Mobula Linda M, Heller David J, Commodore-Mensah Yvonne, Walker Harris Vanessa, Cooper Lisa A
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, USA.
Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
Gates Open Res. 2020 Sep 9;4:125. doi: 10.12688/gatesopenres.13181.1. eCollection 2020.
The coronavirus disease 2019 (COVID-19) pandemic has exacerbated health disparities across ethnic and socioeconomic groups. Non-communicable diseases (NCDs) - such as hypertension, diabetes, and obstructive lung diseases - are key drivers of this widening gap, because they disproportionately afflict vulnerable populations. Vulnerable populations with non-communicable diseases, in turn, are disproportionately affected by COVID-19 itself - but also at increased risk of poor outcomes from those underlying conditions. Proven strategies for NCD control must be adapted to help vulnerable patients react to these dual threats. We detail six key policy interventions - task shifting, workforce protection, telehealth and mobile services, insurance restructuring and increased funding for NCDs, prescription policies for NCDs and community partnerships - to bridge this care gap. Long-term integration of these care models post-COVID-19 may prevent care shocks during future pandemics, bolstering emerging universal primary care models.
2019年冠状病毒病（COVID-19）大流行加剧了不同种族和社会经济群体之间的健康差距。非传染性疾病，如高血压、糖尿病和阻塞性肺病，是这一差距不断扩大的关键驱动因素，因为这些疾病在弱势群体中更为普遍。反过来，患有非传染性疾病的弱势群体受COVID-19本身的影响也更大，而且这些基础疾病导致不良后果的风险也更高。必须调整已证实的非传染性疾病控制策略，以帮助弱势患者应对这双重威胁。我们详细介绍了六项关键政策干预措施——任务转移、劳动力保护、远程医疗和移动服务、保险结构调整和增加非传染性疾病资金、非传染性疾病处方政策以及社区伙伴关系——以弥合这一医疗差距。在COVID-19之后长期整合这些护理模式，可能会预防未来大流行期间的医疗冲击，加强新兴的全民初级保健模式。
