The Effect of the Coronavirus on America’s Black Communities | The New Yorker

The old African-American aphorism “When white America catches a cold, black America gets pneumonia” has a new, morbid twist: when white America catches the novel coronavirus, black Americans die.

Thousands of white Americans have also died from the virus, but the pace at which African-Americans are dying has transformed this public-health crisis into an object lesson in racial and class inequality. According to a Reuters report, African-Americans are more likely to die of covid-19 than any other group in the U.S. It is still early in the course of the pandemic, and the demographic data is incomplete, but the partial view is enough to prompt a sober reflection on this bitter harvest of American racism.

The small city of Albany, Georgia, two hundred miles south of Atlanta, was the site of a heroic civil-rights standoff between the city’s black residents and its white police chief in the early nineteen-sixties. Today, more than twelve hundred people in the county have confirmed covid-19 cases, and at least seventy-eight people have died. According to earlier reports, eighty-one per cent of the dead are African-American.

In Michigan, African-Americans make up fourteen per cent of the state’s population, but, currently, they account for thirty-three per cent of its reported infections and forty per cent of its deaths. Twenty-six per cent of the state’s infections and twenty-five per cent of deaths are in Detroit, a city that is seventy-nine per cent African-American. covid-19 is also ravaging the city’s suburbs that have large black populations.

The virus has shaken African-Americans in Chicago, who account for fifty-two per cent of the city’s confirmed cases and a startling seventy-two per cent of deaths—far outpacing their proportion of the city’s population.

As many have already noted, this macabre roll call reflects the fact that African-Americans are more likely to have preëxisting health conditions that make the coronavirus particularly deadly. This is certainly true. These conditions—diabetes, asthma, heart disease, and obesity—are critical factors, and they point to the persistence of racial discrimination, which has long heightened black vulnerability to premature death, as the scholar Ruthie Wilson Gilmore has said for years. Racism in the shadow of American slavery has diminished almost all of the life chances of African-Americans. Black people are poorer, more likely to be underemployed, condemned to substandard housing, and given inferior health care because of their race. These factors explain why African-Americans are sixty per cent more likely to have been diagnosed with diabetes than white Americans, and why black women are sixty per cent more likely to have high blood pressure than white women. Such health disparities are as much markers of racial inequality as mass incarceration or housing discrimination.

It is easy to simply point to the prevalence of these health conditions among African-Americans as the most important explanation for their rising death rates. But it is also important to acknowledge that black vulnerability is especially heightened by the continued ineptitude of the federal government in response to the coronavirus. The mounting carnage in Trump’s America did not have to happen to the extent that it has. covid-19 testing remains maddeningly inconsistent and unavailable, with access breaking down along the predictable lines. In Philadelphia, a scientist at Drexel University found that, in Zip Codes with a “lower proportion of minorities and higher incomes,” a higher number of tests were administered. In Zip Codes with a higher number of unemployed and uninsured residents, there were fewer tests. Taken together, testing in higher-income neighborhoods is six times greater than it is in poorer neighborhoods.

Inconsistent testing, in combination with steadfast denials from the White House about the threat of the virus, exacerbated the appalling lack of preparation for this catastrophe. With more early coördination, hospitals might have procured the necessary equipment and staffed up properly, potentially avoiding the onslaught that has occurred. The consequences are devastating. In the Detroit area, where the disease is surging, about fifteen hundred hospital workers, including five hundred nurses at Beaumont Health, Michigan’s largest hospital system, are off of the job with symptoms of covid-19. Early in the crisis, at New York City’s Mount Sinai Hospital, nurses were reduced to wearing garbage bags for their protection. Across the country, health-care providers are being asked to ration face masks and shields, dramatically raising the potential of their own infection, and thereby increasing the strain on the already overextended hospitals.

The early wave of disproportionate black deaths was hastened by Trumpian malfeasance, but the deaths to come are the predictable outcome of decades of disinvestment and institutional neglect. In mid-March, Toni Preckwinkle, the president of the Cook County Board in Illinois, which encompasses Chicago, lamented the covid-19 crisis and proclaimed that “we are all in this together,” but, weeks later, she closed the emergency room of the public Provident Hospital in the predominantly black South Side. Preckwinkle claimed that the closure would last for a month and was a response to a single health-care worker becoming infected with the virus. Leave aside the fact that nurses, doctors, and other health-care workers have been testing positive for covid-19 across the country, and their facilities have not been shuttered. It is a decision that simply could not have been made, in the midst of a historic pandemic, in any of the city’s wealthy, white neighborhoods on the North Side.

Meanwhile, in Cook County Jail, three hundred and twenty-three inmates and a hundred and ninety-six correctional officers have tested positive for covid-19. Not only have officials not closed the county jail as a result but they also have yet to release a significant number of jailed people, even though the facility has the highest density of covid-19 cases in Chicago. These are the kinds of decisions that explain why there is a thirty-year difference in life expectancy—in the same city—between the black neighborhood of Englewood and the white neighborhood of Streeterville. They are also just the latest examples of the ways that racism is the ultimate result of the decisions that government officials make, regardless of their intentions. Preckwinkle is African-American, and the chairperson of the Cook County Democratic Party, but her decisions regarding Provident Hospital and Cook County Jail will still deeply wound African-Americans across Chicago.

The rapidity with which the pandemic has consumed black communities is shocking, but it also provides an unvarnished look into the dynamics of race and class that existed long before it emerged. The most futile conversation in the U.S. is the argument about whether race or class is the main impediment to African-American social mobility. In reality, they cannot be separated from each other. African-Americans are suffering through this crisis not only because of racism but also because of how racial discrimination has tied them to the bottom of the U.S. class hierarchy . . .

Read More: The Effect of the Coronavirus on America’s Black Communities | The New Yorker

Opinion | My Mother’s Death Will Have Everything and Nothing to Do With Covid-19 – The New York Times

My Mother Is Busy Getting Ready to Die

No insurance. 64 years old. Alone, along with all the other black people at the bottom of the pandemic.

By 

Dr. Manigault-Bryant is an associate professor of Africana studies at Williams College.

My mother is dying a painful death, and it has everything and nothing to do with Covid-19.

In a piece for The Atlantic detailing the ways in which the coronavirus seems to be hitting black people the hardest, Ibram X. Kendi wrote: “Sometimes racial data tell us something we don’t know. Other times we need racial data to confirm something we already seem to know.” My mother is a living example of what we already know about race, class and suffering.

She is not in an elder-care facility, nor a hospital. She has not been, and most likely will not be, tested for the virus or receive a diagnosis of having it.

Still, hers is the body of all the black people at the bottom of the pandemic. No insurance, though not for lack of trying. Medicaid applications denied for reasons we don’t understand. Inconsistent care at a local public clinic meant hard-to-come-by appointments and checkups only at moments deemed most critical. It wasn’t enough.

Now, she’s dying from end-stage liver disease and kidney failure, diagnosed too late to save her. This has nothing to do with Covid-19.

She is not even that old (64, and thus Medicare ineligible), but FaceTime tells no lies, and she is wasting away before us. What’s worse, even as I’m exactly four hours and three minutes away — geographically closer than I’ve been in over a decade — I can’t be near her, touch her, cook for her, kiss her or tell her all of the things that I don’t yet know I need to say. This has everything to do with Covid-19.
On the occasion she’s strong enough to answer the phone, holding the phone for FaceTime proves too much. Calls come too late, even as time is too short. The grandchildren who live close by cannot get close to her — the idea of transmitting anything to her, as she’s so obviously immune-compromised, is terrifying. The underlying conditions would amplify an already-certain death. This has everything to do with Covid-19.

My brother, who lives exactly six minutes and 24 seconds away from Mommy, risks seeing her because someone needs to make sure she’s still breathing. That check-in is thus essential. He scrubs himself clean after work with all manner of chemicals — he’s a waste management truck driver, an essential employee. This is an effort to protect her. He’s close to her. This is an effort to protect us. This has everything to do with Covid-19.

He tries to get her to eat something other than her single meal of applesauce and Vienna sausages. This has nothing to do with Covid-19.

It’s officially power-of-attorney and health-proxy time. Getting my mother to the lawyer — a four-minute drive — is a thing. My brother and I spend hours strategizing transportation. The errand feels like it takes an eternity. This has everything to do with Covid-19.

Like so many, countless others, my family and I are going to be left with the unsettling weight of her death. My mother is going to die soon, and it will most likely be alone. I am afraid. I am one of many grieving, forever-changed faces. No repast. No low-country songs sung graveside. No sending up our timber for her. We cannot grieve properly. Lots of regret. This has everything to do with Covid-19.

When the pandemic is over, we still won’t know how to deal with this. We’re not ready for this kind of grief. Death is so utter, so absolute, yet so much right now is uncertain. My mother is dying a painful death, and it has everything and nothing to do with Covid-19.

LeRhonda S. Manigault-Bryant (@DoctorRMB) is associate professor of Africana studies at Williams College and the author of “Talking to the Dead: Religion, Music, and Lived Memory Among Gullah/Geechee Women.”

 

Confinement and Disease from Slavery to the COVID-19 Pandemic – AAIHS

 

Confinement and Disease from Slavery to the COVID-19 Pandemic

Apartment building in Chicago, 1941, (Russell Lee: Library of Congress)

As many college students as well as others have moved back home during the current pandemic people’s houses are feeling more cramped than ever. The conditions of small living spaces feel even more confining as communities are tasked with staying inside as much as possible with orders to shelter in place still intact in some locations. These conditions have left many feeling restless, bored, agitated and sad as they try to carve out private space and a sense of normalcy in such an uncertain time. The feelings of confinement ordinary people are facing contrasts starkly with the views of celebrity housing available through live streams, photos, and videos on social media. Gal Gadot and several other celebrities, for example, released a video of them singing John Lennon’s “Imagine.” The video was posted to Gadot’s Instagram with the caption “We are in this together, we will get through it together. Let’s imagine together. Sing with us. All love to you, from me and my dear friends.” Immediately, people on Instagram and Twitter noted the emptiness of these gestures coming from wealthy celebrities without the addition of material action.

The pandemic has drawn to a head the inequalities in housing and wealth defining the contemporary US. The nation’s majority have been left scrambling to make rent for their tiny apartments while watching the wealthy squirrel away in large open concept mansions with lush lawns and huge pools.

For Black communities, these contradictions are nothing new, as forced immobility and confinement have defined their historical and contemporary experiences with regard to the matters of space. As West Africans were rendered slaves, one of their primary spatial experiences was confinement, first in slave castles like El Mina in modern Ghana and then aboard the thousands of slave ships that traversed the Atlantic across five centuries. Africans crossed the ocean packed in and chained together with little room to move.

The carceral space aboard the slave ship  put captives in a position of increased vulnerability to diseases and illness. Despite slave trader’s efforts to bring only “healthy” Africans across the sea many ships suffered numerous casualties due to yellow fever, smallpox, scurvy, malaria, flux, and several other diseases. Sowande’ Mustakeem has noted that the isolation caused by the sea voyage along with the cramped and unsanitary conditions captives were held in created unique and devastating encounters with disease. The spread of disease was further aggravated by the violent treatment of captives aboard these ships as well as poor nutrition. As people’s bodies attempted to heal from physical and psychological injuries as well as illness, they faced an environment that only further deteriorated their capacities to fight infection.

In the North American context, despite variation in housing circumstances across different regions and time, the enslaved were forced to live in confining spaces. Whether awaiting sale in a dingy and overcrowded slave pen in Richmond, living in overcrowded gender-segregated barracks in Charleston, or making lives in a drafty and inadequately sized cabin on a rural sugar plantation in New Orleans’ hinterland, slaves experienced the quotidian violence of tight living irrespective of other differences in their social conditions and labor. This contrasts sharply with white slave owners who demonstrated their power with sprawling homes on sprawling estates. Consider for example, Thomas Jefferson’s Albemarle County, Virginia mansion, Monticello in contrast to the small and poorly insulated log cabin structures in which the people he enslaved lived. The contrasts between Black and white space also had another dimension related to mobility. Especially in the wake of the Jacksonian era, white people moved freely, while enslaved people’s movements were legally regulated and violently circumscribed. Even free Black people, especially after Nat Turner’s bloody 1831 rebellion, were strictly delimited in their abilities to move freely. Confinement and immobility were twinned conditions for slaves. As Katherine McKittrick analyzesHarriet Ann Jacobs, spent seven years in her grandmother’s garret or attic space, unable to fully stand upright in nine-foot-long, seven-foot-wide, three-foot-tall space. She hid in this space, carving it as a “loophole of retreat” in order to evade the violence of her master and eventually to escape. For Jacobs freedom required a subtle reworking of the confinement enforced on Black life and Black geographies.

This lack of mobility and confinement continued after slavery as part of its afterlives along with the related condition of predisposition to contagious disease and premature death. In Chicago between the World Wars, Black migrant communities were forced into the West and Southside by legally sanctioned segregation, policing, and vigilante violence. Black families rented small apartments called kitchenettes at exorbitant rates, and as St. Clair Drake and Horace Cayton characterized  in their influential study, lived in cramped poorly heated and congested conditions. As Rashad Shabazz argues, in the spaces of kitchenettes, Black Chicagoans experienced an expression of carceral power in their ordinary lives, manifest in the arrangement of their housing. He writes “by creating close associations between people the kitchenette made privacy of any kind impossible, shaming its residents by putting all actions under the forced gaze of others in the room.”1 This kind of housing arrangement is psychologically wearing, as Richard Wright’s Native Son disturbingly and dramatically fictionalizes. Many Black Chicagoans, across generations, experienced life-long emotional states like the frustration, restlessness, and captivity some people stuck in their homes due to the pandemic currently are experiencing for the first time.

This confining geography extending out from kitchenette also had deadly effects. In 1918 and 1919 the Spanish Flu pandemic caused mass death and tremendous social upheaval that anticipated and rehearsed what Black communities are currently experiencing with COVID-19. Prisoners today are among the most vulnerable to COVID-19—the highest number of cases tied to a location is a prison in Ohio where 80% of the prisoners have tested positive. This resonates with the history of the Spanish Flu in Chicago. As one Chicago Defender writer noted, “Chicago police stations are doing more to breed disease than any other agency supposed to be working for the good of Chicago.”2 The journalist went on to note the way Chicago jails “huddle prisoners together” without medical examinations and how this led to the spread of the deadly flu.3 The carcerality of the kitchenette also made its residents vulnerable. Shabazz notes that Black Chicagoans had higher rates of mental illness, disease, and death all of which were influenced by their crowded and run-down living conditions. These kinds of vulnerabilities tied to spatial confinement are ongoing in Chicago where 50% of the deaths from COVID are Black, and where segregation and carcerality continue to define the landscape.”4

Blackness’s tie to tight spatial control and confinement,extending between living spaces and formal carceral institutions, and from slavery to the present, puts Black people at greater risk for disease and infection exacerbated by the mental health effects of confinement. This greater vulnerability tied to spatial confinement, overcrowding, and other effects of our nation’s anti-Black geography buttresses the spatial advantages white communities enjoyed historically and which they continue to enjoy. White slave owners profited from the confinement and forced vulnerability of their slaves. White landowners in Chicago profited from overcharging their Black tenants for poor quality housing. The risk of death, disease, and mental illbeing that Black people live with exists to produce white safety and comfort, guaranteed in exclusive geographies away from lead paint, rusty water, over-policing, and gratuitous violence. In order to mitigate the unequal deadly effects of COVID-19  and to prevent the future of devastating conditions disproportionately affecting Black people, we must reimagine the American landscape outside this history defined by the twinned and reinforcing structures of Black immobility and confinement.

  1. Rashad Shabaz, Spacializing Blacknes: Architectures of Confinement and Black Masculinity in Chicago. (Chicago: University of Illinois Press, 2015), 50. 
  2. “Spanish Plague Raging in Chicago: All Places of Public Assemblage Ordered Closed by Health Officials,” Chicago Defender (Chicago, IL), Oct. 19, 1918. 
  3. Ibid. 
  4. The Color of Caronavirus: COVID-19 Deaths by Race and Ethnicity in the US.” APM Research LAB, May 5th, 2020. https://www.apmresearchlab.org/covid/deaths-by-race. 

Source: Confinement and Disease from Slavery to the COVID-19 Pandemic – AAIHS

‘The Father of Environmental Justice’ Isn’t Surprised by COVID-19 Health Disparities – Texas Monthly

As the coronavirus keeps large swaths of Texas shut down, from the economy to the education system and social life, it has become common to note that the disease “doesn’t discriminate.” But Robert Bullard, a professor and former dean at Texas Southern University’s Barbara Jordan–Mickey Leland School of Public Affairs, has spent the past four decades researching the opposite: how natural disasters and crises wreak havoc on society unequally. Low-income communities of color often have far fewer resources to address disaster and, as a result, face far greater risks than whiter, wealthier neighborhoods in times of crisis.

Indeed, across the nation, evidence suggests that people of color are dying at higher rates from COVID-19 than are white people. Though Texas’s Department of State Health Services has so far reported incomplete racial data, some counties are following the national trend. In Harris County, for example, 40 percent of those who died from COVID-19 were black, though black people account for only 20 percent of the county’s population.

A number of factors could be responsible for the disparity. In Texas, black and Latino communities have higher rates of preexisting conditions that make the coronavirus deadly, like asthma and high blood pressure. When it comes to health care, black, Hispanic, and Native Americans in the state are more likely to be uninsured than white residents, according to data from the Kaiser Family Foundation. Testing for COVID-19 is also far from equally accessible: in the city of Dallas, testing is concentrated in high-income areas. And people of color might also be more likely to be employed in sectors that preclude social distancing: black and Latino workers are the least likely to report being able to work from home, according to the U.S. Bureau of Labor Statistics.

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While COVID-19 is a new phenomenon, racial disparities in health outcomes are not. In the seventies, Bullard’s research in Houston demonstrated that toxin-releasing facilities like waste and sewage plants were disproportionately placed in the city’s black neighborhoods, leading to a higher concentration of health problems. To this day, the pattern holds true.

Bullard’s work catalyzed the American environmental justice movement, which argues that environmental problems disproportionately affect communities of color and the poor, and that race and class should be accounted for in their potential solutions. Texas Monthly spoke with Bullard about how the pandemic intersects with environmental issues and why people of color are more vulnerable to the disease.

[This interview has been lightly edited for length and clarity.]

Texas Monthly: In your book The Wrong Complexion for Protection you write, “When societal resources are distributed unequally by class and race, it should be no surprise that population health is distributed along those lines as well.” Were you at all surprised by the racial disparities many counties are reporting with COVID-19?

Robert Bullard: No. When it comes to who gets in line first, and who has priority [for resources like health care], a lot of that is predetermined by the power structures, politically and economic. Oftentimes privilege aligns with race, with white people getting the first and the best protection. And so it’s not surprising when you look at how structural and institutional racism has given privileges for some and disadvantaged others. And when you have poverty, lack of access to health care, [high rates of] uninsured, many who have no private automobiles and are dependent on the buses and public transportation, and neighborhoods in pollution sacrifice zones—and then you pile on top of that the stress of racism—you’re going to get people who are vulnerable. It’s not rocket science. These social determinants of health have been known for many years.

And so the coronavirus is basically taking advantage of those vulnerabilities, and you’re seeing it play out in the deaths. And that’s more than sad. It’s unacceptable.

TM: The coronavirus seems to be a public health disaster that’s layering on top of existing disparities in environmental and social determinants of health. How do you see these things as interconnected, and how are environmental vulnerabilities making the coronavirus worse in certain communities?

RB: We know that if communities are saturated with all kinds of polluting facilities—landfills, incinerators, petrochemical plants and refineries, and coal power plants—and the air quality is bad, you’ll find high rates of ill health: asthma, respiratory illnesses, and other kinds of diseases that are elevated among people of color and poor people, like diabetes and hypertension.

We’re not even dealing with the coronavirus yet: we’re talking about studies that have shown that areas that have high concentration of polluting facilities also have high concentration of health disparities.

So when you apply that to this virus that appears to be attacking the respiratory system … and the cardiovascular system, it’s already hard to breathe in some of these neighborhoods. The coronavirus will make it even harder. It will kill you.

The idea is that if a community is located physically on the wrong side of the levee, the wrong side of the river, on the wrong side of the tracks, it receives less protection than those who are on the right side. Communities of color are disproportionately more vulnerable.

You tell me your zip code, and I can tell you how healthy you are. And so when you talk about trying to map out those social, economic, and racial vulnerabilities, and then overlay health, you can see that there’s a big disparity. You can go from one census tract or one zip code to another, and life expectancy changes by more than fifteen or twenty years by just crossing that line.

TM: Has Texas’s response failed to acknowledge preexisting health disparities?

RB: Texas has the second lowest percentage of testing but that doesn’t surprise me. What surprises me is that it doesn’t have the worst.

This virus does not does not look at your race, or your color. It looks at vulnerability. You can try and look at geographic areas the virus is hitting and not look at race. But then if you put race back in, you will see that there is a discernible pattern. Oftentimes, lax enforcement of environmental law means that communities on the frontline suffer. And that goes hand in hand with lax civil rights enforcement. Texas has the highest rates of uninsurance in the nation, and it has resisted expanding Medicaid, for example. So these policies have created vulnerabilities and it disadvantages communities.

If you talk to people in those neighborhoods on the streets, they can tell you without mapping that they’re most likely to get flooded. Most likely to get polluted. Most likely to suffer from extended unemployment. Or they don’t have the benefit of working from home or a safety net for sick days and paid leave. The medical folks call it comorbidity. Folks on the frontline have always known that’s how things are connected. It’s the cumulative impact of all these things coming at you at one time.

TM: What sort of public policies do you think that Texas, or the United States more generally, should implement to close these racial disparities?

RB: There are some obvious things that need to happen like strengthening people’s access to health care and health insurance. In the last few weeks, we’ve seen attempts to weaken both access to health care and environmental standards with federal rollbacks of specific provisions of the Clean Air Act and tailpipe pollution, and even today with mercury emissions.

So for many of us who have been advocates of environmental justice and health equity, that’s the wrong direction. Other states have taken the high road, and expanded Medicare and access to health insurance. And we should also acknowledge that climate change will make it even more difficult in the future for Texans with hotter days and more bad air-quality days. There will be more outbreaks [because of climate change], as health professionals and scientists have said. We can’t wait to address these issues. We need a real emergency plan for disasters, especially as our population is growing in Texas, to make our cities and rural areas more resilient.

TM: Low income communities are also more likely to live in environmentally vulnerable areas, particularly those at risk of flooding. Do you have concerns about hurricane season coming up and how that might put a double strain on some communities?

RB: The communities that are hit hardest and take the longest to recover, those are the same communities that I’m worried about. On June 1, if we have an active hurricane season in communities that are already suffering from COVID-19, how can you shelter in place when you have to evacuate? Where do people go? If you go to a shelter, it’s going to be hard to social distance. So you’re talking about disasters compounding. That should be worrisome for FEMA and the state government. I’m hoping there is planning for that, so that we don’t get caught flat-footed. I would hope that the smartest people in government are working on the areas that have historically had these severe weather events.

People are stressed about the virus, and people who live on the Gulf Coast, April and May is when they start getting stressed about hurricane season. How are we going to respond to another Harvey or Imelda? In many cases, community groups are the first line of defense. People aren’t going to wait on the government for [immediate aid], because if we do, it will be too late. It’s important to lift up organizations and institutions that have built up that trust in communities. We have to make sure that these organizations are funded and positioned in a way that can address what’s happening.

Why African-Americans may be especially vulnerable to COVID-19

African-Americans are more likely to die from the disease than white Americans

two people wearing masks
African-Americans have increased exposure to COVID-19, in part, because they disproportionately have jobs in the service sector. Here, a man is shown with his ride share driver at a train station in Joliet, Ill., on April 6.CHARLES REX ARBOGAST/AP PHOTO

COVID-19 was called the great equalizer. Nobody was immune; anybody could succumb. But the virus’ spread across the United States is exposing racial fault lines, with early data showing that African-Americans are more likely to die from the disease than white Americans.

The data are still piecemeal, with only some states and counties breaking down COVID-19 cases and outcomes by race. But even without nationwide data, the numbers are stark. Where race data are known — for only 3,300 of 13,000 COVID-19 deaths — African-Americans account for 42 percent of the deaths, the Associated Press reported April 9. Those data also suggest the disparity could be highest in the South. For instance, in both Louisiana and Mississippi, African-Americans account for over 65 percent of known COVID-19 deaths.

Other regions are seeing disparities as well. For instance, in Illinois, where the bulk of infections are in the Chicago area, 28 percent of the 16,422 confirmed cases as of April 9 were African-Americans, but African-Americans accounted for nearly 43 percent of the state’s 528 deaths.

Other data find similar trends. A study published online April 8 in the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report looked at hospitalizations for COVID-19 across 14 states from March 1 to 30. Race data, which were available for 580 of 1,482 patients, revealed that African-Americans accounted for 33 percent of the hospitalizations, but only 18 percent of the total population surveyed.

Here are three reasons why African-Americans may be especially vulnerable to the new coronavirus.

1. African-Americans are more likely to be exposed to COVID-19.

SARS-CoV-2, the coronavirus that causes COVID-19, is highly contagious, even before symptoms appear (SN: 3/13/20). So to curb the virus’ spread and limit person-to-person transmission, states have been issuing stay-at-home orders. But many individuals are considered part of the critical workforce by the U.S. Department of Homeland Security and must continue to work. That includes caregivers, cashiers, sanitation workers, farm workers and public transit employees, jobs often filled by African-Americans.

For instance, almost 30 percent of employed African-Americans work in the education and health services industry and 10 percent in retail, according to 2019 data from the U.S. Bureau of Labor Statistics. African-Americans are less likely than employed people in general to work in professional and business services — the sorts of jobs more amenable to telecommuting.

Additionally, a disproportionately high percentage of African-Americans may live in places that could increase their risk of exposure. Census data from January 2020 show that only 44 percent of African-Americans own their own home compared with almost 74 percent of white people. Consider a family living in a crowded inner-city apartment, says epidemiologist Martina Anto-Ocrah of the University of Rochester Medical Center in New York. “Can you possibly take an elevator alone? No.”

African-Americans’ risk of higher exposure to COVID-19 has historical roots — including legal segregation in schools and housing, discrimination in the labor market and redlining, the practice of denying home loans to those living in predominantly African-American neighborhoods. Those forces have contributed to a persistent racial wealth gap, with African-Americans continuing to struggle to move into neighborhoods with the sorts of socioeconomic opportunities that allow white families to better avoid exposure to COVID-19.

“All the ingredients are in place for there to be a sharp racial and class inequality to this [pandemic],” says Robert Sampson, a sociologist at Harvard University.

2. African-Americans have a higher incidence of underlying health conditions.

Among those at highest risk of getting severely ill with COVID-19 are patients with other serious health problems, such as hypertension, diabetes and heart disease (SN: 3/20/20). Over 40 percent of African-Americans have high blood pressure, among the highest rates in the world, according to the American Heart Association. By comparison, about a third of white Americans have high blood pressure. Similarly, African-Americans tend to have higher rates of diabetes.

Part of that heightened risk has to do with African-Americans’ disproportionate exposure to air pollution. Such pollution has been linked to chronic health problems, including asthma, obesity and cardiovascular disease (SN: 9/19/17). In an April 2019 study in the Proceedings of the National Academy of Sciences, Sampson and fellow Harvard sociologist Robert Manduca showed that poor African-American neighborhoods have higher levels of lead, air pollution and violence than poor white neighborhoods (SN: 4/12/19).

 

 

 

Researchers are still sorting out how neighborhood stressors contribute to poor health. But even if the causes aren’t always clear, research suggests that helping people move to better neighborhoods can improve health. For instance, a 2017 study in JAMA Internal Medicine showed that for African-American adults, moving out of racially segregated neighborhoods was linked to a drop in blood pressure (SN: 5/15/17).

3. African-Americans have less access to medical care and often distrust caregivers.

Inequities in access to health care, including inadequate health insurance, discrimination fears and distance from clinics and hospitals, make it harder for many African-Americans to access the sort of preventive care that keeps chronic diseases in check.

According to a December 2019 report from The Century Foundation, a nonpartisan think tank based in New York City and Washington, D.C., African-Americans are still more likely to be uninsured than white Americans. And African-Americans who are insured spend a greater fraction of their income on premiums and out-of-pocket costs, about 20 percent, than the average American, who spends about 11 percent.

Census data show that about 20 percent of African-Americans live in poverty compared with 10 percent of white Americans. As a result, African-Americans have been disproportionately hurt by some states’ decisions not to expand Medicaid as part of the Affordable Care Act. Expanded Medicaid has been linked to a reduced likelihood of deaths from cardiovascular disease (SN: 6/7/19) and a reduction in the racial health gap between white and black babies (SN: 4/23/19).

Lack of preventive care means that African-Americans are more likely than other racial groups in the United States to be hospitalized or rehospitalized for asthma, diabetes, heart failure and postsurgery complications, researchers reported in 2016 in the Annual Review of Public Health.

African-Americans can also face hidden biases to care. For instance, an algorithm used to determine which patients should receive access to certain health care programs inadvertently prioritized white patients over African-American patients (SN: 10/24/19), researchers reported in October 2019 in Science. That disparity arose because the algorithm used health care spending as a proxy for need, but African-Americans often spend less on health care because they are less likely to go to a doctor. In part that may be because African-Americans have a long-standing distrust of the medical establishment due to events such as the Tuskegee experiment (SN: 3/1/75), in which hundreds of African-American men with syphilis were denied treatment for decades.

“These long-standing structural forms of discrimination that African-Americans have faced in the [United States] are manifesting in what we’re seeing with COVID right now,” says epidemiologist Kiarri Kershaw of the Northwestern University Feinberg School of Medicine in Chicago.

Even so, more can be done to identify communities that might be especially vulnerable to COVID-19 and improve their odds of coping with the pandemic, Sampson says. For example, “look at a map of incarceration, lead risk and violence in Chicago [and] you’ll basically see a map of COVID deaths,” he says. Those kinds of proxies could provide a road map to identifying at-risk communities and targeting resources to them, such as greater access to COVID-19 testing, distribution of masks and mobile clinics to provide care.

INCREASING PUBLIC POWER TO INCREASE COMPETITION: A FOUNDATION FOR AN INCLUSIVE ECONOMY

INCREASING PUBLIC POWER TO INCREASE COMPETITION:  A FOUNDATION FOR AN INCLUSIVE ECONOMY

ISSUE BRIEF BY WILLIAM DARITY JR., DARRICK HAMILTON, AND RAKEEN MABUD
MAY 2019

Executive Summary

The United States needs an economy grounded in justice and morality, where everyone, free of undue resource constraints, can prosper. To achieve this, citizens ought to have universal access to undeniable economic rights, such as the right to employment, medical and health care, high quality education, sound banking and financial services, or a meaningful endowment at birth (Paul, Darity, Hamilton 2018). Currently, our system provides these rights primarily through the “free market” by private providers, but these private companies often fail to meet the following criteria:

•   Quantity: Are goods adequately supplied?
•   Quality: Are the goods high quality?
•   Access: Do people have adequate access to these goods?

Because of the failure of America’s markets-first approach to policy, the federal government should intervene by introducing public options that provide these essential goods and services in direct competition with private firms. Doing so will set “floors” on wages and quality and “ceilings” on price for private actors who are intent on providing important economic rights at a cost. In employment, this might mean providing a federal jobs guarantee (FJG); in financial services, this could mean access to bank accounts and safe, nonpredatory loans. Throughout this issue brief, we explore what public options might look like in employment, health, housing, education, and financial services. We argue that in these sectors, public options are necessary to combat high-cost, low-quality provision by private actors and ensure universal and better quality access to all Americans.

Full Report here.   https://rooseveltinstitute.org/wp-content/uploads/2019/04/RI_Increasing-Public-Power-to-Increase-Competition-brief-201905.pdf

CREATIVE COMMONS COPYRIGHT 2019 | ROOSEVELTINSTITUTE.ORG

The report features the work of OUR COMMON GROUND Voices, Drs. William “Sandy” Darity and Darrick Hamilton

Darity Hamilton

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