Amid the seemingly never-ending quarantine, we’ve been told that the coronavirus doesn’t discriminate. National leaders are demanding people to stay in their homes because this virus will attack you with no regard to your economic status, political affiliation, social standing, faith, or any other differentiator. Yet, we are seeing a phenomenon that points to the very opposite conclusion. In Detroit, for instance, people of color are dying at an unprecedented rate. It seems that this virus is picking its victims based on the color of their skin. And Detroit is not alone. 

In fact, as of April 22, Chicago had reported 627 deaths due to COVID-19. Of these, roughly 80 percent of total deaths were from patients of color. This imbalance is not peculiar to Chicago or Detroit — we’re seeing this disparity reflected throughout the U.S. So, why is this happening? Could persons of color be more susceptible to the virus than white Americans? 

The simple and most accurate answer is no. The only prejudice the virus shows is toward the vulnerable: the elderly, those with immune disorders and those who are under extreme stress or exposed to the virus often. 

So, that leads us to point the blame in a new direction, namely, the existing socioeconomic issues and health care problems persons of color in our country face. The existing socioeconomic issues in our country have led to persons of color becoming especially vulnerable. 

The pandemic is a symptom, not the cause 

Persons of color, specifically brown and black Americans, are and have always been disproportionately impacted by health issues in our nation. The acuteness of the coronavirus pandemic is highlighting chronic societal problems that have affected us for many years, issues that have either not been acted upon, or where solutions have been inadequate. The fact is that of those 627 Chicagoan victims, nearly all of them had an underlying chronic condition, the most common of which are diabetes, hypertension and lung disease. 

So, this begs the question: Why do so many people in our black and brown communities have these health issues, and what can and should be done to improve the situation? 

Lori Lightfoot, Mayor of Chicago, said in an interview on CBS’s "Face the Nation," that the underlying conditions suffered by people of color, particularly African Americans, had long plagued communities in her city and that these conditions “lead to life expectancy gaps. This virus attacks those underlying conditions with a vengeance.” 

There were early warnings. Georges E. Benjamin of the American Public Health Association pointed out that evidence indicated that people over 65 with chronic illnesses would find it toughest. He argues, “When you put that together with the understanding that in this country you already have a [black and brown] population disproportionately affected by disparities in things like diabetes, heart disease and asthma, we understood that if those populations got infected they would be more at risk.” 

In New Orleans, City Councilman Jay Banks also voiced concerns: “This is unprecedented. This has been one of the hardest things I’ve ever had to do because you’ve got to get people to understand just how serious and devastating this thing is.” The councilman is also chairman of a New Orleans-based Mardi Gras krewe — which has lost six members to the pandemic. 

All over America, poor black communities have suffered from unemployment and access to health care for generations — this is why we’re seeing such high rates of African American patients. When you add to this the fact that almost 10 percent more black workers are employed in essential roles (most of which are “blue-collar” jobs) than white people, you start to see why the problem is impounding. 

The insufficient access to proper health care, living around environmentally unsustainable infrastructure, little support in that area from employers, lack of nutritional education, and lower average income has resulted in higher rates of diabetes, heart disease and pulmonary problems —precisely those things that make COVID-19 more deadly. 

Low income usually means living in higher densities of population, less access to proper health insurance, poorer diets and few work-from-home options — precisely the criteria that allow a viral pandemic to take its toll on a population. The government can ask this population to be careful. In fact, it is easy for the government to suggest this population stay at home or practice social distancing. But, the suggestions lack practicality and the damage has already been done. 

It’s a compounding effect rooted in environmental health disparities 

When you also consider environmental factors such as air and water quality — fundamentals for our well-being — you begin to understand why there is such a discrepancy. 

The world’s wealthy often live in places where the air is clean and the water pure, while the poor end up clustered together in cheaply built, overcrowded accommodations with poor infrastructure. In modern America, the poor are largely — though by no means exclusively — racial minority groups. That legacy lives on. In 2010, the median income for black families was $39,715; that’s down from $44,000 in 2000. 

But it is more complex than whether or not a black family has the financial ability to fund their health care. It appears that black people just don’t get the same standard of health care as their fellow white citizens. The National Academy of Medicine (NAM), a nonprofit, nongovernmental body, published a study that found that “racial and ethnic minorities receive lower-quality health care than white people — even when insurance status, income, age and severity of conditions are comparable.” 

NAM ends its report with: “some people in the United States were more likely to die from cancer, heart disease, and diabetes simply because of their race or ethnicity, not just because they lack access to health care.” This is a statement that gives you chills — this is not a dystopian novel; this is the reality we face. The conclusion seems to be that health workers’ biases are interfering, or, more likely, the quality of healthcare available in built-up areas is of unsatisfactory quality. 

This begs the question — to what degree is this provider bias to blame? I find it hard to believe that the bulk of these disparities stem solely from provider bias. This may be the case; however, it can’t be the reason for persons of color throughout the country dying at an unprecedented rate. There has to be something more significant. It is clear that the justification is nuanced; it isn’t just provider bias that leads to these disparities, rather it is a combination of historical factors that has led to where we are today. Income disparities, environmental damage in communities of color, poor access to care, unsustainable infrastructure and more has led to the continued mistreatment of persons of color — the color disparity, I call it. Most importantly, this disparity is leading — and has already led — to the deaths of countless people. 

Although a part of me understands that these historical injustices are to blame for the deaths in our country, the year is 2020. It isn’t just the historical issues that are to blame for the color disparity. 

It’s simple. People are dying due to our inaction. 

Could the pandemic be the wake-up call? 

There is a silver lining to the global pandemic, albeit a small one. While the government can’t provide a quick fix, it can begin the work to vastly improve the situation. There must be enhancements to where and how people live and are educated to make a country where everyone is equal and where health care is not a lottery. 

If, at the same time, communities work within themselves, with other communities, and with the state and government to improve their quality of life, to live better and more healthily, we will see the health and lives of those in our most impoverished communities improve. Most importantly, we will see a decrease in the color disparity I address earlier. 

The young have a vital role to play in all this — we have the energy, the enthusiasm and the determination to create change and are not hampered by the chains of the past. We can provide fuel through community outreach and civic engagement that will help empower all communities. By providing a voice to the historically voiceless and understanding the nuanced nature of the color disparity, we can lead the way for a future of justice. 

We can act, and we can save lives.

Rohan Arora is a youth environmental health activist and an aspiring physician-leader-advocate based out of Washington, DC. His work and interests focus on the overlap of healthcare and community reform, specifically the reduction of health disparities for underserved communities. He is the founder of the organization The Community Check-Up and has been working to alleviate environmental health disparities by bolstering civic engagement and promoting educational and outreach efforts.  
Published on May 04, 2020