Letters to the Editor • Opinion
We already know how to prevent pandemics
The caskets of Lola M. Simmons-Jones and her daughter, Lashaye Antoinette Allen, who both died of covid-19, are placed next to each other before burial in Dallas late last month. (Bryan R. Smith/AFP/Getty Images)

Counties with the highest percentage of White residents have had the lowest rates of coronavirus infections, even as infections have increased with the reopening of some states’ economies, an indication that residential segregation is a significant factor in the pandemic’s spread, a study has concluded.

That doesn’t mean White people have more immunity but rather that they have been better able to limit their exposure than have Black people, Latinos and Native Americans, who have been disproportionately infected by the novel coronavirus and killed by covid-19, the disease the virus causes.

Neither does it mean that people of color are engaging in reckless behavior, the study by Amfar states. Rather, their higher rate of infection is due to “poverty and living in densely occupied households, living in localities with greater air pollution, lack of health insurance and being employed in jobs that increase exposure to” the coronavirus.

“We need to stop victim-blaming communities of color for these types of diseases,” Greg Millett, vice president and director of public policy for Amfar, the Foundation for AIDS Research, said in a recent interview about the study, which notes a similar pattern for infection rates for HIV. “Where you live determines your health in the United States … and we need to take immediate action to make sure we reduce these disparities in communities of color.”

Amfar has released two other studies during the past few months that have focused on how social and economic inequities have fueled higher infection and death rates in Black and Latino communities. The newest study found that regardless of region and before and after states began reopening their economies, counties in which White people make up more than 60 percent of the population have the fewest number of coronavirus cases. And recent declines in cases in states in the Northeast and Midwest are due largely to drops in counties with racially diverse populations.

Although some public health experts initially cited high rates of underlying disease for the disparities, Amfar’s studies have found that people of color have a higher risk of exposure to the virus because most are unable to work from home because they disproportionately hold jobs that require them to interact with the public, they tend to live in larger, multigenerational households, and they rely much more on public transportation.

Improving access to health care would be one of the most effective steps to help communities of color, which have the lowest rates of insurance coverage and the fewest doctors, clinics and hospitals to serve residents, Millett said. The study cites national surveys that have found that “racial minorities on average travel farther than whites to access healthcare and spend more time in a waiting room to see a healthcare provider.”

Although governors and legislatures in many Republican-led states rejected the Affordable Care Act when it launched a decade ago, voters in two of those states — Oklahoma and Missouri — approved ballot initiatives during the past two months to expand access to Medicaid. The report says these voter-driven efforts “may increase healthcare access in communities of color and improve overall health outcomes.”

The report also calls for more robust testing in communities of color, where the lack of a national public health strategy has resulted in uneven or nonexistent screening and education campaigns.

The study looked at infection rates through the end of June in counties where the population was more than 60 percent White. It found that as infections flared in the South and West, regions where some states were among the first to reopen their economies, counties with higher percentages of White residents still had the lowest coronavirus rates.

As President Trump pushes states to reopen schools, Millett says, the ongoing disparities point to the need to develop guidelines to slow the spread of the virus. This is especially a concern for Black and Latino children, who according to a new CDC report are far more likely than White children to be hospitalized with covid-19. Children can also spread the disease to adults in already hard-hit communities of color.

Millett said that although overwhelmingly White communities have not seen infection rates as high as those in more diverse communities, residents shouldn’t think they’re immune. “Infectious diseases do not stay in one area,” he said, particularly as people begin to move around and interact more.