Elderly Black and Latino Americans are more likely to get infected and die from COVID-19, often due to historic distrust of the healthcare system, and may be less likely to get vaccinated when a vaccine is ready, health experts told a Senate committee Tuesday.

Experts from the healthcare industry, epidemiology and the education system testified at a Senate Special Committee on Aging hearing on the impact of the coronavirus pandemic on the elderly, particularly those of color.

According to the data from the Centers for Disease Control and Prevention, 80% of COVID-19 deaths in the United States have been adults over 65.

“COVID-19 has exposed our healthcare system vulnerabilities and revealed our inability to respond effectively to a pandemic,” said Rodney B. Jones, president and chief executive officer at Atrium Health, a healthcare provider covering North and South Carolina. “It also highlighted the fact that low-income older adults and older adults of color suffered in significantly greater proportion than their white counterparts.”

Sen. Bob Casey, D-Pa., said the racial health disparity results from a lack of affordable housing, food insecurity, an education gap and police misconduct against Black Americans.

“We must not only acknowledge these injustices, but we are summoned by the example of John Lewis to take action to do something about it,” he said in a reference to the senator from Georgia who died Friday.

Historical injustices, including medical experimentation, have left a legacy of mistrust and skepticism among many Black Americans, committee Chairwoman Susan Collins, R-Maine, said. According to a study from California health system, patients’ negative prior experiences with the healthcare system can lead to distress and a decision to seek care only in the most extreme circumstances, she said.

“Without building rapport and trust in these communities, there is no guarantee that the highest risk populations will get the vaccine or that they even want the vaccine,” said Mercedes Carnethon, a professor of epidemiology at Northwestern University. “One of the most challenging features is that we’ve got to try to build trust in an urgent situation where the very individuals who are experiencing the worst outcomes are the most concerned about trust within the healthcare system.”

Carnethon said healthcare providers and community leaders need to engage the communities hardest hit by the pandemic to bridge the gap. Trusted community leaders can promote prevention, while government officials often create anxiety and concern in immigrant communities, she said. Carnethon recommended that health officials build partnerships with community leaders to better understand people’s needs.

“What we really need to do is put ourselves in the shoes of community members to try to understand what those barriers are to accept these vaccines,” Carnethon said. “This can best be done through community partnerships.”

Greater healthcare workforce diversity also should be part of the solution to the racial health disparity, Collins said.

Thirteen percent of the U.S. population is Black, while 5% of physicians are Black, according to a recent report from the Association of American Medical Colleges. Dominic H. Mack, a professor of family medicine at the Morehouse School of Medicine, said more funding and resources should go to medically underserved communities to increase diversity in the healthcare workforce.

“If there was ever a time to meaningfully act to address racial and ethnic health disparities and health inequities in the United States, it is now, ” Mack said.

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