CORONA VIRUS PANDEMIC HIGHLIGHTS RACISM AND INEQUALITY IN U.S.

The corona virus pandemic has highlighted critical issues in the U.S. economy and society that have led to unnecessary hardship, suffering, and deaths. These include racism and economic inequality. Despite limited data on COVID-19 by race and ethnicity (because some jurisdictions have not been collecting or reporting these data), clear patterns emerge.

The infection and death rates have been higher among people of color than among Whites. In addition, low-income households and people living in densely populated areas are at higher risk for COVID-19 than others. These three risk factors occur concurrently for many, resulting in a particularly high-risk population. The infection rate for these populations is likely to be understated because there has probably been less testing among them than among well-off, White populations who typically have better access to health care. People of color also have more severe cases when they get the virus. One study of COVID-19 patients, where 18% of the patients were Black, found that 33% of the severe cases were with a Black patient.

The death rate for these at-risk populations may well be understated as well. Research has found that the national 2020 death rate has been significantly higher than usual after adjusting for the known COVID-19 deaths. This almost certainly means there have been COVID-19 deaths that were not recognized as being caused by the virus. These unrecognized COVID-19 deaths are likely to be disproportionately among these at-risk populations because of their reduced access to health care and virus testing.

At the state level, analyses at various points in time in April and May of 2020 have found significantly higher death rates for Blacks (60% to 370% higher than their presence in the overall population): [1]

• Wisconsin: 33% of deaths were Blacks, who make up 7% of the population
• Michigan: 40% of deaths were Blacks, who make up 14% of the population
• Louisiana: 70% of deaths were Blacks, who make up 33% of the population
• Mississippi: 61% of deaths were Blacks, who make up 38% of the population

Similarly, Chicago and New York City have death rates of minorities that are roughly twice the rate of their presence in the population.

Rates of COVID-19 infections are also significantly higher for Blacks and Latinos than for Whites: [2]

• Nationally, based on limited data, 33% of people with COVID-19 infections were Black, while they are only 13% of the population.
• In Massachusetts,
  • 18% of people with COVID-19 infections were Black, while they are only 9% of the population.
  • 23% of people with COVID-19 infections were Latino, while they are only 12% of the population.
• In Boston, 40% of people with COVID-19 infections were Black, while they are only 25% of the population.

Researchers in Massachusetts have also looked at the density of population and poverty based on the zip codes of COVID-19 patients’ addresses, along with data on race and ethnicity. They found that death rates were: [3]

• 40% higher in cities or towns with the highest proportions of people of color versus those with the lowest proportions.
• 14% higher in cities or towns with the highest population densities versus those with the lowest densities.
• 9% higher in cities or towns with the highest poverty rates versus those with the lowest rates.

Native Americans, especially the Navajo Nation, have been extremely hard hit by the pandemic. The Navajos have experienced an infection rate higher than any U.S. state, with over 4,000 cases and over 140 deaths as-of May 17. As with other low-income communities, this reflects a lack of public infrastructure, including a lack of access to health care, shortages of protective equipment and supplies, and in some places a lack of water and/or sewer systems. [4]

There are multiple factors that lead to the higher coronavirus infection and death rates among people of color, low-income households, and people living in densely populated areas. It is important to recognize and acknowledge that these disparities are not linked to individual decisions and behaviors, but to long standing characteristics of their social and physical environments. These social determinants of health, as they are called, are most often driven by public policies and spending patterns, as well as by institutional racism. [5]

My next post will review the reasons for the disproportionate impact of COVID-19 on people of color, low-income households, and people living in densely populated areas.

[1]      Villarosa, L., 4/29/20, “ ‘A terrible price’: The deadly racial disparities of Covid-19 in America,” The New York Times Magazine (https://www.nytimes.com/2020/04/29/magazine/racial-disparities-covid-19.html)

[2]      Osterheldt, J., 4/11/20, “With virus, racism is underlying ill,” The Boston Globe

[3]      Ryan, A., & Lazar, K., 5/10/20, “Disparities drive up coronavirus death rates,” The Boston Globe

[4]      Goodluck, K., 5/21/20, “Every corner of the Navajo Nation has been hit by COVID-19,” Mother Jones (https://www.motherjones.com/politics/2020/05/every-corner-of-the-navajo-nation-has-been-hit-by-covid-19/)

[5]      Villarosa, L., 4/29/20, see above