Has the pandemic displaced America’s biggest health concerns?

There’s no question about it—the pandemic, now in its second year, still dominates news headlines and health stories. As of today, the United States surpassed 30 million coronavirus cases, with over half a million deaths. According to the CDC, 130 million vaccines have been administered so far, and the rollout continues, with all its complexity. Case counts dropped and then plateaued in many parts of the country, but infection levels remain high in some regions. Meanwhile, we’re warned of a new “avoidable surge,” while Europe experiences its third wave of the virus.

Against this mind-boggling backdrop, physicians and healthcare organizations are still faced with tackling other pressing healthcare issues—some of which have been exacerbated by the pandemic. Looking beyond COVID-19, here are the four biggest health concerns that we’ll face this year, according to industry experts. 

Mental health

Mental health in this country was already on the decline prior to the pandemic. According to a report from Mental Health America, almost 20% of Americans were living with a mental illness in 2018. But COVID-19 has exacerbated this, according to experts. Becker’s Hospital Review places mental health at the top of its list of public health issues that have worsened during the pandemic.

The impact of added stress from COVID-19 was observed as early as May 2020, when a US Census Bureau report revealed that roughly one-third of Americans showed signs of clinical depression or anxiety, according to Becker’s report. A CDC report published last August showed that 40% of US adults were experiencing adverse mental health conditions. The report found that roughly 25% of 18-24 years olds had “seriously considered” suicide within the last month and that 75% of that age group reported having at least one mental or behavioral health symptom.

A report published by the Kaiser Family Foundation (KFF) supports these findings, noting that the pandemic and resulting economic recession have “negatively affected many people’s mental health and created new barriers for people already suffering from mental illness and substance abuse disorders.”

Further, the authors wrote, history has shown that the mental health effects of disasters typically outlast the physical impacts, adding, “As policymakers continue to discuss further actions to alleviate the burdens of the COVID-19 pandemic, it will be important to consider how the increased need for mental health and substance use services will likely persist long term, even if new cases and deaths due to the novel coronavirus subside.”

Other infectious diseases

While the healthcare industry focuses on tackling the coronavirus, the battle to curb other communicable diseases has taken a back seat. As a result, the Pan American Health Organization included non-COVID infectious diseases on its list of top health concerns for 2021.

Coronavirus travel restrictions and stay-at-home orders have not only hampered efforts to stamp out diseases like polio, HIV, tuberculosis, and malaria, they may have set progress back a couple of decades. 

“COVID-19 risks derailing all our efforts and taking us back to where we were 20 years ago,” said Pedro L. Alonso, MD, director of the World Health Organization’s global malaria program, in a New York Times article.  

According to the UN, roughly 80% of tuberculosis, HIV, and malaria treatment and vaccination programs worldwide have reported disruptions in services since the beginning of the pandemic, the article noted. Likewise, the WHO reported that at least 120 countries have seen a decrease in the number of tuberculosis patients visiting clinics.

Last July, the organization issued a statement warning of a “substantial drop” in the number of children receiving vaccines for diphtheria, tetanus, and pertussis. According to the WHO, this was “the first time in 28 years that the world could see a reduction in DTP3 coverage—the marker for immunization coverage within and across countries.”

Drug overdoses

According to the CDC, 81,000 drug overdose deaths occurred in the United States in the 12 months ending May 2020—the highest number ever recorded in a 12-month period. “While overdose deaths were already increasing in the months preceding the 2019 novel coronavirus disease (COVID-19) pandemic, the latest numbers suggest an acceleration of overdose deaths during the pandemic,” noted the CDC. 

According to a report published in The Washington Post, this increase is linked to social isolation, disruptions to the drug trade, and economic fallout experienced during the pandemic. The Post reported that in 2020, drug overdoses were up by 18% in March, 29% in April, and 42% in May compared to the same period in 2019. In some states, fatal overdoses have doubled.

Stay-at-home orders and social distancing have led to an increase in the numbers of people taking drugs alone, which means it’s less likely someone will be there to call 911 or administer the overdose antidote naloxone, also known as Narcan. At the same time, some treatment centers and recovery programs have been forced to scale back or close. 

Even prior to the pandemic, drug programs in the United States were struggling to keep up. As we ease out of the pandemic, this epidemic of substance abuse will be one of the top issues to address.

Healthcare disparities

As with substance abuse and mental health issues, healthcare disparities were prevalent long before the COVID-19 pandemic. They include factors like: how often people from different racial backgrounds are screened for diseases; the severity of the impact of certain diseases; how likely they are to die from diseases; and whether they have proper access to healthcare. 

According to data from the Emergency Care Research Institute (ECRI), maternal mortality is 3.3 times higher among Black mothers compared with White mothers, Black adults are 50% more likely to have a stroke than White adults, and Black people are far more likely to suffer a fatal stroke than White people.

The pandemic has shed further light on these disparities. According to the National Center for Health Statistics, Hispanic people make up just 18.5% of the US population, but account for 32.5% of COVID-19 deaths, noted ECRI.

This issue has been recognized by the CDC, which acknowledged various causes for the healthcare disparities, including discrimination; differences in occupation (“people from some racial and ethnic minority groups are disproportionately represented in essential work settings”); inadequate healthcare access; educational, income, and wealth gaps; and housing issues, like overcrowding. 

As a result, the CDC announced it would spend $2.25 billion over the next two years to address COVID-19-related health disparities and to “advance health equity among populations that are at high-risk and underserved.” But until change happens, healthcare disparities remain a top concern.