Department of Medicine, David Geffen School of Medicine at UCLA, University of California, , Los Angeles, CA, USA.
Department of Community Health Sciences, Fielding School of Public Health, University of California, , Los Angeles, CA, USA.
J Gen Intern Med. 2020 Dec;35(12):3685-3688. doi: 10.1007/s11606-020-06264-5. Epub 2020 Oct 2.
Coronavirus disease 2019 (COVID-19) is a global pandemic. In the USA, the burden of mortality and morbidity has fallen on minority populations. The understanding of the impact of this pandemic has been limited in Asian-Americans and Pacific Islanders (AAPIs), though disaggregated data suggest disproportionately high mortality rates. AAPIs are at high risk for COVID-19 transmission, in part due to their over-representation in the essential workforce, but also due to cultural factors, such as intergenerational residency, and other social determinants of health, including poverty and lack of health insurance. Some AAPI subgroups also report a high comorbidity burden, which may increase their susceptibility to more severe COVID-19 infection. Furthermore, AAPIs have encountered rising xenophobia and racism across the country, and we fear such discrimination only serves to exacerbate these rapidly emerging disparities in this community. We recommend interventions including disaggregation of mortality and morbidity data, investment in community-based healthcare, advocacy against discrimination and the use of non-inflammatory language, and a continued emphasis on underlying comorbidities, to ensure the protection of vulnerable communities and the navigation of this current crisis.
新型冠状病毒肺炎(COVID-19)是一种全球性大流行病。在美国,死亡和发病的负担落在了少数族裔人群身上。尽管分类数据表明亚洲裔美国人和太平洋岛民(AAPI)的死亡率过高,但对这一流行病的影响的了解有限。AAPI 人群感染 COVID-19 的风险很高,部分原因是他们在必要劳动力中所占比例过高,部分原因是文化因素,如代际居住,以及其他健康的社会决定因素,包括贫困和缺乏医疗保险。一些 AAPI 亚群报告说,他们的合并症负担也很高,这可能使他们更容易受到更严重的 COVID-19 感染。此外,AAPI 在全美遭遇了越来越多的仇外和种族主义,我们担心这种歧视只会加剧该社区中这些迅速出现的差异。我们建议采取干预措施,包括分类死亡率和发病率数据、投资社区医疗保健、反对歧视的宣传和使用非煽动性语言,以及继续强调潜在的合并症,以确保保护弱势群体,并应对当前的危机。