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Dr Alexander-Scott on the social, racial and economic determinants of health

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If you live in a community where you are part of the critical infrastructure workforce and you’re living paycheck to paycheck, your housing may not be of the best quality, the schools may not have had the ability to allow for remote distancing – that exposes those populations to more negative outcomes…


During Rhode Island Governor Gina Raimondo‘s daily press update, Dr Nicole Alexander-Scott, Director of the State Department of Health spoke about the racial, economic and social determinants of health. Her words came in answer to a question from The Public’s Radio‘s Ian Donnis, who asked, “Why do people of color in Rhode Island have higher morbidity from COVID-19? How does this compare nationally?”

“So we are definitely seeing this nationally,” said Dr Alexander-Scott. “Morbidity means [we are] seeing challenges or side effects, complications of people who are hospitalized more or have negative outcomes connected to COVID-19. What this virus reveals to us is when you have the ability, economically, with good quality and access to the resources that you need, you can effectively stay at home, follow the stay at home order, perhaps work from home, be limited in the types of groceries that you need to go out to get and have the finances to support this approach for social distancing and community mitigation.”

“If you live in a community where you are part of the critical infrastructure workforce and you’re living paycheck to paycheck, your housing may not be of the best quality, the schools may not have had the ability to allow for remote distancing – that exposes those populations to more negative outcomes,” continued Dr Alexander-Scott. “Those living situations may also have predisposed someone to having other illnesses already in place. If you don’t have access to fresh fruits and vegetables or transportation to be able to get to the pharmacy to take the medications, or time off from your job to have sick leave if you needed it, then your diabetes might not have been as well controlled or your asthma may not have been as well controlled as it needed to be. Those are the types of situations that set people up in this case, for negative outcomes.

“That’s why as part of our response, we have to be very focused and targeted in addressing those underlying needs within those communities, because as this continues over the course of the next year, we need to make sure that communities have the quality schools that can do the adjustments needed to make sure that the children are educated effectively and have access to the fresh fruits and vegetables and have the economic job support they need to continue to work or to work remotely. So that’s what we are talking about when we address determinants of health in this situation and COVID-19 has exposed the importance of doing that.”

Steve Ahlquist is a frontline reporter in Rhode Island. He has covered human rights, social justice, progressive politics and environmental news for half a decade. Uprise RI is his new project, and he's doing all he can to make it essential reading. atomicsteve@gmail.com