The coronavirus is infecting and killing African Americans at a higher rate than the U.S. population overall, according to data released this week by several states and large cities. The racial disparity in Covid-19 deaths reflects systemic racial inequalities stemming from our nation’s history of racial injustice.
Alarming Racial Disparities in Covid-19 Deaths
The Washington Post reported this week that majority-Black counties across the U.S. have three times the rate of infections and almost six times the rate of deaths as counties where white residents are in the majority.
In Louisiana, governor John Bel Edwards said in a press conference on Monday that slightly more than 70% of the 512 people who had died from Covid-19 were African Americans. Black people make up about 33% of the population in Louisiana, which has the fourth largest number of Covid-19 cases in the country. The majority of deaths are in New Orleans.
Michigan officials said that African Americans make up 40% of the 845 reported deaths in the state, where the population is 14% Black. The state’s cases are most concentrated in Detroit—the death rate in the city accounts for 40% of the state’s fatalities.
In Illinois, Black people make up 14% of the population but account for 30% of confirmed cases and 41% of deaths statewide. More than half of the state’s deaths have been in Chicago, where mayor Lori Lightfood said on Monday that African Americans made up 72% of the city’s coronavirus deaths despite comprising only about a third of its 2.7 million residents.
Wisconsin officials have reported that more than half of the state’s 86 confirmed deaths are in the state’s largest city, Milwaukee. In Milwaukee County, African Americans make up 26% of the population, but about 70% of those who have died from the virus were Black.
Officials in Washington, D.C., released data this week showing that nearly 60% of its 22 fatalities were Black, although African Americans make up about 46% of the city’s population.
As some states and cities release race data, civil rights advocates, physicians, and members of Congress are calling on the CDC to provide racial data, which every state is legally required to track and report to the CDC. Fewer than a dozen have released that data so far. The CDC released hospital data this week showing that about 1 in 3 people who become sick enough to require hospitalization are African Americans, who comprise about 13% of the population nationwide.
Racial disparities in Covid-19 deaths are especially apparent in Southern states, where inequalities based on race and poverty are fueling the deadly pandemic.
More than 40% of the people killed by the virus in Alabama were Black, even though Black people make up about 26% of the state’s population. Mississippi officials said African Americans account for more than 50% of coronavirus deaths in that state even though they make up just about 38% of the population.
North Carolina and South Carolina have also reported a ratio of Black residents to white residents who have tested positive for the virus that well exceeds the general population ratio.
In Georgia, the highest number of deaths is in Dougherty County and the city of Albany (pop. 90,000), where 56 people have died as of Tuesday. (In contrast, Fulton County, which includes Atlanta, has reported 39 deaths among its more than one million residents.) Dougherty’s population is 70% Black, but more than 90% of its fatalities were African Americans. Albany City Commissioner Demetrius Young said last week, “Historically, when America catches a cold, Black America catches pneumonia.”
A Legacy of Racial Inequality
Officials and public health experts trace these stark disparities to longstanding inequalities that have left more African Americans without health insurance, living in segregated communities that lack adequate health care services, and subject to racial bias in the health care system that prevents them from getting proper treatment. As a result, Black Americans have higher rates of underlying medical conditions, such as asthma, diabetes, heart disease, and hypertension, that put them at heightened risk of hospitalization and death from Covid-19.
“It starts out with the disparity that has already existed in health care provision for people of color. We already started out with an unequal system of healthcare,” Illinois Governor J.B. Pritzker said on Monday. “It gets massively exacerbated when you bring on something like COVID-19.”
African Americans are twice as likely as white people to lack health insurance and more likely to live in medically underserved areas. And researchers have found that healthcare providers in majority African American or Latino neighborhoods tend to provide lower-quality care.
Initial indications are that racial bias in health care may have directly contributed to African American deaths from the coronavirus. Doctors have been less likely to refer African Americans for testing when they visit a clinic with symptoms of Covid-19, which can lead to worse outcomes given how quickly the disease can progress.
Black Americans also face a higher risk of exposure to the coronavirus because they disproportionately work in essential industries. Only 20% of Black workers reported being eligible to work from home, compared with about 30% of white workers. Women of color also are overrepresented in essential jobs, including health care and child care.
Some of the starkest racial disparities are in the South, where a history of racial injustice and economic inequality is clearly reflected in modern policy choices. The poor, Black, Latino, or rural residents who make up large shares of Southern states’ populations tend to lack access to high-quality doctors and care, The Atlantic reports. Nine of the 14 states that have refused to expand Medicaid under the Affordable Care Act are in the South, and Southern states have some of the lowest doctor-to-patient ratios in the country—leading to higher rates of chronic conditions like lung disease, heart disease, and obesity among Southerners than other Americans. Yet even though their populations face a greater risk from Covid-19, Southern governors waited long past those of other states to impose shelter-in-place orders.
Mass incarceration—a legacy of our history of racial injustice—is also likely to contribute to Covid-19’s spread in the South. Incarcerated people are extremely vulnerable to the coronavirus, and the South incarcerates a larger proportion of its population than anywhere else in the U.S.
U.S. Surgeon General Jerome Adams addressed racial disparities in coronavirus infections and deaths at a news conference on Tuesday in personal terms as a 45-year-old Black man. “I’ve shared myself personally that I have high blood pressure, that I have heart disease and spent a week in the [intensive care unit] due to a heart condition, that I actually have asthma and I’m prediabetic,” he said, “and so I represent that legacy of growing up poor and Black in America.”