Polarized politics make it more difficult to implement guardrails on these behaviors.įloundering responses by federal, state and local governments compounded existing issues, and eventually allowed pandemic-related public health guidance to become political and cultural footballs. Americans are more likely than citizens of other countries to engage in what public health researchers consider risky behavior, such as gun ownership, smoking, consuming more calories and exercising less. In just one example, the US Constitution makes public health the responsibility of individual states, creating a patchwork of different pandemic responses.Ĭulture and environment also appear played a role. Although policies that exclude 28 million uninsured individuals from healthcare have likely made things worse, they are only one example of how fragmented policy has worsened Americans’ health.Ĭoncepts fundamental to US governance also proved problematic in the pandemic. However, America’s reliance on an expensive, private and exclusionary health system is not solely to blame. “There’s a set of reasons for it, but all of those rolled right into the pandemic.” Life expectancy in the US is the lowest of any high income country,” said Woolf. “The US has been experiencing worse health outcomes for some years now. Missed academic time appears to have caused the educational achievement gap to widen. Millions of children were also thrust into food insecurity, as the numbers of children receiving school meals plummeted. Pediatricians, children’s hospitals and psychiatrists declared a mental health crisis among the nation’s youth, and a recent CDC study has shown how emergency room visits for eating disorders has increased dramatically among adolescent girls. Meanwhile, the mental health of adolescents in particular has suffered, as millions were cut off from the mental health services provided by schools. Rates of sexually transmitted diseases have reached the “ highest numbers in American history”, as overwhelmed and underfunded local health agencies reallocated resources to Covid-19. Thousands of young children, particularly in low-income households, have fallen behind on routine vaccinations. The all-consuming nature of the pandemic has also allowed preventable and treatable infectious diseases to flourish. Community health centers help treat indigent and marginalized Americans who cannot pay for healthcare. “It just exacerbated the struggles we currently have and pulled back the curtain on all the issues we’ve been dealing with for so many years,” said Terrence Shirley, CEO of the Community Health Center Association of Mississippi. One recent study has shown how at least one advanced Covid-19 therapy, monoclonal antibodies, were the least likely to reach the highest risk patients for whom they are recommended. Vaccines were at first slow to reach minority, low-income and rural areas. The US has nonetheless had difficulty correcting course. Such disparities are the “intended or unintended consequences of policy decisions”, a recent commentary in the Journal of the American Medical Association said. The drivers of those outcomes – the disproportionate likelihood for people of color to lack the same quality housing, employment and healthcare access as white Americans – are well known and documented. The pandemic shone a light on longstanding racial and ethnic health disparities, as Black, Latino and Native American people were infected, hospitalized and died of Covid-19 at rates that were, at times, double those of white Americans. “And, on top of that, mishandling of the pandemic by the government and by the public, frankly.” “In terms of understanding why we had such a bad experience from the pandemic, we have to think about the systemic issues that already were in place when the pandemic arrived,” said Steven Woolf, a social epidemiologist and population health researcher at Virginia Commonwealth University. The extraordinary toll has set the US apart among wealthy, peer nations, exposing inequality, a unique and fragmented health system, and polarized politics – all of which likely made the crisis worse, researchers said. This number crossed the one million threshold in mid-February. Chronic conditions such as heart disease, hypertension and dementia have contributed to the number of “excess deaths” – a number which includes other ailments exacerbated by the pandemic, as well as those deaths caused directly by Covid-19. Deaths from drug overdoses hit a record high in 2021, killing at least 100,000 Americans. Among the 20 worst affected nations, only one other countries – Brazil – has higher mortality rates per 100,000 people.ĭeaths directly attributable to Covid-19 are only one measure of the pandemic’s toll. For every 100,000 residents, 303 people have died from Covid-19, according to the Johns Hopkins University Coronavirus Resource Center.
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