Syndemies and the obligation to finish fairly

An equity-driven COVID-19 pandemic response includes more than just diagnostics, PPE, vaccines, and treatment, especially when considering tobacco use and other risk factors for chronic diseases. It includes focusing on individual factors leading to social inequality, which has been long-standing in communities across the country. To ensure fairness in health, public health needs to address COVID-19 and tobacco as a syndrome and unite efforts to mitigate the root causes of these social factors that make it possible to promote health inequalities in both epidemics.

Historically, low-income people are more likely to smoke, spending as much as 10% of disposable income on tobacco products, which can help maintain a poverty cycle, both domestically and globally. Rural areas also have an influence, as does racial and ethnic background on the likelihood of tobacco use. Recent meta-analysis has also suggested that there is an association between smoking and COVID-19 progression, meaning that the effects of COVID-19 are more severe in patients with a higher average pack-per-year history. This World No Tobacco Day should mean investing in historically vulnerable communities so that they just come out of the root causes that make COVID-19 and tobacco so much more deadly to them.

The HHS InnovationX team worked with the HHS COVID-19 Diagnostics Informatics team to better understand social inequality in the COVID-19 country. By analyzing several important open datasets, COVID-19 created the Community Vulnerability Crosswalk, a machine-readable dataset that takes snapshots of several key factors related to geography, demography, and socioeconomics:

This dataset helps to show current COVID-19 related impacts with long-term data on social disparities: low-income areas, rural and tribal communities, factors that also affect tobacco disparities. The dataset also weighs these variables using a scoring method from recent federal grants that helps ensure they overlap correctly. You can learn more about this Community Vulnerability Crosswalk project here.

Figure 1 – A look at the communities with the most resources in the 50 US under COVID-19

This data-driven innovation highlights the overlapping impacts in the areas where there is the greatest shortage of resources. As COVID-19 diagnostics, PPE, vaccines, and treatment resources are sent to these areas of greatest need, federal, state, local, territorial, and tribal health leaders should also consider how to ensure that better resources are made available for the prevention of chronic diseases. areas. For tobacco use, this means that increased access to cessation tools such as the Food and Drug Administration-approved nicotine replacement therapy and counseling can help reduce the effects of these long-term social factors, among other actions.

World No Tobacco Day has historically been an opportunity to celebrate the progress made towards the global tobacco epidemic, and this year may help mark progress towards the global COVID-19 pandemic. The U.S. Department of Health and Human Services is committed to stopping the tobacco epidemic by developing resources such as Centers for Disease Control and Prevention tips from former smokers and the FDA’s The Real Cost, the national Quitline portal (1-800-QUIT-NOW) and Smokefree .gov. These resources provide free information and resources to help individuals in all communities stop using tobacco and stay tobacco-free. Considering tobacco as a syndrome with COVID-19 and understanding the upstream social root causes of health inequalities can help bring us closer to improving health and achieving health inequality in our society with the least resources.

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