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Historical Insights on Coronavirus Disease 2019 (COVID-19), the 1918 Influenza Pandemic, and Racial Disparities:

Lakshmi Krishnan1, S Michelle Ogunwole2, Lisa A Cooper3

  • 1The Johns Hopkins University School of Medicine, Johns Hopkins Department of History of Medicine, and Johns Hopkins Center for Medical Humanities and Social Medicine, Baltimore, Maryland (L.K.).

Annals of Internal Medicine
|June 6, 2020
PubMed

Insights

Historical analysis of the 1918 influenza pandemic reveals how racial inequities exacerbated health disparities. Understanding this history is crucial for addressing current health inequities in ethnic minority communities during the COVID-19 pandemic.

Area of Science:

  • Public Health
  • Epidemiology
  • Sociology of Health

Background:

  • The COVID-19 pandemic disproportionately affects ethnic minority communities, highlighting existing health care disparities.
  • Historical parallels are drawn to the 1918 influenza pandemic to understand the current crisis.
  • Limited scholarly attention has focused on race in the context of both pandemics.

Observation:

  • The 1918 influenza pandemic's impact on Black Americans reveals complex interactions with racial, sociopolitical, and public health structures.
  • Epidemic diseases have historically served as a "sampling device for social analysis," exposing societal inequities.
  • Structural inequities and health care gaps have consistently contributed to disparate health outcomes in communities of color.

Findings:

  • The 1918 influenza pandemic exacerbated existing racial inequities, leading to disproportionate health outcomes for Black Americans.
  • Historical data demonstrates a recurring pattern of marginalized communities bearing the brunt of public health crises.
  • Racial disparities in health are deeply rooted in historical structural factors and healthcare access limitations.

Implications:

  • Framing racial health disparities through a resilience approach, rather than a deficit model, is essential.
  • A historical lens on race and epidemics provides a framework for addressing the COVID-19 crisis and its long-term effects.
  • Promoting health equity requires acknowledging and rectifying historical and ongoing structural inequities in healthcare access and treatment.

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