibility , Social Determinants of Health , Social Discrimination , Vulnerable Populations , Humans , Black or African American , COVID-19/epidemiology , COVID-19/ethnology , COVID-19/prevention & control , COVID-19/psychology , Emigrants and Immigrants/psychology , Emigrants and Immigrants/statistics & numerical data , Ethnicity/statistics & numerical data , Health Services Accessibility/economics , Health Services Accessibility/statistics & numerical data , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Indigenous Peoples/psychology , Indigenous Peoples/statistics & numerical data , Poverty/ethnology , Poverty/psychology , Poverty/statistics & numerical data , Social Determinants of Health/economics , Social Determinants of Health/ethnology , Social Determinants of Health/statistics & numerical data , Social Discrimination/economics , Social Discrimination/ethnology , Social Discrimination/psychology , Social Discrimination/statistics & numerical data , Social Marginalization/psychology , Trust/psychology , United States/epidemiology , Vaccination/economics , Vaccination/psychology , Vaccination/statistics & numerical data , Vulnerable Populations/psychology , Vulnerable Populations/statistics & numerical data , White/psychology , White/statistics & numerical dataABSTRACT
Survivors of COVID-19 are a vulnerable population, with complex needs because of lingering symptoms and complications across multiple organ systems. Those who required hospitalization or intensive care are also at risk for post-hospital syndrome and post-ICU syndromes, with attendant cognitive, psychological, and physical impairments, and high levels of health care utilization. Effective ambulatory care for COVID-19 survivors requires coordination across multiple subspecialties, which can be burdensome if not well coordinated. With growing recognition of these needs, post-COVID-19 clinics are being created across the country. We describe the design and implementation of multidisciplinary post-COVID-19 clinics at two academic health systems, Johns Hopkins and the University of California-San Francisco. We highlight components of the model which should be replicated across sites, while acknowledging opportunities to tailor offerings to the local institutional context. Our goal is to provide a replicable framework for others to create these much-needed care delivery models for survivors of COVID-19.