On Monday, Pfizer announced that its COVID-19 vaccine exhibits an efficacy rate of approximately 90% in preventing infection with the SARS-CoV-2 virus. The race to develop a vaccine against COVID-19 is receiving significant support from both the Trump administration and the incoming Biden-Harris administration, highlighting the increased role of government in health-related matters. In light of the COVID-19 pandemic and the recent presidential election, healthcare has become more politicized than ever before. In “Towards a Politics of Health”, Bambra et. al. argue that there are three reasons for said politicization:
- Health is unequally distributed.
- Determinants of health are influenced by political action, or a lack thereof.
- Health is, or should be, a component of citizenship and a human right.
Last month, I introduced social determinants of health (SDH). As the 2020 election cycle draws to a close, it feels like an appropriate time to elaborate upon political determinants of health, the political decisions that can positively or negatively influence SDH.
What are Political Determinants of Health?
In his book The Political Determinants of Health, Daniel Dawes, Director of the Satcher Health Institute at the Morehouse School of Medicine, posits that there are three political determinants of health – voting, government, and policy.
- Voting: People deciding who will make the “big picture” decisions for the country. According to Dr. Clyde Yancy, the Chief of Cardiology at Northwestern University, partisanship is the primary predictor of how a person will vote, the policies they will support, and recently, their response to the COVID-19 pandemic.
- Government: This encompasses the House of Representatives, the Senate, and the Supreme Court. These governing bodies oversee the process of proposing, finalizing, and/or reshaping policies.
- Policy: These are implemented to achieve particular goals. They are also useful in outlining priorities and building consensus amongst the general public (e.g. the Affordable Care Act).
Voting influences government, government influences policy, and policy goes on to influence SDH including, but not limited to, food, social support, work, and transportation. These SDH impact patient health experiences and outcomes and exacerbate health disparities.
COVID-19 and the 2020 Election
Let’s tie this information back to the current COVID-19 pandemic and the disparate responses to it from the Trump administration and the incoming Biden-Harris administration. Additionally, I will also briefly examine how the outcome of the 2020 election will influence the healthcare system in the United States going forward.
Trump did not have a robust plan for approaching the COVID-19 pandemic, and his focus was the rapid development and distribution of a vaccine. Unfortunately, a vaccine has not yet become available during his time in the White House. He also pushed for the elimination of the Affordable Care Act, even just this week, eliminating protections for those with pre-existing conditions in the midst of the pandemic. It can be seen that voting Trump into office has influenced the policies that have been developed (or have not been developed) by the government, and the lack of policies put forth by the administration to control the pandemic has led to the death of nearly 200,000 Americans.
On the other hand, President-Elect Biden and Vice President-Elect Kamala Harris have developed a seven step plan to combat COVID-19 that they hope to roll out in late January. This plan involves increasing the amount of testing, making use of the Defense Production Act to increase production of PPE, developing a plan for safe and equitable distribution of vaccinations, and more.
It is no secret that this virus, and a plethora of other conditions and illnesses, has a predilection for people of color. As such, Biden also plans to implement a COVID-19 Racial and Ethnic Disparities Task Force that will work to directly serve those communities that have felt the disproportionate impact of the pandemic. Once the pandemic ends, he hopes that this will morph into an Infectious Disease and Racial Disparities Task Force. Furthermore, Biden and Harris support the Affordable Care Act and are working to strengthen this law, which was put into place under the Obama administration.
For more information on these topics, or the incoming Biden-Harris administration in general, check out Alexa and Grace’s recent article, too.
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