Editor's Note: This article is part of a series in partnership with the All of Us Research Program, which collects and studies health data to help scientists identify health trends. More than 80% of participants are from groups that have been historically underrepresented in research.

There’s growing evidence that Black, Hispanic, American Indian, and Alaska Native people are among those hardest hit by COVID-19. These groups are more likely to get sick or die from the virus.

Experts can’t pinpoint a single reason. But they think longstanding discrimination, social determinants of health, and other factors play a role. Here’s a look at some of the root causes behind these disparities.

Barriers to Health Care

Your chances of getting really sick from COVID-19 go up if you have other health conditions. They include:

  • Diabetes
  • Cardiovascular disease
  • Asthma
  • Obesity

These medical conditions show up more often in minority groups for lots of complex reasons. But they’re not the only reason for COVID-19 disparities. Minorities face other challenges to health care. They include:

Lack of health insurance. Some racial and ethnic groups are less likely to have coverage. That can make health care so expensive that they won’t go to the doctor. Or they may wait until they’re really sick.

Limited access to testing. Some experts think there wasn’t as much COVID-19 testing in minority or underserved communities at the beginning of the pandemic. And most states required a doctor’s note to get tested. But some people may not have a regular doctor. Drive-thru testing can also be a problem. That’s because you have to have a car. Both mean you’re less likely to get tested.

Lower quality of care. Systemic racism can raise stress levels, which can worsen overall health. But research shows that Black people and other minorities tend to get lower quality care. That includes fewer medical interventions, like surgery or medication.

Unconscious discrimination. Medical professionals may not know when they judge someone based on their race. That’s called implicit bias. And it may affect the kind of care someone gets. Some experts think this kind of discrimination may be worse during times of stress, like the COVID-19 pandemic.

Less use of telehealth. Many health care services went online went the pandemic started. Studies show racial and ethnic minorities didn’t use these as much.

Poor communication. Sometimes language or cultural barriers make it hard to talk with doctors or get the right information.

Lack of trust. Certain racial and ethnic minorities may not seek treatment because they don’t think they’ll be treated fairly. Examples include the U.S. government and health care systems that in the past performed studies and surgeries on Black people without permission, which has left a legacy of mistrust.

One program that can help meet the challenges of health care in minority communities is the All of Us Research Program. It's a large, diverse organization that helps researchers find answers to pressing health issues. The program's scientists have helped identify activities that contribute to COVID-19 research.

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