RALEIGH, N.C. (WNCN) — More than 26,500 North Carolinians have died of COVID-19, and during the past 2 1/2 years, public health officials have found answers to some of the most pressing “W” questions about those deaths — who, when and why.
But there’s another component that’s just as telling: Where.
“This is not a disease that you should be dying at home with,” said Dr. David Wohl, an infectious disease specialist at the University of North Carolina School of Medicine.
Wohl and Jessie K. Edwards, an epidemiologist at UNC, looked closer at death certificate data from the nearly 23,000 people in the state who died of COVID between the start of the pandemic and the end of 2021.
They found 1 in 12 of those deaths took place at home, and the risk of dying at home was higher among Black and Latino people than it was for white people.
And by the middle of last year, the risk of dying of COVID at home for Latinos surpassed that of Black people — who at the time had higher rates of COVID mortality.
“If you die at home with COVID-19, it means there’s probably a failure,” Wohl said. “A failure for you to be able to get into a clinic, in a hospital, a failure for you to access it, to utilize it. Whatever it is, there’s some reason. This is a disease that you need oxygen for. Oxygen and life support.”
Even when they adjusted those figures to account for age differences, “we continued to see disparities,” Wohl said.
“This is death-certificate data — it doesn’t tell us the why, it just tells us the what,” he said. “But I think one can speculate that there are going to be questions about the access to care.”
Pointing out discrepancies in access to health care between racial and ethnic groups is not exactly new — they existed long before the pandemic, and numerous studies since March 2020 have illuminated them — but these findings underscore yet another way they have shown up.
Those barriers tend to affect people of color, people living in poverty and those who are uninsured or underinsured. Wohl pointed to people reluctant to seek medical care because they were not legal residents of the country.
“I think there’s a whole bunch of things that we’re seeing that were amplified, during this pandemic, that were already barriers to care for people of color and lead to inequities that I think we’re seeing amplified during the pandemic, and leading unfortunately, to lethal outcomes among these populations here,” Wohl said.
So, how can those barriers be removed?
One way: Expanding access to health insurance and health care — perhaps by expanding Medicaid, as state leaders have been discussing for months.
“There has to be more information because there’s two parts — access, and utilizations,” Wohl said. “Access is, ‘I can’t get to a clinic because it’s too far away or it’s going to cost me money.’ Utilization is, ‘It’s there, but I’m not going to use it because I don’t think I need it.’
“I think there’s some of both, but I worry a lot about the access to care,” he added. “There are disparities in accessing health care, and we can knock down those disparities by creating on-ramps to health care that are easy to use, that don’t cost people money, are very low-cost so that they can access these things, and I think during COVID-19 everything just got worse.”
CBS 17’s Joedy McCreary has been tracking COVID-19 figures since March 2020, compiling data from federal, state, and local sources to deliver a clear snapshot of what the coronavirus situation looks like now and what it could look like in the future.