Racism’s plague on public health

COVID-19’s devastating impact on the Black community has been widely known since the very early stages of the pandemic. Yet in a spectacular display of federal foot-dragging, the Department of Health and Human Services waited until June 4th to require the collection of anonymized data regarding the race and ethnicity of those who test positive for coronavirus (which won’t start until Aug. 1). 

With such data, public health officials could have helped direct resources to where they were needed most. They could have documented the coronavirus’s impact on minority populations sooner and responded rapidly. Why did it take so long for federal agencies to act? Why weren’t minority groups disproportionately affected given priority access to testing and treatment?

The answer is simple. Racism is a public health crisis in our country. This ugly truth, one of many receiving deserved attention in the aftermath of the recent protests across the country: the color of one’s skin has a direct relationship to one’s health, well-being, and overall life-expectancy in America. 

“[A] person who’s classified as black in the United States is less likely to have access to high-quality health care, is more likely to be subjected to unequal treatment by their physician and is more likely to live in a neighborhood where they have other obstacles to their health,” says former NYC Health Commissioner Dr. Mary Bassett. “Poor health outcomes tend to cluster in places that people of color call home and where many residents live in poverty.”

Statistics support Dr. Bassett’s view. The Century Foundation found that African Americans continue to be paid lower than white Americans for the same jobs in the U.S. That’s the very definition of racial bias and is the main reason why the black community continues to be one of the most economically disadvantaged populations in America. Financial strains impact every aspect of one’s health: from living conditions to food quality, health care access, and health coverage.

Where one lives has a major bearing in determining an individual’s overall health. People who live in communities with less access to health care, healthy food, and greater exposure to crime and pollution are at higher risk of experiencing mental and physical health issues.

And despite meaningful efforts to expand health coverage under the Affordable Care Act, 9.7 percent of African Americans remained uninsured in 2018, compared to just 5.4 percent of white Americans. The average family spends roughly 11 percent of family income each year on health premiums and other health expenses. It’s near twice that amount — 20 percent — for African Americans.

Which brings us back to the coronavirus. While affluent Americans have been able to work from home and continue to earn a living during the pandemic, many in the African American community haven’t been able to do so. The Economic Policy Institute found that less than one-in-five black workers are able to work from home, compared to roughly one-in-three white workers. More African Americans are on the front lines and at greater risk of contracting COVID-19. Representing just 12.3 percent of the overall workforce, black workers make up 25 percent of all courier and food delivery essential personnel services.  Combine that with the fact that African Americans have higher rates of pre-existing conditions such as diabetes, at a rate seven times higher than white people, it’s clear systemic racism plays an undeniable role in raising the public health risk for these men and women who are disproportionately providing critical services to others during the pandemic. 

A month ago, black patients in Philadelphia were dying of COVID-19 at a rate 30 percent higher than white patients. Hospitals weren’t receiving the resources they desperately needed, so a local group took matters into their own hands. Churches and doctors formed the Black Doctors COVID-19 Consortium and pooled supplies and went out into the community to make testing more available to those who needed it. They started this nearly two months ago. The fact the U.S. government is so late in even collecting data to address this problem is appalling. 

Racial disparity in public health is, at its core, a firmly rooted social injustice in America. Let’s hope the recent uprising will give us the courage to take the steps needed to achieve health equity. 

Black Lives Matter.

Lyndon Haviland, DrPh, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy.