TDNet Discover

Background: Pandemics are catastrophic events that occur when a virulent and opportunistic pathogen permeates throughout the planet. Such occurrences, although rare, are generally disastrous for any country the pathogen may invade as pandemics historically lead to poor health outcomes and high death tolls. 1918 Spanish flu, 2009 H1N1 outbreak, as well as the current COVID-19 pandemic each have left their mark on our planet with their varying degrees of resulting morbidity and mortality rates as well as their public health responses aimed at staving off any future pathogenic outbreaks. Objective: To assess morbidity and mortality rate of different racial/ethnic groups over the course of three major pandemics in the United States: Spanish Influenza, H1N1, and COVID-19. Methods: An evidence-based medicine literature review study design was completed by searching databases such as Google Scholar, Mendeley, and PubMed using search phrases such as “Race AND 1918 influenza”, “Race AND H1N1 AND disparities”, “Race AND COVID-19”, “Race AND pandemics”, “Pandemic disparities in the United States”, and “1918 influenza AND racial disparities”. Limits of the database search included peer- reviewed articles, human subjects, and full text documents. Data that included morbidity and mortality rate for these pandemics in countries outside of the United States were excluded from our search. Results: Six systematic reviews were used in this review. The patient populations were reviewed included several different ethnic groups: White, Black/African-American, Hispanic, Pacific Islander, Asian, and Native American. Each of the articles we used for our review were either rated as “good” or “fair” for internal validity. The studies suggest that minority (non- white) communities tend to have higher morbidity and mortality rates in the face of each of these pandemics. Morbidity tended to vary the most during each of these pandemics however, mortality rates consistently were higher amongst non-white communities. Minority communities, iv also tended to be disproportionately represented as it pertains to total death tolls in the setting of each pandemic reviewed in this study. Conclusion: Much has not changed as it pertains to the morbidity and mortality trends in the pandemics used in this review that ranged from 1918 - 2020. Minority communities were disproportionately affected by pandemics then, and in the face of the current COVID-19 pandemic, that still seems to be the case. It is not surprising as many of the factors that may play a role in such discrepancy: socioeconomic status, crowded living conditions, lack of access to quality healthcare as well as predisposition to comorbid conditions, are still prevalent amongst minority communities today.