A growing body of research is better explaining why the novel coronavirus has taken such a terrible toll on communities of color and especially black Americans. The evidence underscores the urgency for the nation to address racial injustice and inequities, particularly in health care.
As the New York Times reported, experts analyzing mountains of data are seeing that “there is no innate vulnerability to the virus among black and Hispanic Americans … Instead, these groups are more often exposed because of social and environmental factors.” The newspaper found this in talking to experts about their multiple, often sizable studies:
“The[ir] new findings do not contradict an enormous body of research showing that black and Hispanic Americans are more likely to be affected by the pandemic, compared with white people. The coronavirus is more prevalent in minority communities, and infections, illnesses and deaths have occurred in these groups in disproportionate numbers … [But among] many other vulnerabilities, black and Hispanic communities and households tend to be more crowded; many people work jobs requiring frequent contact with others and rely on public transportation. Access to health care is poorer than among white Americans, and rates of underlying conditions are much higher. ‘To me, these results make it clear that the disparities in mortality that we see are even more appalling,’ said Jon Zelner, an epidemiologist at the University of Michigan who led one of the new studies.”
‘It has nothing to do with genes’
Besides Zelner, the newspaper interviewed Dr. Gbenga Ogedegbe, director of the division of health and behavior at New York University’s Grossman School of Medicine. He and his colleagues reviewed medical records of 11,547 patients in the NYU Langone Health system who were tested for coronavirus infection between March 1 and April 8. They found this:
“After accounting for various disparities, Dr. Ogedegbe found that infected black and Hispanic patients were no more likely than white patients to be hospitalized. If hospitalized, black patients had a slightly lower risk of dying.”
The doctor told the newspaper:
“We hear this all the time — ‘Blacks are more susceptible,’” Dr. Ogedegbe said. ‘It is all about the exposure. It is all about where people live. It has nothing to do with genes.’”
The researchers’ findings have implications for not only how the nation failed to safeguard communities of color earlier in the pandemic but also in what might need to occur now, and in the days ahead, particularly with coronavirus vaccination plans.
Those efforts took a huge step forward, with the federal Food and Drug Administration accepting an expert advisory panel’s recommendations and deciding to allow emergency use of a coronavirus vaccine made by Pfizer. The action came after similar moves by other nations, including approval of and administering of a Covid “jab” in Britain and a vaccine’s OK in Canada.
In this country, federal, state, and local governments could better have protected citizens from infection risks on the job by providing income subsidies allowing them to stay home, Zelner said, adding it also would have helped if officials had ensured adequate protective equipment to workers in nursing homes and long-term care facilities.
A call to erase health inequities
Separately, an erudite and scholarly commentator, with one son a surgeon and the other a hospital administrator, has emphasized that health care must be a right, not a privilege, and that the nation must redouble its efforts in coming times to erase racial inequities in this area. Here’s a hint about the author of this attention-grabbing article who wrote:
“My life is at risk. Not just because I’m 73 with the usual annoying aches and pains that accompany age, but because I’m tall and I’m black. At 7 feet, 2 inches, I’m statistically more prone to blood clots, lower back and hip problems, higher risk of cancer, especially prostate cancer, atrial fibrillation (a heart rhythm disorder), and a shorter life span in general. Being black means I’m more likely to suffer from diabetes, heart problems, obesity, cancer, and a shorter life in general. Yup, tall people and black people have shorter life expectancies. So far, in keeping with these statistical risks, I’ve had prostate cancer, leukemia, and heart bypass surgery.”
As basketball legend Kareem Abdul-Jabbar also said in his Op-Ed:
“The future of equity for black Americans starts with physical and mental health, and as long as they are at the end of the line for services, true equity can’t happen. Black lives have to matter in every aspect of American society if they are to thrive.”
He makes his case with anecdote and evidence. He says that black Americans can be disadvantaged with their health due to an array of factors, especially educational attainment blocked by systemic racism:
“Having lesser education, and less financial resources, means less opportunity to compete for higher education, which means less opportunity for better paying jobs. Even those who manage to claw their way through these substantial obstacles and enter the job market with higher degrees face hiring discrimination based on race. The Harvard Business Review stated that an examination of 21 studies concluded that, due to racial stereotyping and unconscious biases, ‘hiring discrimination against blacks hasn’t declined in 25 years.’ The result is that African Americans are not only twice as likely to be unemployed, but even when employed they earn almost 25% less.”
As with the health experts who point to disparate exposure by the poor and minority group members, Abdul-Jabbar argued this:
“[O]ne of the reasons blacks are contracting and dying from Covid-19 at higher rates is because they work at what the government has defined as essential jobs more than any other ethnic group: 37.7% Black versus 26.9% white. In health care and social assistance industries, the rate is even higher. So, they’re both essential, yet disposable, like protective gloves. The mistake is to think we can fix any one aspect of racism without fixing the others. That’s like having four flat tires and only fixing one. Education, the criminal justice system, the health care industry, the job market, low-income housing—these are all rungs in a ladder that must be solid enough to lift everyone up.”
Indeed. In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent health care. This has become an ordeal due to the complexity, uncertainty, and skyrocketing cost of treatments and prescription medications, too many of which turn out to be dangerous drugs.
Too many inequities
For too many Americans, the health care system also is far too rife with inequities based in race and economics. The nation has an urgent need to address relentless health inequities for patients and health workers of color, especially for African Americans. Women also too often do not get equitable medical care and this must improve. The historic mistreatment of groups by the medical establishment has sown deep suspicions — and these may become obstacles in the country’s current effort to quash the pandemic, especially in dealing with hesitancy among black and Latino patients about prospective coronavirus vaccines and treatments.
Public health officials, politicians, and community leaders can’t duck sensible concerns raised about what has been, thus far, a shambolic federal response to the pandemic and a politicized but important push to develop coronavirus vaccines. They can look for help from savvy folks like Abdul-Jabbar.
The White House and its current occupant deserve historic shaming for both their silence and persistent public falsehoods about the coronavirus and the U.S. tsunami of death, sickness, and debacle. It takes rare malignancy, for example, to devalue rare, rising, and life-saving treatments for the disease by dispensing them as a spectacle and gift to oleaginous cronies. We’ve got a lot of work to do to put the country on a far better course — immediately.