In addition to being the editor of International Paramedic Practice and the Journal of Paramedic Practice, I am a South Asian woman whose parents were born and raised in Uganda, east Africa; the wife of a black African man from a tiny island called Sao Tome off the west coast of central Africa; and the mother of two mixed-race children, aged 3 and 7. Like many (I hope most), I am heartbroken by the racial discrimination and violence that are being brought to the world's attention with increasing frequency as instant access to smartphone cameras and widespread publishing via social media platforms have become the norm. As a human, I am deeply offended and ashamed that fellow human beings can be mistreated and killed based on their race in today's age after so much work has gone into abolishing such prejudice. As a woman of colour married to a black man and with two young biracial children, I am concerned about the world they are having to grow up in.
In the current issue of International Paramedic Practice, Hamel et al investigate the impact of socioeconomic status on student paramedic academic performance in the United States of America (USA) by looking at county-level income, poverty, food insecurity and high school graduation rates, and conclude that support is needed for students in communities of lower socioeconomic status.
It is no secret that in many countries, the USA in particular, race and socioeconomic status are closely linked. Systems of enforced residential racial segregation, designed to ‘protect’ whites from blacks, are largely responsible for the lower socioeconomic status of black people in the USA, their access to food, healthcare, education and employment (Williams and Collins, 2001).
In recent months, it has been highlighted that COVID-19 occurs with higher frequency in people of minority ethnic backgrounds. In the UK, for example, it was found that despite making up only 14% of the population, 35% of coronavirus patients in intensive care were from ethnic minorities (Siddique and Marsh, 2020). The impact of social determinants of health on the occurrence of chronic disease is by now well known—but how often do we question the causes of these social determinants? As world events are shining a blinding light on the racial inequalities and social disparities that are present in our societies, we must look towards the systems and institutions that have created these gaps, and which will continue to perpetuate them unless we turn our attention towards making permanent change.
In this issue's comment, Aidan Baron delves deeper into the gaping holes in our health and social care systems, exposed by the COVID-19 pandemic: if patients do not have the funds to afford food, childcare, and travel, how can they be expected to meet their daily medication adherence? He draws the links between these social crises and their impact on our global healthcare resources—acute and emergency care in particular—as well as the physical and mental health of individuals.
Baron goes on to note the responsibility of health professionals to advocate and to ‘apply firm and considerate pressure upon policy-making bodies’—as patient lives and the health of our global communities are on the line. What action will you take?