This article reports on a recent Boston city council meeting at which councilors urged local hospitals and health authorities that may be forced to allocate scarce critical care resources to consider the impact of systemic racism on the prevalence of preexisting health conditions that are part of assessing a patient’s priority for resource allocation.

Massachusetts state health officials issued guidelines for scarce resource allocation that prioritizes patients most likely to survive with intervention and to live longer overall. The guidance is not mandatory, and Boston city councilors urged hospitals and health authorities to consider the impact of race and systemic racism on health in making potential allocation decisions if resources become scarce. The city councilors emphasized that patients’ underlying health conditions that may be factored into this assessment, such as diabetes, hypertension, obesity, and asthma, are more prevalent in communities of color and that these disparities result from historical and systemic inequities and racism. Simultaneously, communities of color appear to represent a disproportionate share of COVID-19 cases based on initial data, a combination of factors that threatens to further inequitably burden these communities if case surge results in a need to ration critical resources.