As the United States faces the novel coronavirus pandemic, people feel lost, frustrated, and unprotected amid inconsistent government orders, lack of tests, and economic uncertainty. As states and cities begin to share the racial breakdown of cases, however, a disturbing trend is quickly becoming evident. Black communities are being disproportionately affected by the public health crisis, according to the preliminary numbers we have available today. While comorbidities and environmental factors may certainly play a role, it’s also important to remember that on a structural level, black Americans face long-standing bias and discrimination when seeking medical care across the board.
First, let’s look at the numbers we have so far. As reported by Vox, in Louisiana, for example, black Americans make up 70% of coronavirus deaths. Louisiana Gov. John Bel Edwards described the numbers in his state as “disturbing,” and added it, “deserves more attention, and we’re going to have to dig into that and see what we can do to slow that trend down.”
In Chicago, 72% of COVID-19 related deaths are black Americans; which is close to six times the rate of white Chicago residents. Another haunting similarity to Louisiana? In both areas, only about 30% of the population is black. In Illinois as a whole, black Americans are 14% of the population—and 41% of coronavirus deaths.
"This new data offers a deeply concerning glimpse into the spread of COVID-19 and is a stark reminder of the deep-seated issues which have long created disparate health impacts in communities across Chicago," said Chicago Mayor Lori Lightfoot.
In Michigan, a startling number of coronavirus cases are in Detroit, a majority-black city. Black Americans are less than 15% of Michigan’s entire population—but comprise close to 40% of coronavirus-related deaths and 35% of cases. ProPublica reports that in Milwaukee County, Wisconsin, 81% of people killed so far by the virus are black Americans.
These disturbing numbers lend to a major question: Why? As The New York Times suggests, some possible explanations are fairly obvious when we consider structural inequalities—black Americans may have higher rates of preexisting health conditions, such as asthma and high blood pressure, as well as less access to health insurance through an employer. Environmental pollution is a reasonable factor. Michigan state Rep. Tyrone Carter, for example, stated: “This pandemic just magnifies what we already knew: Access to health care, environmental issues in certain communities, air quality, water quality. We think about Flint and think about my district who has air issues, asthma.”
As NPR points out, however, bias may also be a factor. Black Americans, as it is, routinely experience discrimination and anti-black bias when seeking medical care. This systemic discrimination can impact black communities in everything from accessing pain medication to maternal survival rates. It’s not surprising—though it is horrifying—that this trend may continue in the face of a global pandemic. As NPR reports, according to recent billing data in a few states, physicians may be less likely to test black Americans who have cough and fever symptoms for the coronavirus.
Founder and CEO of Advancing Health Equity, emergency medicine physician Uché Blackstock, stressed to The Washington Post that transparency is as key now as ever, given that the pressure of limited resources pushes doctors to decide who, how, and when to treat patients. Blackstock, who practices medicine in New York City, told the Post that when patients “interface with the health-care system now when we are in a situation where we have limited resources, to think about how providers are making their decisions about who gets care and how is incredibly concerning.”
Many disability advocates have voiced a similar concern—if physicians have to make increasingly impossible decisions on who gets what life-saving care and when, the public needs transparency to make sure implicit bias and discrimination aren’t playing into who gets what access.
“I have seen in my waiting room mostly black and brown patients who are essential workers and service workers who can’t afford to stay home,” Blackstock told reporters, according to The Hill. “These are the ones that I see presenting to the clinic with COVID-19 symptoms.”
As with much of the reporting done on the novel coronavirus so far, we’re still early in collecting data. After all, some of the hot spot areas so far, including Washington state and New York, haven’t released a racial breakdown on cases yet. The federal government isn’t officially releasing this data yet, either. You can look up information from the Center for Disease Control and Prevention on age and location, so far, but not race.
Multiple Democrats have called for more consistent race reporting during this public health crisis. Last week, Sen. Elizabeth Warren and Rep. Ayanna Pressley spearheaded a group of lawmakers, including Sens. Cory Booker and Kamala Harris, in writing a letter to Health and Human Services Secretary Alex Azar on the matter.