Covid-19Medicine

How the Coronavirus pandemic has highlighted America’s Racial Disparity

Anoushka Umranikar and Arnav Umranikar

All statistics correct as of May 3rd, 2020.

Introduction

The COVID-19 coronavirus pandemic has had devastating social and economic impacts on families, communities and countries around the world. As of the 3rd of May, there have been 8,990,547 cases and 468,328 deaths. [3] What has become apparent is that the virus has particularly affected those with comorbidities, compromised immune systems, and those of a poor socioeconomic status. In the United States of America, the country with the greatest number of cases: 2,344,018 cases, and the highest number of deaths: 122,127 deaths, an observed racial disparity has emerged. [3] As the pandemic continues to prevail over the world, the black population in America seems to be suffering in a disproportionate amount to the white population and the coronavirus has thus highlighted the racial discrepancy within American societies.

In Chicago, Mayor Lori Lightfoot has recently addressed the profound racial gap in COVID-19 death rates, highlighting that 70% of virus deaths were those of black people, despite constituting only 30% of the population. [1] Lightfoot further claimed that this stark difference in deaths related to coronavirus is a result of “underlying conditions that people of colour and particularly black folks suffer from”. [1] This is supported by the fact that African-Americans are 60% more likely to have been diagnosed with diabetes than white Americans and black women are 60% more likely to have a high blood pressure than white women. Furthermore diabetes was seen in 40% of the deaths and obesity in 25%. [2] This is compelling evidence to show that there is a link with people with underlying health conditions and increased vulnerability to the virus, and such health disparities are clear markers of racial inequality.

Underlying Health Conditions

One of the underlying health conditions that a large number of black people suffer from is obesity. Obesity is strongly associated with other health conditions such as diabetes, heart conditions and hypertension. [17] Obesity has been proven to adversely affect the body’s immune system. [11] It is linked to low socioeconomic backgrounds and race and hence the fact that obesity is linked with weaker and compromised immune systems helps to explain why black people are disproportionately affected by health conditions and therefore the virus.

Correlation Between Percentage of Obsese Adults and Black Population in Each State

This graph visually shows America’s high obesity rates across each state, as of 2018. [16]

Comparing the two maps above, it is apparent that states with a high black population have a high correlation of obesity rates. [6]

For example, the South East of the USA has some states with the highest black population in the country, and this correlates with relatively higher obesity rates. However, it must be acknowledged that other factors may have also contributed to high obesity rates in these areas. For example, poorer educational services, which may not inform people of healthier diets, or a lack of emphasis on physical education.

Similarly, the West of the USA tends to have a smaller black population, and this seems to correlate with relatively lower obesity rates.

Age-adjusted percentage of persons 18 years of age and over who were obese in the United States of America, 2018. (Body Mass Index (BMI) of 30 or greater). [15]

Black White Black/White Ratio
Men 31.2 31.2 1
Women 44.2 28.7 1.5
Total 38.3 30.0 1.3

Percentage of high school students who were obese in the United States of America, 2017

Black White Black/White Ratio
Men 16.7 10.3 1.6
Women 19.7 14.8 1.3
Total 18.2 12.5 1.5

These two tables both show the increased rates of obesity in African Americans as compared to the Non-Hispanic White population, both for adults and adolescents.

Socio-economic Factors

Statistically, it appears that the country suffers from higher rates of obesity as compared to the rest of the world, and within the country itself, the rates of obesity are much higher within the black population, which could be as a result of low socioeconomic backgrounds. Furthermore ‘low quality’ housing often tends to be cheaper and can often be in areas with higher pollution levels and is thus linked with pre-existing conditions such as asthma. [8] This is compelling evidence to show a link as to why black people have suffered disproportionately from the virus.

Mayor Lori Lightfoot sums it up in no uncertain terms; “This virus attacks these underlying conditions with a vengeance.” [1]

Racial discrimination has tied the African American population to the bottom of the US class hierarchy. Economic inequality amongst different racial populations in America is not unheard of and likely to be more pronounced in the years to come as the black-white wage gap continues to expand. The current pandemic has caused this economic disparity to become obviously apparent as survival as opposed to negative outcomes i.e. death has come into play.

Many African Americans, often with low incomes, are forced to continue working despite showing symptoms of the virus, according to case studies highlighted by The New Yorker. [14] This is only an observed correlation between the economic status of African Americans in comparison to the white population and how this perhaps links to their higher vulnerability of contracting the coronavirus. This is based on anecdotal evidence only, and therefore should not be used to generalise for all African Americans.

Furthermore, a source from the BBC reveals that 19% of African Americans could not afford to see a doctor [9] and an American doctor has said that there are many difficulties in getting tests for the coronavirus in low-income communities where many black populations reside. [4] This limited testing in poorer communities and economic inequality has not only left many black Americans feeling neglected yet also highlights how it is not surprising that the death rates for black Americans are soaring above those of the rest of the population.

The Effect of the US Healthcare System

The USA has become a huge hotspot for the COVID-19 pandemic and this is largely due to the flaws within the healthcare system. Yet the hard-hitting truth about the United States is that there is no real public health system. The US does not have a universal healthcare apparatus, instead consisting of a combination of publicly and privately funded systems. As of 2018, an estimated 30.4 million people have no health insurance [5], the uninsured rate among African Americans being 9.8% while only 5.4% among the white population. [13] In the context of the pandemic, this has proved to be detrimental. The system does not mean that ill people are turned away; often, however, at the end of a procedure an invoice is mailed to the patients and frequently this is unaffordable, resulting in many uninsured individuals neglecting their health. [7] Whilst the US healthcare system does not discriminate against black people directly, their socioeconomic position in society has meant that they lack the availability of private health care services.

Compared to the private sector of the USA, the UK private sector is far smaller in size. A pillar of the NHS system is that it is available to everybody, and a parallel can be drawn against the US healthcare system in this way.

A solution to this observed racial disparity issue regarding availability to healthcare services could therefore be for America to have a public health care system like that of the UK, such that people are treated according to their severity of illness, rather than their ability to pay. This paves for a more equal system in which this observed racial disparity would be much less pronounced.

However, a potential counter argument to the observed factors explained in this article could be the fact that the death rate due to Covid-19 of the black population in the African subcontinent is reported to be not as high as in America, despite the population being of the same ethnicity with similar underlying health conditions, also with inequalities in health care provisions. This could perhaps be due to under reporting of the mortality cases but a definite answer to this reason needs to be further explored as research concerning the virus continues.

Conclusion

Thus, to conclude, it is clear to see that the coronavirus pandemic has accentuated the observed racial disparity in America to a significant level and as the pandemic looms over the world, causing devastating impacts, the cracks and flaws in the American health system are further deepening and bringing to the fore the ultimate question that does there need to be real change in America’s healthcare system, regarding discrimination and liberal access to healthcare, in order to be able to create a more balanced and effective way of treating individuals?

The New Yorker quotes ‘The old African-American aphorism “When white America catches a cold, black America gets pneumonia” has a new, morbid twist: when America catches the novel coronavirus, black Americans die.’ [14]

References

  1. Beavers, David. ‘Mayors, Governor Call out Racial Health Disparities Highlighted by Coronavirus’, 15 April 2020. politico.com/amp/news/2020/04/12/dc-mayor-coronavirus-african-american-health-disparities-180890.
  2. Brooks, Brad. ‘Why Is New Orleans’ Coronavirus Death Rate Twice New York’s? Obesity Is a Factor’. U.S., 2 April 2020. reuters.com/article/us-health-coronavirus-new-orleans/why-is-new-orleans-coronavirus-death-rate-twice-new-yorks-obesity-is-a-factor-idUSKBN21K1B0.
  3. ‘Coronavirus Update (Live): 53,833,627 Cases and 1,310,978 Deaths from COVID-19 Virus Pandemic – Worldometer’, 13 November 2020. worldometers.info/coronavirus/.
  4. Evelyn, Kenya. ‘“It’s a Racial Justice Issue”: Black Americans Are Dying in Greater Numbers from Covid-19’. The Guardian, 1 July 2020. theguardian.com/world/2020/apr/08/its-a-racial-justice-issue-black-americans-are-dying-in-greater-numbers-from-covid-19.
  5. Gunja, Munira Z. ‘Who Are the Remaining Uninsured, and Why Do They Lack Coverage? | Commonwealth Fund’, 1 January 2000. commonwealthfund.org/publications/issue-briefs/2019/aug/who-are-remaining-uninsured-and-why-do-they-lack-coverage.
  6. Kolmar, Chris. ‘These Are The 10 States In America With The Largest Black Population’. RoadSnacks, 3 January 2020. roadsnacks.net/most-african-american-states-in-america/.
  7. Kotecha, Sima. ‘How Does US Healthcare Work?’, n.d. bbc.co.uk/newsbeat/article/10067521/how-does-us-healthcare-work.
  8. Laughland, Oliver. ‘Why Is Coronavirus Taking Such a Deadly Toll on Black Americans?’ The Guardian, 1 July 2020. theguardian.com/world/2020/apr/25/coronavirus-racial-disparities-african-americans.
  9. Maqbool, Aleem. ‘Coronavirus: Why Has the Virus Hit African Americans so Hard?’ BBC News, 11 April 2020. bbc.co.uk/news/world-us-canada-52245690.
  10. News, BBC. ‘Coronavirus Wreaks Havoc in African American Neighbourhoods’. BBC News, 7 April 2020. bbc.co.uk/news/world-us-canada-52194018.
  11. ‘Obesity and the Immune System – Obesity Action Coalition’. Obesity Action Coalition, n.d. obesityaction.org/community/article-library/obesity-and-the-immune-system/.
  12. Ritchie, Hannah, and Max Roser. ‘Obesity’. Our World in Data, n.d. ourworldindata.org/obesity.
  13. Taylor, Jamila. ‘Racism, Inequality, and Health Care for African Americans’. The Century Foundation, 7 May 2020. tcf.org/content/report/racism-inequality-health-care-african-americans/?agreed=1&agreed=1.
  14. Taylor, Keeanga-Yamahtta. ‘The Effect of the Coronavirus on America’s Black Communities | The New Yorker’, 27 April 2020. newyorker.com/news/our-columnists/the-black-plague/amp.
  15. US Department of Health and Human Services, Offices for Minority Health. ‘Obesity and African Americans’. US Department of Health and Human Services, Offices for Minority Health, 26 March 2020. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=25.
  16. ‘US Obesity Levels by State – Obesity – ProCon.Org’. Obesity, 28 January 2020. obesity.procon.org/us-obesity-levels-by-state/.
  17. ‘Who’s at Higher Risk from Coronavirus (COVID-19)’. Nhs.Uk, 2 June 2020. nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/whos-at-higher-risk-from-coronavirus/.

About the Author

Anoushka is a year 12 student, hoping to study medicine at university. She enjoys reading and researching about current world affairs and has a passion for writing. Anoushka hopes to continue writing articles in the future! 

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