Dr Anthony Fauci on Health Disparities Affecting People of Color

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, spoke recently with The American Journal of Managed Care^®. During the interview, we asked about health burdens that disproportionately affect Black and other multiracial US communities.

AJMC^®: As the United States continues to witness protests across the country that began over the police killing of George Floyd, many commentators are noting the health disparities that affect the Black community. Do you think that we’re at an inflection point right now where the health and public health concerns of people of color will become heard more clearly?

Fauci: Well, I certainly hope so. Because what COVID-19 [coronavirus disease 2019] is doing is shedding another bright light on a systemic problem that has been with us for a very long period of time. In fact, even a little bit of a double whammy for the minority communities, particularly African Americans, is that they have a higher incidence and prevalence of the comorbidities that make it more likely that you will have a complicated course of infection, leading to a serious disease, possibly hospitalization and even death, so the relative proportion of these comorbidities in people of color is significantly greater than of the population in general.

The other thing is that the social determinants of health put people of color in a position—because of employment, socioeconomic status, availability of jobs—that makes it more likely for them to be in contact with an infected person and not able to physically separate themselves. So, they have a greater risk (a) of getting infected and (b) of winding up, once they are infected, with a complication that is above and beyond the rate of complications of others.

So, this is another assault, as it were, on people of color, because if you look at other diseases—like HIV in the United States, [since] we’re talking today about the 30th anniversary of the [1990] IAS conference—if you look at HIV in this country, 13% of the population is African American, and yet up to 50% of the new infections [in men] are among African Americans, and about 60% [in women]. So, here again, a greater burden of disease is being seen in the people who are minority groups, particularly people of color.