Evidence map›Paper›PMID 32493833›Full record

ArticleBMJ evidence-based medicine2020

COVID-19 and the US response: accelerating health inequities.

Nneoma E Okonkwo, Ugochi T Aguwa, Minyoung Jang, Iman A Barré, Kathleen R Page, Patrick S Sullivan, Chris Beyrer, Stefan Baral

Open access · hybridAbstract read
In one paragraph

Article in BMJ evidence-based medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 117 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
117citing papers in PubMed, 2 pooled it
45.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

117 citing papers in PubMed, 2 syntheses or guidelines pooled it, 228 citations in OpenAlex.

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57 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Nneoma E OkonkwoSchool of Medicine, Johns Hopkins University, Baltimore, Maryland, USA nneoma@jhmi.edu.ORCID http://orcid.org/0000-0003-3370-5114
Ugochi T AguwaSchool of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Minyoung JangSchool of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Iman A BarréSchool of Medicine, Meharry Medical College, Nashville, Tennessee, USA.
Kathleen R PageDepartment of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Patrick S SullivanDepartment of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA.
Chris BeyrerCenter for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Stefan BaralCenter for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Johns Hopkins University · USEmory University · USMeharry Medical College · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Health inequities have long defined health and the healthcare system in the USA. The clinical and research capacity across the USA is unparalleled, yet compared to other high and even some middle-income countries, the average health indicators of the population remain suboptimal in 2020, a finding at least in part explained by inequity in healthcare access. In this context, COVID-19 has rapidly emerged as a major threat to the public's health. While it was initially thought that severe acute respiratory syndrome coronavirus 2 would be the great equaliser as it would not discriminate, it is clear that COVID-19 incidence and mortality have rapidly reinforced health disparities drawn by historical and contemporary inequities. Here, we synthesise the data highlighting specific risks among particular marginalised and under-resourced communities including those in jails, prisons and detention centers, immigrants and the undocumented, people with disabilities and people experiencing homelessness across the USA. The drivers of these disparities are pervasive structural risks including limited access to preventive services, inability to comply with physical distancing recommendations, underlying health disparities and intersecting stigmas particularly affecting racial and ethnic minorities across the country, including African Americans, Latinx Americans and Native Americans. Advancing the COVID-19 response, saving lives and restarting the economy necessitate rapidly addressing these inequities rather than ignoring and even reinforcing them.

Indexed as

delivery of healthcarehealthcare quality, access, and evaluationinfectious disease medicinepublic healthsocioeconomic factors

Identifiers

PMID32493833
PMCPMC7299650
OpenAlexW3031770522

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.