Over the past several weeks we’ve been seeing data emerge concerning the relation of racial identity to COVID-19 cases and deaths. Across the U.S., communities of color, particularly black communities have been disproportionately affected by the novel coronavirus and for many, there’s no surprise. Health disparity has always been a reality, though there is no biological disposition that makes black or brown communities more susceptible to the virus. So if that isn’t the case, why is this happening? Well, there’s a multitude of reasons and the unfortunate reality of this data highlights the complex racial health, environmental, and economic inequities that have always existed in the United States for people of color, most consistently for black and indigenous people. Of whom are under-served in healthcare and face a higher risk of chronic disease, illness, infection, and injury. Next to race, one of the largest predictors and contributors to health outcome is economic and financial stability, or in this case, lack thereof. Economic advancement is arguably one of the largest struggles that black communities face, and it is often fully out of their control.
As this global health crisis progresses, certain ‘luxuries’ like working from home, access to quality healthcare, ability to stock necessities, and socially distance oneself, are less often afforded to many black people because of determinants like income, education, and housing. We are over-represented in prison and homeless populations along with Indigenous people, and many BIPOC* are now considered essential workers, which places more of us on the frontline of this pandemic.
So, if we peel at these layers, we will undress the physiological, psychological, and economic effects of racism and how these implications tie into these disproportionate numbers. It’s important also to note and identify the structures in place that foster racially motivated, discriminatory, and culturally insensitive practices which contribute to many of the disadvantages that black and brown people face. Many of which prohibit them from accessing clean air, safe housing, quality education, nutritionally valuable food, reliable transportation, and equitable healthcare. Black communities also are more likely to be subject to generational poverty, which also contributes to poor health, and not because of a lack of resources either. But also because discriminatory practices are and have been in place to keep it that way, such as redlining and now the gentrification of black and brown neighborhoods.
These discriminatory practices also exist in the healthcare system, where often there is limited access to healthcare, a perhaps justified distrust of health systems and professionals (remember the Tuskegee Syphilis Study? ), or individual and systemic biases by medical professionals. Black patients experience more illness yet receive poorer care, resulting in worse outcomes and premature death as compared to their white peers. We’ve seen it repeatedly where black people have advocated for themselves in medical settings, only to have their presenting symptoms and experiences trivialized. Thus receiving a separate standard of care than their peers, which then can cause their deaths. I’ve seen it personally and we are, unfortunately (and unsurprisingly) seeing it during the current crisis too. Just look at what happened with Deborah Gatewood, a black nurse who died after being turned away 4 times from the hospital she’s worked at for 31 years, or here where Rana Zoe Mungin, a BK school teacher was turned away twice and told her symptoms resulted from a panic attack. Both women subsequently died despite their pleas and advocation for their lives, which might have been prevented if their concerns were heard. This, unfortunately, is not an anomaly. Medical racism and systemic bias do not always present as blatant, in-your-face racism, or have such immediately drastic effects but it lends to the justified distrust of a system meant to heal and help.
While we can look at the preexisting health and physical conditions, it would be irresponsible to dismiss these disproportionate numbers as being a simple result of that. If we were to remove these comorbidities that frequent black and brown communities, such as high blood pressure, heart disease, diabetes, and other illnesses, those of which can exacerbate coronavirus symptoms, beneath the surface we will find layered, complex individual and systemic racism at its root. Health and medical inequities have always existed for the black community and unfortunately, as we’ve seen with Hurricane Katrina, this current global health crisis only sheds a grim, beaming light on that.
For more information on the statistics as they progress, please visit The COVID Tracking Project at covidtracking.com
*BIPOC; refers to Black, Indigenous, People of Color. *