"You are no better than anyone else, and no one is better than you."

"You are no better than anyone else, and no one is better than you."
– Katherine Johnson


I touched on the racial disparity in the access to care and the death rate when I linked to this article in my last post: Long-Standing Racial and Income Disparities Seen Creeping into COVID-19 Care.

But the issue of race deserves a post of its own.

Across the United States, the black community is suffering proportionally more casualties from COVID-19. New data shows that black people are suffering 30% of the COVID deaths in the U.S. but make up only 14% of the population.

It's true among black communities across the country. The District of Columbia, southern states, and midwestern states are suffering the most disproportionate casualties.

AP

Of course, this virus itself is non-discriminatory. It goes where it goes. It will live in a black person's lungs as well as it will live in a white person's lungs.

But that's the virus. It's the rest of us that's the problem.

Why is this happening?

It's possible that there are genetic factors at work. Recent studies have indicated that genetics may play a role in the ability to fight off this virus. But I highly doubt that this is a factor in the disproportionate casualties in the black population, especially when you look at the specific communities in the chart above. In reality, the reasons go quite deep, as the systemic racism in this country is complex, profound, and long-standing.

Systemic racism has kept people of color in the lower socio-economic strata since the beginning of our country. And as socio-economic pressures increase in vulnerable populations, health risks increase. In general, black people are:

• Less likely to have heath insurance
• More likely to have pre-existing conditions, such as diabetes and heart disease, which increase the risk of complications with COVID-19. These risk factors in themselves are the result of deeper societal and healthcare biases and disparities
• Less likely to have access to health care; for example they are unable to take off work when sick or needing to stay home care for others. They are unable to afford medications
• More likely to be obese - another heartbreaking sequelae of low income. Obesity has been shown to be a higher risk factor for COVID-19
• More likely to have chronic stress - a risk factor in itself for poor health
• More likely to be living in close quarters with poorer sanitation
• More likely to be affected by any type of natural disaster, for all the reasons stated above

There is also systemic racism in America's healthcare system. There have been disparities in healthcare for white people vs. black people for our whole history. Black people are simply treated less well, less often, or differently, than white people.

Black people get treated differently by health care providers. It may be subtle, it may be blatant. It may be intentional, or not. But bias is real.

Black people, rightly so, are distrustful of white physicians. There is a long history of not just subtle bias, but unethical, immoral "studies" like the Tuskegee Syphilis experiment that worked to crush black people under the white medical establishment's heel. This should never be forgotten.

Tony Auth, Philadelphia Inquirer, 1972

All of this adds up to poorer health outcomes in general for people of color. Health outcomes are worse across the board for black people. Read more about racism and health discrimination from Harvard's Health Blog and from the American Academy of Family Physicians.

And it's no different in the days of corona. Specifically for this pandemic:

• Access to coronavirus testing is different for black people. Between subtle bias and lack of access, black people are being tested less.

• People of color are more likely to have lower-paying jobs in the service industry, more likely to be in a higher-risk-of-exposure "essential" job, have a job that precludes working from home, or unemployed.

• Social distancing, the best way to prevent the spread of this disease, is a privilege afforded to white people more than black people. Black people are less likely to be able to survive a furlough or telecommute. They are more likely forced to take public transportation to their job. They can't afford to have food and goods delivered. They can't afford to stock up on food or even to go food shopping only once a week.

• Many African-American men are afraid of wearing a mask in public. They face the choice between bringing unwanted – and possibly dangerous – attention from law enforcement vs. protecting themselves from the virus. Many choose to forego the mask. I. Hate. This. 

I must note that there are similar patterns for Latino and Native American populations. The Navajo Nation, in particular, is experiencing huge casualties in this pandemic. Their rural poverty lends an extra heartbreaking layer to the effect of this pandemic on the Navajos. Washing hands for 20 seconds? They may not even have running water.

What are the solutions for this set of tragic and unjust disparities?

There are no easy answers. The systemic racism is deep. But the first step is: you're soaking in it. Being aware and learning about the problem is the first step. If you're in heath care, it's even more important to be aware and fight back against your own biases.

Think globally, act locally. Work for justice and equal treatment. Advocate for universal healthcare. Fight racism where you are. Get involved. Speak up - educate others. Embody Katherine Johnson's words: "You are no better than anyone else, and no one is better than you."

Support organizations that fight against racial injustice, like the following. (Note: please vet any charity before giving them money!)

NAACP

Black Lives Matter

The Center for African American Health

California Black Women's Health Project

Goochland Free Clinic and Health Services


Read more on how to resist racism. You. Here. Now.  How to Be an AntiRacist by Ibram X. Kendi.

Read. Rise. Resist.  

...And stay healthy, Sister and Brother Resisters!