The coronavirus is not biased about who it infects — so why does data emerging from some US states suggest that African Americans are bearing the brunt of the pandemic there?
Experts have said that blacks are disproportionately affected by underlying health conditions linked to poverty, face discrimination in medical care and are more likely to work jobs that require them to leave their homes.
“We know that blacks are more likely to have diabetes, heart disease, lung disease,” US Surgeon-General Jerome Adams said on Tuesday.
Photo: AFP
These chronic illnesses, which are linked to poverty and structural racism, can lead to more serious forms of COVID-19.
Adams, who is himself black and has high blood pressure and asthma, added: “I represent that legacy of growing up poor and black in America, and I, and many black Americans, are at higher risk for COVID.”
There is no nationwide data available on COVID-19 cases by race, but a pattern of over-representation by black Americans has emerged in states or jurisdictions that are sharing the numbers.
Sixty-eight percent of COVID-19 deaths in Chicago have been among African Americans, who make up just 30 percent of the city’s population.
“Those numbers take your breath away. This is a call to action for all of us,” Chicago Mayor Lori Lightfoot said on Monday at a coronavirus briefing.
The trend is repeated in North Carolina, Louisiana, Michigan, Wisconsin and the US capital, Washington.
The issue is also linked to social class, with black people more likely to work jobs deemed essential that expose them to potential infection, American Public Health Association executive director Georges Benjamin said.
“That population is more public facing: more bus drivers, more people taking public transportation to work, more people providing services in nursing homes, more folks working in grocery stores,” Benjamin said.
The problem is compounded by implicit and explicit bias that African Americans face in the medical system.
James Hildreth, president of the historically black Meharry Medical College in Nashville, Tennessee, said that in his city, most of the initial testing took place at Vanderbilt University Medical Center.
Most of the patients who go to hospital systems such as Vanderbilt have insurance and Nashville only recently built three assessment centers for underprivileged and minority communities — one of them located on the campus of Meharry Medical College and run by its staff.
“My point is, depending on which community you live in, and whether or not you have insurance ... the chances for getting assessed are much less,” he said.
It is also well-documented that when black people seek care, healthcare workers are less likely to believe their symptoms and provide adequate care, University of Virginia Medical Center anesthesiologist Ebony Hilton said.
For example, black women are less likely to have their breast cancer mammograms seen by a specialist as opposed to a general radiologist, a 2012 study released by the University of Illinois at Chicago showed.
Black heart patients who present with elevated levels of a group of proteins indicating cardiac injury are also less likely to be seen by specialists, a 2018 study showed.
The civil rights group Lawyers’ Committee for Civil Rights Under Law wrote this week to US Secretary of Health and Human Services Alex Azar, calling on him to “release daily racial and ethnic demographic data related to COVID-19 testing, disease burden and patient outcomes.”
This is necessary to ensure a robust public health response, and to make certain that care and testing are not being administered in a discriminatory manner, the group said.
The US Centers for Disease Control and Prevention collects the information, but deliberately withholds it, it said.
Hilton said that it was in the interests of Americans as a whole to address the problem, because — unlike high rates of heart disease or cancer — a wave of coronavirus spreading through the black and Hispanic population would ultimately affect everyone else.
“When you have a system that’s not treating these people of lower social economic status and these minority groups, they are then not being tested, they’re sent back home to infect their community,” she said. “Those workers who are now infected are going to the grocery store, and when the upper echelon of America is going to get their food, they will get infected, too.”
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