Conditions in our environment where we live, work, learn and play affect a range of health outcomes. Now, faced with a global pandemic, we are learning just how detrimental viral diseases are for struggling communities.
We are in an unprecedented public health crisis. The United States is being ravaged by the COVID-19 pandemic in every state and the District of Columbia. Like China and Italy before us, the United States currently reports the most COVID-19 cases in the world according to real time visualization by Johns Hopkins. However, that number belies the real impact of COVID-19. Widespread testing is still largely unavailable leaving the true impact of the outbreak unknown at this point. What is emerging from the available state and local data points to an alarming trend — Black people in America are disproportionately infected and dying from coronavirus.
In cities such as Chicago, Milwaukee, Detroit and New Orleans and states such as Illinois, Virginia, Michigan, Maryland and North Carolina, Black residents are disproportionately impacted by COVID-19. In Chicago, the Black population makes up roughly a third of the city, yet 72% of coronavirus deaths have been African Americans. In Mecklenburg County (Charlotte), North Carolina, Black residents comprise approximately 45% of COVID-19 patients, despite the total Black population being estimated at 33%. In Maryland, of those cases where race was a known variable, nearly 50% of COVID-19 cases were Black, while approximately 37% were White and 14% were Asian or another race. Maryland’s Black population percentage is 30% and 60% is White, according to Census 2019 population estimates. And these are just the tests reporting racial data.
The Centers for Disease Control and Prevention (CDC) is not currently reporting COVID-19 cases by race and ethnicity, which some leaders are calling a detriment to fully understanding the spread and impact of the disease, as well as a barrier to adequately addressing issues of care. Section 1557 of the Affordable Care Act and Title VI of the Civil Rights Act of 1964 specifically addresses discrimination in healthcare services. While the CDC may point to a lack of data as its primary reason for omitting race and ethnicity data in the first place, U.S. Surgeon General, Jerome Adams, recently called on the CDC to reverse course and report race in coronavirus cases.
Gaps in data aside, if the virus is the “great equalizer” as New York Governor Andrew Cuomo believes, why is this virus particularly affecting the Black community? And how many more deaths must we endure before we directly address the issue of race as a social determinant of health in this pandemic? For those of us at the intersection of community development and public health, the answer lies in the connection between health and wealth and historical inequalities.
In neighborhoods and communities of concentrated poverty and segregation, low-income residents tend to experience pronounced health disparities – higher-than-average rates of asthma, heart disease and diabetes. Black and Latino/Latina/Latinx families are more likely than White families to live in neighborhoods of concentrated poverty. Low-income people are less likely than higher-income people to have health insurance, benefit from access to specialty care and receive newer treatment plans or technologies. Black Americans disproportionately work in positions that place them on the current essential workers list. That public facing role places Black and Brown people in the high risk category for contracting coronavirus. Crowded urban areas, where Black Americans are more likely to live, allows coronavirus to thrive. Recent analysis even points to implicit bias and disparity in testing for COVID-19 based on race, which will undoubtedly lead to harsh outcomes for those who go untested. If we weren’t aware before, we certainly can’t deny the entrenched health disparities COVID-19 uncovers.
Senators Elizabeth Warren, Kamala Harris and Cory Booker together with Congresswomen Ayanna Pressley and Robin Kelly recently joined the chorus of voices demanding that the administration report COVID-19 testing and treatment data by race and ethnicity. The call to prioritize race and ethnicity data in coronavirus testing cannot stop there. Clear, transparent data is the first step to fully understanding disparate health outcomes; additional voices are needed to amplify what should be obvious if we are to mitigate the infection and death rate of COVID-19 in the Black community.
Karen Kali is NCRC’s program manager of Special Initiatives.
Photo by Judeus Samson on Unsplash
