By: Hadassah Bauerle, CFCC Student Fellow (2019-2020)
COVID-19 is a virus that has impacted everyone regardless of age, gender, or race. In the United States, however, the coronavirus has different effects on people depending upon the resources they have.[1] Helene Gayle, who manages a coronavirus relief fund in Chicago, says that it is impossible to learn from this pandemic without also considering the effect that racial disparity plays throughout the crisis.[2] The poor in America are more likely to have underlying health conditions, making infection of the virus significantly more dangerous; are more likely to be working outside the home at essential jobs and relying on public transportation, making the likelihood of infection much higher; and are less likely to be insured. Each of these factors of inequality on its own is magnified further during this pandemic and creates disparate outcomes, according to Jon Zelner, an epidemiologist at the University of Michigan.[3]
Health disparities
There are three major factors that contribute to health disparities in the U.S. with regard to coronavirus, namely, race, income, and underlying health conditions. Maryland’s Governor Larry Hogan is the chair of the National Governors Association and has requested that the organization encourage leaders across the country to collect racial disparity data as it relates to COVID-19.[4]
According to Dr. Jerome Adams, the U.S. surgeon general, people of color are more likely to live in crowded housing situations, with several generations living in one home.[5] They are also more likely to live in densely inhabited areas, all of which creates a higher likelihood for the spread of disease. Blacks and Latinos are also more likely to work at essential jobs, thereby interacting with people outside of their immediate household and continuously being exposed to infection.[6]
The data regarding infection reflects these racial considerations. In New York City, Latino and Black residents are dying at twice the rate as white residents.[7] In Chicago, 72% of deaths are of Blacks, even though African Americans make up only 29% of the city’s population.[8] Furthermore, 52% of those who tested positive in Chicago were Black.[9] In New Mexico, 25% of positive cases were from Native Americans, even though they are only 6% of the state’s population.[10] In Maryland, 52% of coronavirus-related deaths were African Americans, despite only being 31% of the state’s population.[11]
Another factor that impacts health disparities in the U.S. is income. Americans who struggle financially also struggle to stay healthy.[12] Americans living in poverty work at jobs they cannot do from home, and they also cannot afford not to work as a way to avoid exposure.[13] Those with low income will not seek treatment as quickly and may suffer greater consequences as a result of the infection.[14]
Underlying health conditions also have an impact on the disparities within the U.S. when it comes to coronavirus. Underlying health conditions can make coronavirus more dangerous because the disease taxes organs that are already burdened.[15] 75% of coronavirus patients that have required ICU treatment in America have had preexisting health conditions such as diabetes, chronic lung conditions, and heart disease.[16] Around the world, doctors have reported that COVID-19 patients in the hospital have experienced heart attacks or other heart complications, regardless of the presence of preexisting heart conditions. In America, African Americans are much more likely to have underlying heart conditions than any other groups.[17] Blacks are also more likely to suffer from diabetes, coronary diseases, high blood pressure, and other medical conditions.[18] Because African Americans have higher rates of chronic medical conditions, they are more likely to become sick and have more severe reactions to coronavirus.[19]
Health disparities among poor people of color are largely the result of structural racism in America and not necessarily personal choices. For example, African Americans are more likely to work in racially segregated worksites with higher occupational hazards, fewer benefits, and more stress.[20] Research shows that repeated exposure to stress or physical hazards can lead to a number of health conditions, such as heart disease.[21] Infectious diseases spread more rapidly among African American communities as a result of segregation or isolation within social networks–not more risky behaviors.[22] Segregation, especially residential segregation, can spread disease by isolating racial groups from others and then by concentrating exposures.[23]
Dangerous beliefs
There are a few beliefs that people may have regarding coronavirus that are incredibly dangerous and false. The first is the myth that people of color cannot contract COVID-19. This is a myth that has b journalists have heard in interviews, as well as through social media posts. In Baltimore’s poorest neighborhoods, the public does not appear to trust messages about COVID-19, as many believe that Black people cannot get the disease.
Reverend Alvin Hathaway Sr. of Union Baptist Church in West Baltimore said, “The coronavirus has revealed not only the disparity of health but of information.”[24] In many states, the virus began in white suburbs and spread to poor African American neighborhoods. Additionally, the disease was spread as a result of international travel, primarily done by people of means. For example, the virus came to Maryland as a result of people going on a cruise.
All of this information regarding the origin of the virus has contributed to the false belief that it is a “white person’s sickness.” Despite this belief, Baltimore City, specifically the Pimlico neighborhood, has the highest rates of coronavirus in the state, and it is in this neighborhood that four out of five residents are Black.[25] In the rest of the city, three out of five residents are Black.[26]
Karsonya “Kaye” Wise Whitehead, a professor of African American Studies at Loyola University Maryland, says that the myth has “seeped very deeply into the black community.”[27] She also says that the African American community has good reasons to be wary, as history has shown that whites are not trustworthy when it comes to the health of Black people. The Tuskegee trials from the 1930’s to 1970’s, in which researchers withheld syphilis treatment from sharecroppers in order to observe the devastating effects of the disease and harvesting cancer cells of Henrietta Lacks at the Johns Hopkins University without her consent, are the two most well-known examples. Especially for Baltimore residents where the poorest families still live in the shadows of Johns Hopkins Hospital, this fear and distrust of white leadership is not unfounded.[28]
Many African Americans in Baltimore exhibit dangerous behaviors with respect to the risk of contracting coronavirus. Many have not been practicing social distancing, despite government officials’ pleas for a minimum of six feet of space between people not living in the same household.[29] Especially in areas where drug deals occur, social distancing is not common, and mask wearing is rare during these exchanges.[30] In several neighborhoods within Baltimore, children are still playing on playgrounds, and neighbors sit together on steps outside their homes. Few also wear masks.[31]
Despite the dangerous behaviors, there are several solutions for Baltimore. The first is an online resource. The Maryland Department of Health, along with the Maryland Department of Information Technology and Maryland Emergency Management, has launched a site to dispel coronavirus rumors. That site can be accessed here: https://govstatus.egov.com/md-coronavirus-rumor-control. The site addresses myths and rumors and provides information regarding the spread of the virus. The top of the page asks visitors to the site to report any rumors they may have heard regarding coronavirus so that experts can address it. The site also includes links to the CDC and FEMA’s rumor control pages. Several trusted sources are also cited at the top of the page for anyone wishing to learn more about available resources.
Another solution to address the dangerous behaviors within Baltimore is a music video that has gone viral, encouraging Baltimore residents to wear masks in public. The catchy 92 second video can be viewed here: https://youtu.be/J-tTqJZeNyw. The video uses popular Baltimore club music with updated lyrics and features various Baltimore neighborhoods.[32] The dancers in the video also incorporate Baltimore dance club moves in the choreography.[33] As of the writing of this article, the video has been viewed over 26,000 times since it was uploaded on April 3rd.
One other solution attempting to address Baltimore’s residents is through a nonprofit organization. Food Rescue Baltimore has packed bags of fresh produce and has slipped flyers inside the bags with messages about social distancing, explaining how long six feet is. The bags are distributed on the colorful arabber horse carts, which are one of the “most trusted institutions in the black community.”[34]
Another dangerous and false belief that people may have regarding coronavirus is that it is people of color’s fault for getting COVID-19 because they have not taken precautions to stay safe. It is important to not look at entire racial groups and assume anything based on the individual actions of one person. Calling for the public to take this pandemic seriously is acceptable practice, but it must be done without calling for individual racial groups to take the pandemic seriously.[35]
It is also important to not assume that, because the rates of infection and death are higher among people of color, it is due to the fact that they are taking the pandemic less seriously than whites.[36] In fact, evidence shows that between March 10th – March 16th, 2020, Blacks have been more than two times as likely as whites to view coronavirus as a major threat to their health and that Blacks have been significantly more concerned than whites about the pandemic by stocking up on nonperishable foods and cleaning products.[37] As mentioned above, health disparities that make COVID-19 more dangerous are the result of structural racism, not merely personal food or lifestyle choices. For example, poor whites in the south who eat unhealthy foods are still less likely to have the same health conditions of poor Blacks in the south.[38]
Conclusion
Although the coronavirus can strike anyone and has devastating effects on people regardless of age, gender, or racial groups, the Americans most at risk of contracting the disease and being disproportionately negatively impacted are those who are poor and people of color. It is crucial that lawmakers and leaders continue to address the needs of these vulnerable citizens, who are severely impacted as the virus continues to spread throughout the country. Furthermore, due to the distrust of white leadership, it is important that Black community leaders rise up and encourage the community to take necessary precautions to protect themselves against infection and the spread of the coronavirus.
[1] Sharon Karida and Jon Zelner, Which Populations Are Most Vulnerable to the Coronavirus Pandemic?, University of Michigan School of Public Health (April 6, 2020), https://sph.umich.edu/news/2020posts/which-populations-are-most-vulnerable-to-coronavirus.html.
[2] Natalie Moore, In Chicago, COVID-19 Is Hitting The Black Community Hard, National Public Radio (April 6, 2020), https://www.npr.org/sections/coronavirus-live-updates/2020/04/06/828303894/in-chicago-covid-19-is-hitting-the-black-community-hard.
[3] Bryce Huffman, Black People are 40% of COVID-19 Deaths in MI. What Does That Mean?, Michigan Radio (April 4, 2020), https://www.michiganradio.org/post/black-people-are-40-covid-19-deaths-mi-what-does-mean.
[4] Casey Leins, State, Local Officials Highlight Racial Disparities in Coronavirus Deaths, U.S. News (April 13, 2020), https://www.usnews.com/news/best-states/articles/2020-04-13/state-local-officials-address-racial-disparities-in-coronavirus-deaths.
[5] Id.
[6] Natalie Moore.
[7] Casey Leins.
[8] Natalie Moore.
[9] Id.
[10] Casey Leins.
[11] Id.
[12] Liz Essley Whyte, Underlying Health Disparities Could Mean Coronavirus Hits Some Communities Harder, National Public Radio (April 1, 2020), https://www.npr.org/sections/health-shots/2020/04/01/824874977/underlying-health-disparities-could-mean-coronavirus-hits-some-communities-harde.
[13] Sharon Karida.
[14] Liz Essley Whyte.
[15] Liz Essley Whyte.
[16] Id.
[17] Id.
[18] Natalie Moore.
[19] Casey Leins.
[20] Gilbert C. Gee and Chandra L. Ford, Structural Racism and Health Inequities, Cambridge University Press (April 15, 2011), https://www.cambridge.org/core/journals/du-bois-review-social-science-research-on-race/article/structural-racism-and-health-inequities/014283FE003DFD8EF47A3AD974C72690.
[21] Id.
[22] Id.
[23] Id.
[24] Tim Prudente, Coronavirus Fight Shifts to Baltimore’s Poor Neighborhoods as City Leaders Battle Mistrust, The Baltimore Sun (April 11, 2020), https://www.baltimoresun.com/coronavirus/bs-md-coronavirus-baltimore-african-americans-20200411-hrnrm4li5nd2tcnx73pxi4ziui-story.html.
[25] Id.
[26] Id.
[27] Id.
[28] Id.
[29] Id.
[30] Sameer Rao, Baltimore Club Banger Urges Listeners to Wear Face Masks During Coronavirus Pandemic, The Baltimore Sun (April 8, 2020), https://www.baltimoresun.com/coronavirus/bs-md-put-your-mask-on-20200407-20200408-ufmtiaqssrfs5lodjgy4tfkfzy-story.html
[31] Id.
[32] Id.
[33] Id.
[34] Tim Prudente
[35] Ibram X. Kendi, Stop Blaming Black People for Dying of the Coronavirus, The Atlantic (April 14, 2020), https://www.theatlantic.com/ideas/archive/2020/04/race-and-blame/609946/.
[36] Id.
[37] Id.
[38] Id.