When America catches a cold, Black America catches the flu. This is a phrase that I heard on a conference call I attended with other medical professionals and social workers. We were engaged in a pertinent conversation on COVID-19 & Black Communities. COVID-19 has managed to be the number one topic in the world. It has caused a great interruption of all of our lives. We are also experiencing knowing people being affected socially, economically, and physically through actual infections. I was also made aware of people who have passed away because of this virus whom I actually know. When news hits you with an infection rate and death toll steadily rising day by day, one cannot help but to wonder what further implications will come from this disease on you as an individual, on your family, and on your community.
The Black American community has an extended and sordid history with the American Healthcare system. The distrust the community has is long and deep but not unwarranted. History has shown how the medical industry has either ignored the care needs of this group or intentionally inflicted harm. In the article entitled, African Americans and their distrust of the health care system: healthcare for diverse populations published in US National Library of Medicine and National Institutes of Health, the author states, “The perception of mistrust from the African American community is in large caused by their previous experiences with the health care system. However, the mistrust is not only in perception, but has many other reasons.” Black people that mostly descend from American Slavery were experimented on in the cases of the Tuskegee project where Black men were intentionally infected with Syphilis, Henrietta Lacks whose cells were harvested without her knowledge nor consent, James Marion Sims that conducted gynecological research on enslaved women, or Dr. Charles Drew who was refused care at a hospital and denied the very thing he discovered (plasma) that could have saved his life.
So let us attempt to answer this question: “Why would Black Americans (Freedmen) feel the effects of health care disparities the worse?” Even with this history, we are still seeing the effects that have caused inequities in the healthcare system. Director of Health Care Reform Jamila Taylor said in Racism, Inequality, and Health Care for African Americans, “Inequalities contribute to gaps in health insurance coverage, uneven access to services, and poorer health outcomes among certain populations. African Americans bear the brunt of these health care challenges.” She goes on to say, “The Affordable Care Act (ACA) has helped to ensure health care coverage for millions of Americans. The uninsured rate among African Americans declined after the law was implemented: of the more than 20 million people who have gained coverage under the ACA, 2.8 million of them are African-American. Yet, this population is still more likely to be uninsured than white Americans: as of 2018, the uninsured rate among African Americans was 9.7 percent, while it was just 5.4 percent among whites. African Americans were more likely to be covered through employer-sponsored or private health insurance: 55 percent of African Americans used private health insurance in 2018, while 41.2 percent were enrolled in Medicaid or some other type of public health insurance. While coverage expansions under the ACA have hastened the progress toward universal coverage, the continued high cost of many coverage options means that access to affordable health care is still a challenge for many Americans—particularly African Americans.”
Having access to proper health care facilities will often make or break the health outcome of an individual. Also the quality of care will be a major factor as well. In the American Bar article Implicit Bias and Racial Disparities in Health Care by Khiara M. Bridges, she writes, “Black people simply are not receiving the same quality of health care that their white counterparts receive, and this second-rate health care is shortening their lives.” She then says, “In 2005, the Institute of Medicine—a not-for-profit, non-governmental organization that now calls itself the National Academy of Medicine (NAM)—released a report documenting that the poverty in which black people disproportionately live cannot account for the fact that black people are sicker and have shorter life spans than their white complements. NAM found that “racial and ethnic minorities receive lower-quality health care than white people—even when insurance status, income, age, and severity of conditions are comparable.” By “lower-quality health care,” NAM meant the concrete, inferior care that physicians give their black patients. NAM reported that minority persons are less likely than white persons to be given appropriate cardiac care, to receive kidney dialysis or transplants, and to receive the best treatments for stroke, cancer, or AIDS. It concluded by describing an “uncomfortable reality”: “some people in the United States were more likely to die from cancer, heart disease, and diabetes simply because of their race or ethnicity, not just because they lack access to health care.”
In the midst of the Coronavirus Covid-19 pandemic, preliminary data coming from places like in Milwaukee, Michigan, and Louisiana, are reporting an infection and mortality rate that is very high in Black Americans. In a recent article in ProPublica – Early data reveals African Americans are contracting and dying of coronavirus at an alarming rate: by Akilah Johnson and Talia Buford: “As the disease spread at a higher rate in the black community, it made an even deeper cut. Environmental, economic and political factors have compounded for generations, putting black people at higher risk of chronic conditions that leave lungs weak and immune systems vulnerable: asthma, heart disease, hypertension and diabetes. In Milwaukee, simply being black means your life expectancy is 14 years shorter, on average, than someone white. As of Friday morning, African Americans made up almost half of Milwaukee County’s 945 cases and 81% of its 27 deaths in a county whose population is 26% black. Milwaukee is one of the few places in the United States that is tracking the racial breakdown of people who have been infected by the novel coronavirus, offering a glimpse at the disproportionate destruction it is inflicting on black communities nationwide. In Michigan, where the state’s population is 14% black, African Americans made up 35% of cases and 40% of deaths as of Friday morning. Detroit, where a majority of residents are black, has emerged as a hotspot with a high death toll. As has New Orleans. Louisiana has not published case breakdowns by race, but 40% of the state’s deaths have happened in Orleans Parish, where the majority of residents are black (60%).”
Similar and also alarming reporting is coming out of Chicago as well. In a recent WBEZ.org report by Maria Ines Zamudio, Elliott Ramos, “while black residents make up only 23% of the population in the county, they account for 58% of the COVID-19 deaths. And half of the deceased lived in Chicago, according to data from the Cook County Medical Examiner’s office. As of Saturday, 107 of Cook County’s 183 deaths from COVID-19 were black. In Chicago, 61 of the 86 recorded deaths – or 70% – were black residents. Blacks make up 29% of Chicago’s population. The majority of the black COVID-19 patients who died had underlying health conditions including respiratory problems and diabetes. Eighty-one percent of them had hypertension, or high blood pressure, diabetes or both.”
Self-reporting is also starting to surface concerning Covid-19 patients. Below is a video of a woman who was told that she was infected with the Coronavirus but was told she was fine and sent her home. Her condition worsened and she came back to the hospital. While there, the hospital tried to send her home again.
So what does this tell us? Should Black Americans think that Covid–19 was going to be an equalizer because the infection doesn’t discriminate? Reporting tells us no. If anything, Covid-19 has further exposed the chasm of racial inequity from adverse health care and our socio-economic condition. We are in this time period and some of the precautionary measures are not available to the majority of Black Americans. Just because America is grappling with the coronavirus crisis doesn’t mean the unwritten rules of law enforcement are changing for Black people especially Freedmen Descendants. Let us also not forget that Black men are occupying prisons at a far greater rate than other racial groups and social distancing isn’t even an option. In a recent News One article, the author points out that social distancing for our group is a privilege. Nearly 20 percent of all Black people are able to work from home, according to statistics from the Economic Policy Institute. That percentage decreases when considering Black people that descend from chattel slavery. That means they can’t “shelter in place” or obey that stay at home and social distancing orders that others are able to, thus increasing their chances of being exposed to the coronavirus.
Taking together all above conditions of Black Americans, except without policies geared towards our group, reparations as the heartbeat of it, Pandemic Racism is only expected to increase. Dr. Martin Luther King Jr. said, “There can be no gainsaying of the fact that racism is still alive all over America. Racial injustice is still the Negro’s burden and America’s shame. And we must face the hard fact that many Americans would like to have a nation which is a democracy for white Americans but simultaneously a dictatorship over black Americans. We must face the fact that we still have much to do in the area of race relations.”
We are still here. Is there any moving on?
– Cynthia McDonald Social Worker and Reparationist