“Why is it three or four times more so for the black community as opposed to other people?” President Trump asked at Tuesday’s White House task force briefing. “It doesn’t make sense, and I don’t like it, and we are going to have statistics over the next probably two to three days.”
But based on what we know about the inequities in many black communities, it does make sense. The Fix dug in to better understand why the coronavirus is apparently killing black Americans at a faster rate than other groups. Here are some of the main causes.
1. Higher rates of underlying health conditions, and less access to care
Data has long shown that black Americans have higher rates of hypertension, heart disease, diabetes and lung disease. Medical professionals have said that coronavirus exacerbates the challenges that come with these illnesses, and that’s what Trump administration officials cited first when talking about the disparity in Tuesday’s briefing.
“Health disparities have always existed for the African American community, but here again with the crisis now — it’s shining a bright light on how unacceptable that is,” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said Wednesday.
Uché Blackstock, a physician who works at urgent care sites in Brooklyn, said existing health issues disproportionately affect black communities, making complications more likely.
“We carry a higher burden of chronic disease that predisposes us to the more serious complications of coronavirus,” Blackstock said.
A 2014 National Institutes of Health study found that hospitals in predominantly black neighborhoods are more likely to close down than those in predominantly white neighborhoods, often making it difficult for black Americans to access health care near where they live.
“We don’t have access to care and if we do it’s likely that care is of worst quality because they are often termed minority-serving,” Blackstock said. “And they may not have a specialist or the resources needed to care for covid-19 patients. And there’s implicit bias on the part of the health-care providers, and studies have shown that there’s bias toward white patients over patients of color.”
2. Black Americans hold a lot of ‘essential’ jobs
Black people are more likely to work in jobs that put workers in close contact with others who might be in poor health and that make engaging in social distancing more difficult.
According to data from the U.S. Bureau of Labor Statistics compiled by the Center for American Progress, black people are overrepresented compared to the overall population in the food service industry, hotel industry and taxi drivers and chauffeurs.
Preston Mitchum, policy director for URGE, a nonprofit that advocates for liberal policy issues, said the employment opportunities available for many black people often put them at greater risk of being disproportionately harmed by the coronavirus.
“Black communities are not socially distancing less than other communities and if they are, it is likely because many of us are essential workers or working gig jobs to sustain our living. These jobs require more in-person interaction."
Jason Hargrove, a 50-year-old bus driver in Detroit, posted a video that went viral in which he said he thought he contracted the coronavirus after a passenger repeatedly coughed on his bus without covering her mouth. Hargrove died less than two weeks after he posted the video.
“He knew he wasn’t feeling well,” his wife, Desha Johnson-Hargrove, wrote for Time magazine. “It took over him so very quickly that I’m still in disbelief. He was perfectly fine — a big, strong, 6’3 man — before that day. That day forever changed my life.”
3. Insufficient information
Keneshia Grant, a political science professor at Howard University, focuses on black voters’ relationships with state and local governments. She says poor information from government leaders has shaped black people’s experience with the coronavirus.
“In short, I think the problem was not that black folks didn’t get information from their governments. The problem was that we got bad and inconsistent information from our governments. We also got information that did not seem to represent people who looked like us,” she said.
Grant said mixed messages from the Trump administration and some governors in states with large black populations caused confusion. Most black Americans — nearly 60 percent — live in the South. States like Florida, Alabama, Mississippi and Georgia are all headed by governors whose messaging on how to stay safe was often inconsistent with the guidelines of the federal government.
“I think that what black America, and the entire nation, needed was a clear message from the federal government,” she said. “I think this is especially true, because it took a long while for black people to see themselves represented in this crisis."
“A strong, coherent federal message would have been helpful toward that end,” she added.
U.S. Surgeon General Jerome M. Adams spoke at the White House task force’s briefing Friday about how black Americans are being disproportionately harmed by the illness.
“It’s alarming but it’s not surprising that people of color have a greater burden of chronic health conditions,” he said. “The chronic burden of medical ills is likely to make people of color especially less resilient to the ravages of covid-19 and it’s possible — in fact, likely — the burden of social ills is also contributing.”
Adams spoke about the need to better target messages about the importance of social distancing to communities of color, and he spoke about the needs of individuals in those communities to follow the guidelines.
4. Housing disparities
Vedette Gavin, a principal investigator for the Conservation Law Foundation’s Healthy Neighborhood Study, told The Fix that racial disparities in housing put black lives at much greater risk for contracting an illness. Her organization attempts to better understand and address the effects of neighborhood change on health in the Boston metropolitan area.
A 2017 Princeton University study found that black children are more likely to suffer from asthma because they live in older buildings that harbor fecal matter and rodent infestations, and which are in segregated neighborhoods that are near busy highways that put harmful matter into the air.
The Centers for Disease Control and Prevention released information stating that people with asthma may be at a greater risk of dying from coronavirus.
“People of color are more likely to live in densely packed areas and in multi-generational housing situations, which create higher risk for spread of highly contagious disease like covid-19,” Adams said Friday.
“There are huge issues with housing that are at play,” Gavin said. “The poorer housing stock and code violations for asbestos, mold and cockroaches increase the risk and prevalence of respiratory and pulmonary diseases, which heighten the severity of symptoms for those who contract covid. Black and Latino families in urban centers tend to double and triple up when rent is unaffordable, making distancing in the home impossible.”