Combating COVID-19 health disparities in Black, Indigenous, and People of Colour Communities-A call for critical systems thinking.

Abstract

The Black, Indigenous, and People of Colour populations in the United States are disproportionately affected by the emerging health threat SARS-CoV-2, which causes COVID-19. This paper aims to demonstrate the usefulness of critical systems thinking by using scenario planning based on epidemiological data and tying epidemiology with soft systems methodology to investigate COVID-19 disparities among disproportionately affected Black, Indigenous, and People of Colour populations. Using a review of the COVID-19 literature and publicly available US COVID-19 data, critical systems thinking is applied in a scenario planning example and a call to link soft systems methodology with epidemiology. According to the four plausible Endgame scenarios, levels of community transmission as well as the current state transmission are based on the driving forces of the scenarios. In addition, soft systems methodology explores the effect on stakeholders and strengthens the picture of disease burden beyond sole reliance on traditional data sources. This analysis underscores employing critical systems thinking to critically assess diverse methods appropriate for the ongoing complexity of global crises. It is argued that critically engaged subjectivity should be given space alongside data-dependent objectivity. COVID-19 disparities are reliant on the social determinants of health's effects as driving forces on disease transmission in Black, Indigenous, and People of Colour populations. It is moreover argued that critical systems thinking is demonstrated by linking epidemiological evidence with scenario planning and soft systems methodology. This in turn supports a critical systems thinking approach to uncover the state of health disparities among minoritized communities under COVID-19.