Blacklash

In the early days of the COVID-19 pandemic, when more people began dying in Michigan, where I live, friends in other states would ask me why so many of the virus’s victims were black. We all had our suspicions, but I was hoping for the best. That optimism proved incorrect.

Black people in Michigan make up just 14 percent of the state’s population but accounted for 40 percent of its COVID-19 deaths through early April. Those numbers were still rising on April 15, when protesters descended on Michigan’s capital city, Lansing, demanding that Governor Gretchen Whitmer lift her shelter-in-place order.

Currently, African Americans have the nation’s highest poverty rate, at 27 percent.

By May 18, the pandemic had killed 4,915 Michigan residents, more than in any other state except New York, New Jersey, and Massachusetts. The deaths, centered in Detroit, cut across the black population: police officers, a postal worker, the head of the city’s downtown jail; even a five-year-old girl named Skylar Herbert, the daughter of two first responders.

This is happening throughout the country. In Maryland, black people make up 30 percent of the population but 53 percent of all COVID-19 deaths. In Illinois, they account for 15 percent of the population and 42 percent of coronavirus deaths. In New York City, one of the pandemic’s first epicenters, black and Latinx people have significantly higher death rates than whites and Asians.

An analysis by the Associated Press in early May found that nearly one-third of those who have died from COVID-19 are black, even though they make up just 14 percent of the population. The AP also found that black and Latinx Americans are more likely than whites to have suffered economic impacts from the pandemic.

These harrowing numbers came to light when states and municipalities were urged to begin collecting racial data regarding coronavirus deaths. Most cities with concentrated black populations have had elevated mortality rates, although the data remains incomplete.

“Not all systems have been consistently collecting racial and ethnicity data,” says Dr. Aletha Maybank, the American Medical Association’s chief equity officer. “They’re not standardized necessarily to collect it in consistent ways, even though there’s guidance and there are other opportunities to follow the path of how this data is collected.”

Maybank adds that testing and even treatment for black Americans who come to a hospital or clinic for help have been difficult to obtain.

Historically, there is nothing new about poor health outcomes for African Americans. It is a fact of life in the United States. The injustice has its roots during chattel slavery.

As public health professor Heather Butts wrote in her 2014 book, African American Medicine in Washington, D.C., “Factors such as a poor living standard, the amount and level of work, and the lack of access to health care led to high mortality rates for slaves.” The problem continued under America’s Jim Crow legalized racial caste system and now into the post-civil rights era. The drivers of poor health outcomes for black Americans are numerous.

For one thing, black people are less likely to have access to or use a primary care physician and more likely to use an emergency room rather than a primary care doctor for the treatment of certain health conditions. Additionally, as a result of racial segregation, there are fewer primary care physicians and hospitals in predominantly black communities.

African Americans are also less likely to have health insurance than the general population. Even after the passage of the Affordable Care Act in 2010, black people continue to significantly trail whites and the general population in health care coverage.

Black people also suffer disproportionately from the underlying conditions that make those who contract the virus more susceptible to getting very sick. New York City recently reported that more than 90 percent of its total COVID-19 hospitalizations involved people who also suffer from chronic health conditions like hypertension, diabetes, or obesity. The pandemic has created a nasty systemic cocktail of medical racism amid a dysfunctional health system.

Moreover, according to the Bureau of Labor Statistics, black Americans work in the crosshairs of the virus. While they make up just 12 percent of the nation’s workforce, they account for 25 percent of all postal workers, 31 percent of all public and urban transportation workers, and 28 percent of all nursing facility workers. Black Americans are also heavily represented in health care, grocery stores, home health care, and as food delivery workers and couriers—all essential jobs that require interaction with the public.

Another factor contributing to the disparities is a lack of trust. Black Americans know their connections to the medical system are littered with crazy moments of exploitation, such as the infamous Tuskegee Experiment, where black men were used as guinea pigs by the medical profession to track the effects of syphilis. Or the Henrietta Lacks episode, where the cancer cells of a black woman who died of cervical cancer were used to eventually develop cancer treatments without the knowledge and permission of Lacks or her descendants. Black Americans have good reason to distrust the U.S. health system.

Yet perhaps the biggest factor driving the death disparities is economic inequality. Currently, African Americans have the nation’s highest poverty rate, at 27 percent. Black people also trail whites in wealth considerably. These economic realities impact where and how people live and the kind of community they have to exist within. Their housing, and their communities, might be overcrowded. Their ability to isolate themselves and stay as safe as possible is a daily struggle during the pandemic.

As COVID-19 has continued to exact its deadly toll, one small piece of good news is that some states have committed to studying, and hopefully addressing, the racial health disparities brought to light by the pandemic.

On April 20, Governor Whitmer signed an executive order creating the Michigan Coronavirus Task Force on Racial Disparities chaired by Lieutenant Governor Garlin Gilchrist II.

“There is a specific and severe racial disparity that we need to address,” Gilchrist stated in a recent speech announcing the task force. “It is a systemic problem and a systemic problem requires a systemic solution.” Gilchrist stressed that the goal of the task force is to create real-time solutions.

“People of color,” he noted, “do not have the financial luxury in the state of Michigan of being able to work from home, or they are more reliant on public transportation to get groceries or to get to work, or they don’t have enough money to buy hundreds of dollars of groceries at a time.”

Governor John Bel Edwards of Louisiana also recently announced that his state has formed a Health Equity Task Force “which will look at how health inequities are affecting communities that are most impacted by the coronavirus.”

The scholar Ibram X. Kendi is helping lead a COVID-19 tracking project at his Antiracist Research and Policy Center at American University. The project, he says, is “seeking to collect, ingest, produce, [and] make available, racial data that’s being released by states.” Kendi, the author of Stamped from the Beginning and How to Be an Antiracist, says he wants to analyze that data to “tell a story about what’s happening in our country.”

Even Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, interceded during one media briefing to make a point about health disparities and African Americans during the pandemic and afterward.

“Health disparities have always existed for the African American community,” Fauci said, interrupting Vice President Pence. “But here again, with the crisis . . .  it’s shining a bright light on how unacceptable that is.” Fauci’s quick and well-circulated statement was important, considering the failings of the administration to address the pandemic in a competent and consistent manner.

While the long-term or even short-term success of these efforts to document and address the problem remains unclear, they are at least a start toward stemming the tide of the pandemic in black communities.