Covid-19 is exposing longstanding racial disparities in our healthcare system—disparities that communities are trying to address while the virus kills Black Americans at a rate 2.3 times higher than white Americans.
Residential segregation in America is a legacy of decades of discriminatory housing policy, and it contributes in several ways to the racial disparities in the Covid-19 mortality rate, The Appeal reports. It concentrates in the same neighborhoods people who are more likely to be exposed to the virus because they are essential workers, and it exposes residents to chronic stressors and toxins that leave people more vulnerable to severe cases of Covid-19.
Nationwide, 43% of Black and Latino workers are employed in jobs that can’t be done remotely, compared to only about one in four white workers, The New York Times reports. New federal data showing significant racial disparities in the number of virus cases—not just deaths—highlights racial inequities unrelated to underlying health issues.
“[T]his really is about who still has to leave their home to work, who has to leave a crowded apartment, get on crowded transport, and go to a crowded workplace, and we just haven’t acknowledged that those of us who have the privilege of continuing to work from our homes aren’t facing those risks,” Dr. Mary Bassett, the Director of the FXB Center for Health and Human Rights at Harvard University, told the Times.
Predominantly Black neighborhoods also have little to no access to primary care physicians, healthcare services, or pharmacies, and studies have shown significant disparities in the quality of care that Black and white patients receive. Studies cited by The Appeal show that physicians who treat mostly Black patients are less likely to be board certified, mortality after a heart attack is significantly higher in U.S. hospitals that disproportionately serve Black patients, and Black patients were less likely to survive cardiovascular and cancer procedures largely because of the quality of hospitals that treated them.
Discrimination and mistrust of medical institutions also contribute to poorer healthcare for Black patients. Healthcare workers have been shown to exhibit racial bias that influences treatment for Black patients, and research shows that stressful situations like overcrowding and a high patient load increases implicit and explicit racial biases among physicians, The Appeal reports.
These factors likely underlie reports that Black patients with Covid-19 symptoms have been denied testing. Gary Fowler’s requests for a coronavirus test were denied at three different hospitals in metro Detroit, and he died of Covid-19. His stepson, Keith Gambrell, told CBS News, “I honestly believe it was because my father was Black. They didn’t honestly take his symptoms seriously enough to give him a test.”
Grassroots organizations are now stepping in to provide Covid-19 testing in Black communities across the country, The Appeal reports. In South Atlanta, where the population is over 90% Black, Project South launched its own Covid-19 testing site, offering free drive-thru and walk-up testing to community members regardless of symptoms. It tested 436 people in its first three weeks.
Community-based efforts to provide testing have been organized in communities like Little Village, a predominantly Latino neighborhood in Chicago, as well as in Miami, where the University of Miami Miller School of Medicine and Miami-Dade County is doing randomized sampling to estimate the county’s infection rate. They found the number of infections is potentially 16.5 times higher than the number generated by other testing sites and local hospital data—and the rates are even higher among Black American and Caribbean populations.
As The Appeal observes, these initiatives are underscoring “the critical importance of community-based testing filling in the gaps of a faulty public health system.”