Historical inequities are coming home to roost
First of a continuing story
The national NAACP is holding virtual town hall meetings throughout the month of April to discuss the health, economic and social impacts of the COVID-19 pandemic on the nation’s Black communities.
In addition to providing excerpts from these meetings as they occur over the coming weeks, the MSR is also talking to others both locally and nationally about the impact the coronavirus outbreak is having or may have on our local Black community. This week: the grim current and historical facts.
Minnesota presently has not seen a disproportionate death rate between Blacks and Whites due to the coronavirus outbreak. The Minnesota Department of Health (MDH) has reported that thus far two percent of the 1,400-plus COVID cases in the state have been Black. Nonetheless, many are asking if the COVID crisis will educate the country’s population at large about the longstanding health disparities among Blacks and other people of color and the need to finally address these inequities.
However, according to the APM Research Lab, race and ethnicity data are only available for just under 40 percent of U.S. COVID-19 deaths. They have tracked nine states, along with Chicago, New York City, Milwaukee (Wisc.) and Los Angeles (Calif.) Counties, and found COVID-related deaths alarmingly high among Blacks and other people of color: almost three times higher among Blacks in Michigan and 2.4 times higher in Chicago, for example.
During the April 8 NAACP town hall meeting, National Medical Association President Dr. Oliver Brooks of Los Angeles called the virus “a slow time bomb that hit and now grows and grows.” Health experts say that nearly 1% of all U.S. virus-diagnosed cases have been found by testing; the MDH reports that testing has identified as little as 1% of all Minnesota cases.
Furthermore, it is not readily known just how much the coronavirus inflection was directly the cause of a person’s demise or rather added to the individual’s pre-existing health concerns. The Centers for Disease Control (CDC) reports that 90 percent of individuals hospitalized with COVID had at least one underlying health condition: 50 percent had high blood pressure, 48 percent were obese, 35 percent had chronic lung disease, 28 percent had diabetes, and 54 percent were aged 65 or older.
“We see an incredible painful story” unfolding elsewhere around the country, APM Research Lab Senior Research Associate Andi Egbert told the MSR. She said that the pandemic has added “the burden of death” on the Black community, which has historically carried the economic and social burden of inequality in this country as well.
“What we see is very troubling,” Egbert stated. “Black Americans are about two and a half times more likely to die than we expect. That is so grim.”
“The Black community has been in a crisis before this crisis,” Drexel University Professor Dr. Sharrelle Barber explained, adding that the nation’s health inequalities are “a by-product of structural racism.” She is an assistant research professor at the Dornsife School of Public Health and studies how health inequalities impact communities.
“What we are seeing are the same patterns of racial inequality playing out in this moment with the coronavirus,” Barber explained. “While the rest of the country was surprised and shocked by [the virus], my colleagues and I really saw this coming.
“We knew that some of the existing structural and racial inequalities were going to create a real detrimental situation for Black folk. Black folk have been experiencing a higher rate of death for every major cause of death in the United States for decades.
“We know that Blacks often live in neighborhoods that have limited access to high-quality health care. If they do access that, sometimes it is unaffordable, lack insurance, etcetera.
“And testing is an issue, and if they get tested and are positive, can they afford it? We also know that within healthcare systems, Black folk experience discrimination, racial bias, etcetera that might put them at risk of dying or being turned away.”
Barber pointed out another understated fact that comes into play here as well: a historical mistrust of doctors and medical personnel among Blacks. “This mistrust is real, not imagined, with the healthcare system,” she said. “It’s a combination of all these things—mistrust, discrimination, lack of access, residential segregation all coming together that is really producing what we are seeing right now.”
“In some ways, I wasn’t surprised to see Black Americans have the worst outcomes and have a heavier death burden from this disease,” Egbert concurred. “It’s an unfortunate history… Sometimes their pain is discounted and not given the same weight as White people for Black Americans in the healthcare system.”
“The negative impact [of the coronavirus outbreak] has been profound” in nearly every aspect of Black life, said U.S. Rep. Karen Bass (D-Calif.), chair of the Congressional Black Caucus. “You see the incredible disparities by race.
“Within highly segregated neighborhoods by race and income, not everyone has the luxury of living in housing that you can self-quarantine in if they got [the virus],” Barber said. “Some communities have limited access to clean water. All of these things are really the structural drivers that are driving the higher transmission rate as well as higher death rates.
“We have to look holistically at all of those things, and medical mistrust is one of them,” Barber said.
Without the necessary racial breakdown data, it is hard to accurately determine at this time how much the coronavirus outbreak has affected the Black community nationwide, Egbert said. “Minnesota is the only state that we don’t have an undue burden of death, extra deaths that are based on the population.
“Every state is putting out this data differently [and] it is sloppy,” she added. “The hard thing is, it does change every day. We don’t know what the next month or two months will bring, but certainly a different story than around the country.”
The pandemic “has literally made the world stop,” Barber said. “My hope is that it will help us all reflect on the entrenched inequities that exist in our country.”
Next: The coronavirus impact on the Black community’s spiritual and mental health