Experts: Coronavirus has magnified long-held inequities of Austin’s health care system

A view of Downtown Austin from Lady Bird Lake (Iain Oldman/Community Impact Newspaper)
A view of Downtown Austin from Lady Bird Lake (Iain Oldman/Community Impact Newspaper)

A view of Downtown Austin from Lady Bird Lake (Iain Oldman/Community Impact Newspaper)

Austin’s top doctor said thinking solely about the coronavirus will not solve its disparate impact on the community.

“If we only focus on [the coronavirus], we’re not going to save more people,” Austin-Travis County Interim Health Authority Dr. Mark Escott told Austin City Council on June 2. “We’re only going to save more people by getting to the heart of the matter.”

The heart of the matter, Escott said, is the fundamental inequities that have persisted in the local health care system for generations. He said saving more people means making sure everyone has access to nutritious food, affordable and adequate health care, and the tools to take care of themselves. Escott said the community could address these issues in the short term.

Since infiltrating the Austin community in mid-March, Austinites of color have bore the brunt the highly infectious coronavirus. Austin Public Health presented an in-depth statistical analysis to City Council on June 2 to visualize the pandemic’s disproportionate local impact.

Although Hispanics make up 33.9% of the Austin-Travis County population, they accounted for 56.9% of the infections and 62.2% of the hospitalizations between March and the end of April, according to Austin Public Health’s findings. African-Americans, accounting for 8.9% of the population, have made up 10.1% of the hospitalizations and 8.4% of the total cases.

African-Americans have a case fatality rate of 5.4%, far greater than any other group, Austin Public Health found using the same data set; they are also hospitalized at a rate of 18.5%, also greater than any other group. Hispanics are hospitalized at a rate of 16.8%. Escott emphasized that the sample size used for the data was 30 deaths but felt the numbers remained significant. Austin plans to have the data peer-reviewed and published in a science journal.


Escott called the findings serious and concerning. However, he maintained the focus should be shifted to the social determinants of health that make minorities more susceptible to the infectious virus. Diabetes and hypertension, two health conditions that complicate coronavirus infections, overwhelmingly impact black and Hispanic communities.


Escott said called it “shameful” that the community has not addressed the impact of those two conditions. He said they are low-hanging fruit; any health care professional has the capacity to diagnose the illnesses, and the cost of treatment is minimal.

“[Emergency room physicians] see people over and over and over again from African American and [Hispanic] communities coming to the ER over complications from these two diseases,” Escott said. He said hospitals pay for the emergency care, yet the same cost of one ER visit could have paid for a lifetime’s worth of medication. “We need to think about investment in prevention.”

District 1 City Council Member Natasha Harper-Madison said the local health care community needed real systemic change, which, she said, involves changing all systems, not just health care.

Austin Public Health Director Stephanie Hayden said the county health department was working on a targeted testing program that brings mobile testing to specific communities. She said the department is looking at Pflugerville, Dove Springs, Montopolis and Colony Park.
By Christopher Neely
Christopher Neely is Community Impact's Austin City Hall reporter. A New Jersey native, Christopher moved to Austin in 2016 following years of community reporting along the Jersey Shore. His bylines have appeared in the Los Angeles Times, Baltimore Sun, USA Today and several other local outlets along the east coast.


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