COVID-19 has devastated Black and Latinx/Hispanic communities in the United States during the past year, erasing recent life expectancy gains and reinforcing racism as a potent, structural driver of health and human inequity. The health disparities contributing to this burden are long-standing. They reach well beyond the pandemic and have left many communities of color with historically worse outcomes. This chartbook details inequities between white, Black, and Latinx/ Hispanic communities across a range of health indicators in four main areas: (1) insurance coverage and access to care; (2) receipt of health services; (3) health status; (4) mortality. To say that these communities are at higher risk of poor health means recognizing the reasons why. During the pandemic, socioeconomic factors--where people live and work, how much they are paid, and what kind of access they have to healthy living environments and high-quality health care--have all influenced who is exposed to COVID-19 and, ultimately, who has died. Across almost all U.S. age groups, that has disproportionately been Black and Latinx/Hispanic people. These associations should invoke moral outrage, but they should not surprise us. They stem from a history of structural racism that is entrenched in U.S. policies. It is a legacy where, in some U.S. cities, people born a few miles apart might have a 20-year difference in life expectancy. It is therefore important to assess the performance of U.S. health care through a racial equity lens. And, in our efforts to reform that system, we must acknowledge that health inequities cannot be separated from "the policies and institutions that undergird the U.S. racial hierarchy."
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