There’s a case to be made that the coronavirus pandemic is exposing the preexisting cracks in our society. It certainly seems to be true in terms of preparation for such disasters and the health insurance to which millions of Americans have been denied access.
But we’re now learning that, in North Carolina and elsewhere, black people are dying of COVID-19 at alarmingly high rates — another reminder of the racial disparities that exist in American life.
“This current crisis lays out what we have known for a long time, which is that your ZIP code is often a determinant of your health outcome,” Dr. Mandy Cohen, secretary of the North Carolina Department of Health and Human Services, told the New York Times earlier this week. Blacks make up 32.9% of Mecklenburg County’s population but, as of April 4, were 43.7% of the 650 confirmed cases for which racial demographics were available, according to North Carolina Health News. Statewide, as of April 6, blacks accounted for 691 or 37% of the COVID-19 cases in which race is known, despite comprising only 22 % of the state’s population.
And it’s not just in North Carolina. While 14% of the population of Michigan is black, 33% of coronavirus cases and 41% of deaths there have been in the black community. In Louisiana, 7 out of 10 coronavirus victims have been black. Coronavirus hot spots include a number of cities with large nonwhite populations, such as New Orleans and Detroit, as well as the majority-minority New York City boroughs of Queens and the Bronx.
President Trump acknowledged the problem during his daily briefing on Tuesday and said federal officials were exploring the causes. But we already know some of them.
Many conditions that increase vulnerability to coronavirus — from asthma to diabetes to HIV — appear at higher rates among African Americans. “Our communities were already more vulnerable,” Dr. Uché Blackstock, founder and CEO of Advancing Health Equity, said.
Also, many African Americans hold hourly low-wage jobs and have to choose between possible exposure to coronavirus or possible loss of wages or employment. They don’t have the luxury of social distancing or working from home. They’re also less likely to be insured and may be reluctant to take on the expense of visiting a doctor. Medicaid expansion would help address that. Many black residents live in segregated neighborhoods that lack job opportunities, stable housing and grocery stores with healthy food.
“We knew that groups with preexisting health vulnerabilities would have a higher risk of death,” said Hedwig Lee, a sociology professor at Washington University in St. Louis who studies racial disparities in health. “But still, it’s sobering to see the numbers.”
Beyond that, “Based on what we know from copious research studies, there is bias in terms of how health care providers determine care,” Blackstock said. “Patients are going to require ventilators. There are a limited number so you’re asking clinicians to make decisions about who gets ventilators and who doesn’t.”