The racial disparity in COVID-19 cases and deaths is narrowing as the pandemic wears on and vaccination rates among Black and Latino adults are approaching parity with white adults (thanks, white Republicans, for that anyway). But Black and Latino communities have disproportionately suffered the ravages of the pandemic, a reflection of the systemic racial inequality in the nation’s health care system.

That includes, according to a report from the General Accountability Office (GAO) released in August, the federal government’s efforts to combat chronic health conditions related to diet. “Many chronic health conditions are preventable,” the GAO opens the report with, “yet they are leading causes of death and disability in the United States.” The GAO identified 200 federal programs designed to help improve diets and fight chronic disease—diabetes, heart disease, cancer—but because they are “fragmented across 21 agencies,” they aren’t as effective as they could be.

This comes back to COVID-19, because chronic illness related to poor diet is far more prevalent in low-income communities and communities of color. People with these chronic illnesses have been at a much higher risk of serious illness if they caught COVID because of their underlying conditions.

The Centers for Disease Control and Prevention has tracked deaths by race, and its data show that the COVID-19 death rate among Black people is twice that of white people. It’s 2.3 times higher in the Latino population, and 2.4 times greater among Native Americans. Again, serious and chronic underlying health conditions are a primary factor in COVID-19 death. In 2018, according to the GAO, “Black Americans died from diabetes in 2018 at a rate 1.2 times higher than American Indians and Alaska Natives, 1.9 times higher than Whites, and 2.3 times higher than Asians and Pacific Islanders.”

A bit of improvement, according to the White House, is that “vaccination rates in Black Americans compared to Whites and Latinos has closed. Data show that more than 70% of Black Americans, 73% of Latinos and 71% of White Americans have received at least one shot, compared to 56%, 57%, and 65%, respectively, in May.”

But the federal government needs to do more. “The toll of diet-related chronic health conditions in the United States is high and may worsen if current trends continue,” the GAO concluded in its assessment. ”In 2018, over half of deaths among adults were the result of conditions that, in some cases, could have been prevented with improved diet. And increases in adult obesity—including a 46 percent rise in severe obesity in approximately a decade—could be a bellwether for increases in other chronic health.”

In 2011, the Obama administration developed a national prevention strategy, but it was centered in the White House, and not continued by the former guy’s administration. “In the absence of this or any other strategy,” GAO says, “federal officials are left without reasonable assurance that their extensive efforts are effective in reducing Americans’ risk of diet related chronic health conditions.” The agency recommends that Congress “consider identifying and directing a federal entity to lead the development and implementation of a federal strategy to coordinate diet-related efforts that aim to reduce Americans’ risk of chronic health conditions.”

That’s a start. But as the Kaiser Family Foundation notes from new analysis of CDC data, “many of the underlying structural inequities in health and health care and social and economic factors that placed people of color at increased risk early in the pandemic remain. They may remain at risk as the pandemic continues to evolve or if future health threats emerge.”