BCMS Medical Record Fall 2020 - 16

Why Do Obese Patients Suffer Worse from COVID-19?
continued from page 15

Reading Hospital Tower Health has taken many steps
to combat disparities caused by the various social
determinants of health. Tower Health has taken action to
-screen 30,000 patients per year to take better metrics
about the various social determinants of health
-start the Ride Health program to curtail challenges
involving transportation
-implement a program which pairs 120 pediatric
asthma patients per year with Community Health Workers
-monitor 500 patients with obesity, diabetes, and
congestive heart failure in the year 2020
-provide care and support to 900 patients in vulnerable
populations annually to lower ED use by 5%
-determine legal barriers to housing and income
stability in 220 cases per year through the Medical Legal
Partnership program
-promote wellness through bike sharing program, trail
identification program, nutrition education, and Fresh Food
Mobile Market36
Penn State Health St. Joseph Medical Center has
undertaken a myriad of initiatives to address the social
determinants of health, including
-increasing screenings, programs, training, and
education to the community about mental health
(specifically for the Berks community), addiction, and
chronic diseases
-restoring and sustaining the Reading Youth Violence
Prevention Project
-hosting 4,000 participants in programs that promote
nutrition and food access, which also involves donating
1000 pounds of produce, enrolling hundreds in the
Veggie Rx program, and providing nutrition education for
thousands
-providing community outreach for diabetes
management in underserved areas
-educating and providing support for dental health,
including building a dental clinic
-promoting walking and biking in communities37

16

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poisoning, and greater susceptibility to parasites"27. Geary argues that
these mechanisms, many of which are tangible in the city of Reading,
allow for greater susceptibility to infections. In 2018, the rate of
people living below the poverty line in Reading was still very high at
35.4%24. The condition of poverty results in chronic stress, which has
been shown to raise blood sugar levels, a major contributor to type 2
diabetes28. Furthermore, from a Reading Eagle article published this
year, "Berks County has one food desert-residents living in an area
of greater than one mile distance from the nearest supermarket-that
includes the area between West Reading and Kenhorst, including
the Oakbrook Homes. Other portions of Reading fit a subcriteria
of food desert, where residents are between a half and one mile
from the nearest supermarket."29 Living in a food desert can make
it more difficult to access healthy foods, increasing the likelihood
of conditions such as obesity and diabetes that worsen COVID-19
symptoms and outcomes.
Moreover, in 2014 17.9% of Latinos in Berks County were
uninsured as compared to only 7.2% of non-Hispanic whites30, and
given such a high population of Hispanics and Latinx people in
Reading and Berks County this gap is particularly felt. According
to Berks Community Health Center cardiologist Dr. Demetrius
Bravidis, although insurance coverage is no longer a determinant of
one's ability to get tested for COVID-19, this was not the case for
the first several weeks of the pandemic31, which likely exacerbated the
issue for the uninsured and may continue to do so for those who are
not aware that they can get tested. Even after the testing step, outof-pocket cost concerns pose a barrier for the treatment step30, which
negatively impacts the uninsured as well as those who are insured but
have not yet met their deductible.
To make things worse, the essential jobs Latinx people perform
are likely making them more susceptible to contracting COVID-19:
One study of Californians conducted at UC Berkeley found that
Latinos were the only racial or ethnic group surveyed where less
of 50% reported they were able to work from home, as well as the
only group where more than 50% were concerned about losing a
job32. Michael Toledo, president and CEO of the Daniel Torres
Hispanic Center in Reading, sees a similar trend in Berks County:
"Unfortunately, a lot of members of our community have a higher
probability of getting infected because of the work that they
do. Black and brown individuals in our community are putting
themselves at risk every day when they go to work."33 In places like
Reading, living in multigenerational housing can also allow the
disease to hit minority populations at younger ages.
Furthermore, 20 states do not report any racial or ethnic data;
while Pennsylvania reports some of this data, it is missing more
than 40% of this data34 at the time of this writing. Consequently,
historically oppressed populations such as the Latinx and AfricanAmerican communities have remained invisible despite all signs
pointing to them being hit particularly hard by the disease. Racial
and ethnic COVID-19 hospitalization data that is available has


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BCMS Medical Record Fall 2020

Table of Contents for the Digital Edition of BCMS Medical Record Fall 2020

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